Legislature(2023 - 2024)BUTROVICH 205
02/27/2024 03:30 PM Senate HEALTH & SOCIAL SERVICES
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| Audio | Topic |
|---|---|
| Start | |
| Presentation: Department of Health Response to Legislative Budget & Audit Findings | |
| SB240 | |
| Adjourn |
* first hearing in first committee of referral
+ teleconferenced
= bill was previously heard/scheduled
+ teleconferenced
= bill was previously heard/scheduled
| + | TELECONFERENCED | ||
| *+ | SB 240 | TELECONFERENCED | |
| + | TELECONFERENCED |
ALASKA STATE LEGISLATURE
SENATE HEALTH AND SOCIAL SERVICES STANDING COMMITTEE
February 27, 2024
3:31 p.m.
MEMBERS PRESENT
Senator David Wilson, Chair
Senator Löki Tobin
Senator Forrest Dunbar
Senator Cathy Giessel
MEMBERS ABSENT
Senator James Kaufman, Vice Chair
COMMITTEE CALENDAR
PRESENTATION: DEPARTMENT OF HEALTH RESPONSE TO LEGISLATIVE
BUDGET & AUDIT FINDINGS
- HEARD
SENATE BILL NO. 240
"An Act relating to medical assistance coverage for
rehabilitative, mandatory, and optional services furnished or
paid for by a school district on behalf of certain children."
- HEARD & HELD
PREVIOUS COMMITTEE ACTION
BILL: SB 240
SHORT TITLE: SCHOOL DISTRICT MEDICAL ASSISTANCE
SPONSOR(s): RULES BY REQUEST OF THE GOVERNOR
02/19/24 (S) READ THE FIRST TIME - REFERRALS
02/19/24 (S) HSS
02/27/24 (S) HSS AT 3:30 PM BUTROVICH 205
WITNESS REGISTER
EMILY RICCI, Deputy Commissioner
Department of Health (DOH)
Anchorage, Alaska
POSITION STATEMENT: Co-presented the Department of Health
Response to Legislative Budget & Audit Findings.
HEIDI HEDBERG, Commissioner
Department of Health (DOH)
Anchorage, Alaska
POSITION STATEMENT: Co-presented the Department of Health
Response to Legislative Budget & Audit Findings.
DEB ETHERIDGE, Director
Division of Public Assistance
Department of Health
Juneau, Alaska
POSITION STATEMENT: Answered questions on FY2022 legislative
audit findings.
HEIDI HEDBERG, Commissioner
Department of Health (DOH)
Anchorage, Alaska
POSITION STATEMENT: Introduced SB 240 on behalf of the
administration.
EMILY RICCI, Deputy Commissioner
Department of Health (DOH)
Anchorage, Alaska
POSITION STATEMENT: Gave a presentation on SB 240.
LEAH VAN KIRK, Deputy Director
Healthcare Policy Advisor
Department of Health
Juneau, Alaska
POSITION STATEMENT: Offered a presentation on SB 240.
DEBORAH RIDDLE, Operations Manager
Division of Innovation and Education Excellence
Department of Education and Early Development (DEED)
Juneau, Alaska
POSITION STATEMENT: Answered questions on SB 240.
TREVOR STORRS, President
Alaska Children's Trust
Anchorage, Alaska
POSITION STATEMENT: Testified in support of SB 240.
ACTION NARRATIVE
3:31:31 PM
CHAIR DAVID WILSON called the Senate Health and Social Services
Standing Committee meeting to order at 3:31 p.m. Present at the
call to order were Senators Dunbar, Giessel, Kaufman, Tobin, and
Chair Wilson.
^PRESENTATION: DEPARTMENT OF HEALTH RESPONSE TO LEGISLATIVE
BUDGET & AUDIT FINDINGS
PRESENTATION: DEPARTMENT OF HEALTH RESPONSE TO LEGISLATIVE
BUDGET & AUDIT FINDINGS
3:32:18 PM
CHAIR WILSON announced the consideration of the presentation
Department of Health Response to Legislative Budget & Audit
Findings.
3:32:52 PM
HEIDI HEDBERG, Commissioner, Department of Health (DOH),
Anchorage, Alaska, introduced herself.
3:33:00 PM
EMILY RICCI, Deputy Commissioner, Department of Health (DOH),
Anchorage, Alaska, co-presented the Department of Health
Response to Legislative Budget & Audit Findings. She moved to
slide 2:
[Original punctuation provided.]
Division of Behavioral Health
FY22 Audit Findings
Audit Finding Category 1
Major Impacted Programs:
• Medicaid/CHIP (Children's Health Insurance Program)
Audit Finding Conditions
• Benefit Payment Issues
• Member Eligibility Ingestion
• Provider Eligibility Screening
MS. RICCI said Category 1 of the audit finding pertains to
Medicaid and the Children's Health Insurance Program (CHIP),
particularly focusing on audit findings 2022-050, 2022-051, and
2022-056. These findings primarily concern benefit payment
issues, member eligibility, and provider eligibility screening,
with the Division of Behavioral Health and the Division of
Healthcare Services being the most impacted. The findings are
related to a combination of systems and process issues between
the two divisions.
3:33:56 PM
MS. RICCI highlighted that audit finding 2022-050 involves the
provisional enrollment of certain provider types for a period of
time while they were still providing services to Medicaid
recipients, which did not align with existing department
regulations. Among other issues, efforts to resolve this include
a review of provider enrollment and documentation by both the
Division of Behavioral Health and the Division of Healthcare
Services to ensure providers meet certification. Also, both the
Division of Behavioral Health and the Medicaid Management
Information System in the Division of Health Care Services are
to maintain regulation standards. The issue is expected to be
fully resolved in FY 2025, following the transition to a single
Medicaid Enterprise system. Meanwhile, divisions are using
system updates along with manual process review and oversight to
keep further issues from occurring.
3:35:40 PM
MS. RICCI explained that audit finding 2022-056 also pertains to
documentation gaps in the system for providers. For example,
one of the gaps found in the system was the requirement for
documentation of a master's degree for the position of Mental
Health Professional Counselor that is a Behavioral Health
rendering provider type covered under the State plan. The
divisions are collaborating to ensure that all necessary
documentation is correctly housed within the Division of
Behavioral Health and the Medicaid Management Information System
(MMIS).
MS. RICCI noted that audit finding 2022-051 was self-reported
and concerns the Behavioral Health Administration Services
Organization's issues with processing eligibility fees from the
Division of Public Assistance. Some issues have been resolved
through system updates. However, Optum Alaska Administrative
Services Organization (ASO) is not able to address all the
issues. Full resolution is anticipated in FY 2025 with the
transition to a single Medicaid claims payment system. In the
meantime, the department is doing manual checks to address
ongoing issues.
3:37:16 PM
CHAIR WILSON inquired about audit finding 2022-050, specifically
concerning paid behavioral health claims. He asked if the
department has a new estimate on the error rate.
3:37:57 PM
MS. RICCI responded that the error rate is lower than 68
percent, but she did not have the exact figure available. She
explained that the division has taken several corrective
actions, including issuing two cure letters, engaging in a
corrective action plan with Optum, and implementing process
reviews. The division is also holding historical claims for
accuracy reviews, conducting more frequent claims monitoring,
performing quarterly reviews specifically related to this audit
finding, and increasing post-payment reviews to quickly identify
and resolve any issues.
3:38:39 PM
COMMISSIONER HEDBERG moved to slide 3:
[Original punctuation provide.]
Division of Public Assistance FY22
Audit Findings
Audit Finding Category 2
Major Impacted Programs:
• Medicaid/CHIP (Children's Health Insurance Program)
• Low Income Heating Assistance Program (LIHEAP)
• Supplemental Nutrition Program (SNAP)
• Temporary Assistance for Needy Families (TANF)
Audit Finding Conditions
• Benefit Payment Issues for SNAP and TANF
• Member Eligibility Issues for Medicaid/CHIP and TANF
• Program Reporting for LIHEAP and TANF
COMMISSIONER HEDBERG addressed the second category of audit
findings, primarily involving public assistance programs managed
by the Division of Public Assistance. The audit findings related
to the Supplemental Nutrition Assistance Program (SNAP),
Temporary Assistance for Needy Families (TANF), Medicaid, and
the Low-Income Home Energy Assistance Program (LIHEAP), also
known as the Heating and Water Assistance Program.
3:39:10 PM
COMMISSIONER HEDBERG said she would discuss the five major
strategies the division is focusing on to address the audit
findings:
• Quality Improvement Plan: Prior hearings with the Division of
Public Assistance, Field Services, discussed a business process
redesign. The division has finalized a strategic roadmap to
identify gaps, streamline processes, and improve service
deliveries. This plan involves five committees composed of staff
across various sectors of Public Assistance, including policy,
finance, field staff, and leadership. These committees will
address state and federal corrective action plans, audit findings,
and pull together data analysis from the five focus areas of:
financial accountability, state and federal corrective action,
information technology, policy and procedure, and business process
redesign. The five committees will pull together documentation to
look at the issues that were identified, how to prevent the
issues, and what system changes need to happen surrounding IT,
staff training, and policy. The continuous quality improvement
plan will occur in April. Home and Community-Based Systems (HCBS)
Strategies was contracted to initiate strong facilitation of the
quality improvement process.
3:42:04 PM
COMMISSIONER HEDBERG continued discussing the department's five
strategies:
• New Deputy Director: The division has appointed a new deputy
director with 20 years of state government experience,
specifically in administration and finance, to help ensure the
accounting structures are properly set up and expenditures are
correctly categorized.
• Accounting Structure Review: The division is conducting a deep
dive into its accounting structures to ensure they are set up
properly and that expenditures align with the correct accounting
code.
• TANF Program Compliance: A contractor, Public Consulting Group
(PCG), has been engaged to provide technical assistance and help
bring the TANF program into compliance. This includes reviewing
audit findings and administrative practices.
• Partnership with U.S. Digital Services: The division is
collaborating with U.S. Digital Services to improve the ex parte
process for Medicaid redeterminations and enhance the data
connections, increasing the percentage of automatically determined
redeterminations to 20-25 percent per month. Additionally, they
are assisting with improving the SNAP reapplication process.
3:44:21 PM
SENATOR DUNBAR commented that he had been informed that the new
deputy director has relevant experience related to the
transition away from Optum and the [Administrative Services
Organization (ASO)] system. Dunbar expressed hope that this
transition will proceed smoothly, noting that many providers are
eager to return to a system that does not involve [ASOs]. He
then inquired about the SNAP program, observing that it seems to
have a lower rate of inaccuracies or insufficient documentation
compared to Medicaid, where timeliness is a bigger issue. He
asked whether the 10 percent of incorrectly calculated cases and
the 42 percent with insufficient information are related to the
income of the benefit recipients or other factors, such as their
assets.
3:45:43 PM
COMMISSIONER HEDBERG deferred to the question.
3:45:56 PM
DEB ETHERIDGE, Director, Division of Public Assistance,
Department of Health, Juneau, Alaska, clarified that asset
levels do not impact SNAP calculations. However, several factors
could affect the calculations, not just income. She explained
that verification of shelter costs or utilities could also
influence the amount of SNAP benefits distributed and the
eligibility determination.
3:46:26 PM
SENATOR DUNBAR noted that 10 percent of SNAP cases were found to
be incorrect, and 42 percent had insufficient information or
inaccurate data in ILINX. He requested a description of the
types of documents that were missing in these cases.
MS. ETHERIDGE explained that errors in SNAP cases could result
from both agency and client mistakes. For example, income might
not have been reported correctly by the client, or the agency
could have registered it incorrectly. She clarified that the
ILINX system is the division's online document management
system. Errors in this system could occur if verified income
documents were not properly stored, making them inaccessible
during the audit.
SENATOR DUNBAR asked if the ILINX system is primarily used for
income verification documentation or if it includes other types
of documentation that individuals might have failed to upload.
3:47:36 PM
MS. ETHERIDGE explained that the ILINX system contains a variety
of documents, including applications, renewal forms,
identification, and any other forms required by the division to
make a determination. Additionally, the system may store copies
of notices, letters, and requests for fair hearings. She likened
the ILINX system to an old-fashioned paper file, except that all
documents are stored electronically.
SENATOR DUNBAR inquired whether asset tests are documented and,
if so, whether those documents are stored in the ILINX system.
3:48:15 PM
MS. ETHERIDGE confirmed that all assets, when there are asset
tests, are documented, and the related documentation should be
stored in the ILINX system. She suggested that some of the
errors might have occurred due to issues with the storage of
these documents in the system.
3:48:37 PM
CHAIR WILSON asked whether the department has conducted a
retrospective review by taking a random sampling of files to
assess the potential error rate.
MS. ETHERIDGE responded that the department conducts a
management evaluation, which includes both a federal and an
internal management assessment. This evaluation not only reviews
cases to determine if they were processed correctly or made an
error but also involves extensive staff interviews to assess
their knowledge. She noted that this evaluation occurs every
other year.
3:49:20 PM
COMMISSIONER HEDBERG acknowledged the end of the presentation.
3:49:52 PM
At ease
SB 240-SCHOOL DISTRICT MEDICAL ASSISTANCE
3:51:51 PM
CHAIR WILSON reconvened the meeting and announced the
consideration of SENATE BILL NO. 240 "An Act relating to medical
assistance coverage for rehabilitative, mandatory, and optional
services furnished or paid for by a school district on behalf of
certain children."
3:52:24 PM
HEIDI HEDBERG, Commissioner, Department of Health (DOH),
Anchorage, Alaska, introduced SB 240 on behalf of the
administration stating it aims to improve access to school-based
services for all Medicaid-eligible children. She explained that
SB 240 supports access by removing statutory barriers. The bill
offers convenient options for parents seeking care for their
children, supports parent-directed services within the school
setting, promotes early intervention, and eliminates obstacles
that prevent schools from leveraging federal Medicaid matching
funds. Additionally, it increases the flexibility for schools to
seek Medicaid reimbursement for eligible children.
3:53:40 PM
EMILY RICCI, Deputy Commissioner, Department of Health (DOH),
Anchorage, Alaska, moved to slide 3 and provided a brief
overview of school-based services in Alaska under the Medicaid
program. She explained that these services, delivered in a
school setting as specified in Alaska's Medicaid state plan,
include speech-language therapy, occupational therapy, physical
therapy, behavioral health, and nursing services. Currently,
state law mandates that for a service to be Medicaid
reimbursable for a Medicaid-eligible student, it must be
outlined in the student's Individual Educational Plan (IEP), and
the student must have a disability.
3:55:23 PM
MS. RICCI noted that SB 240 would remove the requirement for
these services to be covered under an IEP, thus broadening the
scope of services for which schools can seek Medicaid
reimbursement. She emphasized the challenges schools face in
navigating Medicaid reimbursement due to their primary role as
educators rather than healthcare providers. She mentioned that
SB 240 addresses the administrative barrier of the statutory
requirement that the service be covered under an IEP, but
acknowledged that other challenges remain, which the department
is prepared to help school districts overcome. She stated that
currently, only six out of 54 school districts in Alaska
leverage Medicaid reimbursement for services, including
Anchorage, Delta Greeley, Fairbanks, Juneau, Ketchikan, and
Matsu. Kenai participated until the 2019-2020 school year. She
noted that speech, occupational, and physical therapy make up
about 96 percent of the reimbursed services in schools.
3:57:10 PM
MS. RICCI moved to slide 4 and began discussion of the Healthy
Families Initiative. She expressed that SB 240 would increase
access to care for students in a convenient location for
parents, aligning with the governor's Healthy Families
initiative, particularly focusing on Healthy Beginnings and
healthcare access.
3:57:40 PM
LEAH VAN KIRK, Deputy Director, Healthcare Policy Advisor,
Department of Health, Juneau, Alaska, moved to slides 5 -6 and
said SB 240 allows schools to seek Medicaid reimbursement for
services provided to all children covered by Medicaid, enabling
access to services in a familiar, daily setting. She emphasized
that removing statutory requirements increases schools'
flexibility to seek reimbursement when a child is eligible. The
federal Medicaid match of 65 percent is crucial for schools,
particularly when they already provide some services without
seeking reimbursement. Additionally, SB 240 gives schools the
option to offer services to children who previously couldn't
access them, allowing decisions on service provision to include
more children who may not have qualified before.
3:59:08 PM
CHAIR WILSON noted that the federal match of 65 percent is a
little higher than the usual 50 percent match for most Medicaid
services. He asked who pays for the remaining 45 percent.
MS. RICCI clarified that the federal match rate could vary
between 50 percent and 65 percent, depending on the student's
enrollment status, such as whether they are covered by the
Children's Health Insurance Program (CHIP) or another Medicaid-
qualifying status. She noted that the current system is
cumbersome for both school districts and the Division of
Healthcare Services. Currently, school districts pre-fund the
state's match for services, which the Division then uses to draw
down the federal match, passing both the federal and state funds
back to the districts. However, under this system, districts
must provide the state match upfront, which complicates the
process. She mentioned that the presentation would later cover
new federal options for Medicaid reimbursement, such as roster
billing or a per-student-per-month mechanism, which could be
reconciled quarterly, as potential solutions to these
challenges. She added that many school systems have failed to
leverage federal matching funds due to the complexity of the
process.
4:01:25 PM
CHAIR WILSON asked that during the presentation the Department
discuss billing and why SB 240 has a zero fiscal note.
4:01:40 PM
MS. RICCI explained that SB 240 has a zero fiscal note because
the services are already available to Medicaid-enrolled children
in community settings. SB 240 is removing an administrative
barrier that would also make services available in a school
setting. The anticipated slow increase in the utilization of
school-based services is partly due to the need to resolve
administrative challenges in creating a reimbursement system
that works for both Medicaid and school districts. She mentioned
that workgroups have been established, with the first meeting
scheduled for next week, to begin discussions with school
districts. Additionally, the Department is applying for a grant
to cover implementation costs and necessary contractual support.
She emphasized that SB 240 results in a cost shift from acute
settings to more early intervention and prevention. Addressing
students' needs before they become acute results in a cost shift
rather than new costs to the system.
4:03:15 PM
SENATOR DUNBAR agreed with Ms. Ricci's final statement,
expressing hope that if the bill passes, an economics student or
researcher will conduct a dissertation over the next 10 years to
track potential cost reductions in other areas due to early
intervention. He noted that Alaska is not the first state to
implement this type of school-based, non-Individualized
Education Program (IEP) dependent services, and it would be
interesting to observe if there are downstream cost savings as
Alaska joins other states in providing these services.
4:04:01 PM
MS. VAN KIRK moved to slide 7 and emphasized that the SB 240
supports parents by providing another setting for their children
to receive services, reducing the transportation challenges
parents face, such as leaving work to transport their child to
and from appointments. She highlighted the importance of this
support, especially as children's re-engagement with health
services has declined nationally since the pandemic. The Centers
for Medicare and Medicaid Services (CMS) is working to increase
flexibility for delivering school-based services and simplify
the administrative process for schools to submit Medicaid
claims. She also pointed out that children are more comfortable
receiving services in the familiar school environment, which is
beneficial for trauma-informed care. She clarified that the bill
does not add any new services but gives schools the option, not
a mandate, to submit claims for reimbursement through Medicaid.
4:05:51 PM
CHAIR WILSON asked if SB 240 requires school districts to hire
mental health professionals directly or can districts contract
providers.
4:06:03 PM
MS. VAN KIRK responded that services could be provided either by
a school district employee or through a contracted provider.
4:06:17 PM
MS. RICCI moved to slide 8 and reiterated the benefits SB 240
would provide Alaskans:
[Original punctuation provided.]
Families and Children
• Provides more convenient choices for parents
seeking care for their children
• Increases access to services for children
• Promotes early intervention and prevention
System Efficiencies
• Reduces administrative burden
• Maximizes federal Medicaid match
MS. RICCI added that early intervention and prevention were
consistently emphasized during the Department's work on the
behavioral health roadmap. She noted that there was a strong
desire for increased school-based services in nearly every
region visited, making this bill responsive to stakeholder
feedback. She reminded the committee that there are
administrative burdens that involve process issues that need to
be worked through, such as figuring out how to apply the new
Medicaid flexibilities to the current system in a way that
provides flexibility to school districts in Alaska. It also
provides opportunities to maximize federal matching funds.
4:07:29 PM
MS. VAN KIRK moved to slide 9 and noted that new flexibilities
were released in May 2023 to encourage schools to claim
reimbursement for school-based services. She mentioned that 25
states have updated regulations and statutes to allow
reimbursement for services beyond those included in an
Individualized Education Program (IEP). She emphasized the
state's efforts to connect with stakeholders, including schools,
behavioral health organizations, current service providers, and
the Department of Education, to identify effective systems and
reduce the administrative burden currently limiting
participation. With only six school districts currently
submitting Medicaid reimbursement claims, the goal is to
increase that number, which will take work and require
stakeholder engagement.
4:08:57 PM
MS. VAN KIRK announced the initiation of a stakeholder
engagement process, with the first meeting scheduled for Friday,
involving various organizations, divisions, and departments. The
state is also applying for a grant from the Centers for Medicare
and Medicaid Services (CMS) to support the implementation of
school-based services, with a focus on ensuring rural
communities can participate. She highlighted concerns about
small rural school districts navigating Medicaid and mentioned
that the state is exploring models from other states to address
these challenges. She reiterated that school-based services were
identified as essential in every region during the behavioral
health roadmap process and stressed that Medicaid-reimbursable
services are a critical component, though not the complete
solution, in meeting the needs of youth across the state.
4:10:41 PM
CHAIR WILSON asked what the cost to the state is if the grant
for starting up the program is not awarded.
MS. VAN KIRK explained that the grant provides an opportunity to
explore improvements, such as data systems that would enhance
schools' ability to submit claims to Medicaid. She described it
as a chance to envision and build a more effective system than
the current one. She noted that stakeholder engagement and
support for this bill were already planned before the grant's
release, and consultation support has been engaged to guide the
process.
4:11:43 PM
MS. RICCI stated that the grant would enhance conversations and
bring sophistication to healthcare systems as the department
enters the planning phase. However, she assured that even if the
grant is not awarded, department staff will continue to support
stakeholder engagement, planning, and implementation for school-
based services.
4:12:31 PM
CHAIR WILSON inquired about the dollar amount of the grant.
MS. VAN KIRK replied the grant is $2.5 million over three years.
4:12:47 PM
CHAIR WILSON raised concerns about the challenges small
healthcare providers, such as independent Licensed Professional
Counselors (LPCs), face when billing Medicaid, particularly due
to frequent audits. He acknowledged that technical assistance is
often provided but questioned whether the state is considering
setting up its own billing and claims management service for
school districts. He noted that managing billing and denials is
a significant resource burden, especially for small clinics, and
suggested that a state-supported service could alleviate this
burden. He emphasized that while larger districts or third-party
providers might manage these tasks efficiently, smaller rural
districts might struggle, highlighting concerns from these
districts and the need for stakeholder engagement.
MS. VAN KIRK stated that stakeholder engagement would address
the concerns raised, including topics like billing and Medicaid
services. She confirmed that school districts participating in
Medicaid billing would help guide the work and contribute to
related discussions.
4:14:12 PM
MS. RICCI discussed the new flexibilities released by the
Centers for Medicare and Medicaid Services (CMS) in May of the
previous year, which other states are expanding upon. These
flexibilities address the challenges school districts face with
traditional Medicaid billing, such as managing billing, denials,
and authorizations. She mentioned that some of these
flexibilities include waiving the requirement for Medicaid to
pursue third-party liability for school-based services, allowing
for a larger error rate, extending time for time studies, and
exploring alternatives to direct billing, such as a per-pupil-
per-month mechanism or roster-based services reconciled
quarterly.
MS. RICCI emphasized that the department would work with school
districts to apply these theoretical flexibilities to their
practical needs. She acknowledged the challenges, such as
managing documentation and tracking in a roster-based system and
expressed optimism that these CMS flexibilities could be
translated into a system that is not administratively cumbersome
for school districts.
4:16:04 PM
MS. RICCI moved to slide 11 and said SB 240 is relatively simple
and the sectional analysis has one section:
[Original punctuation provided.]
Sectional Analysis
Section 1
This section removes the requirement that Medicaid
services provided in a school setting are limited to
those covered under an Individual Education Plan
(IEP).
4:16:51 PM
CHAIR WILSON expressed a potential concern regarding SB 240. He
noted that the bill allows school districts to provide
behavioral modification services within the school setting,
which might enable schools to bypass the Individualized
Education Plan (IEP) process. He pointed out that students on
IEPs have a different funding mechanism, with a differential
rate of 13 to 1. He questioned whether school districts might
opt to avoid the IEP process to access services through the
program, which could result in less funding for those schools.
4:17:57 PM
MS. VAN KIRK recommended the question be deferred to the
Department of Education and Early Development (DEED). She noted
that stakeholders have mentioned that children referred for
services, such as speech therapy, often do not meet the required
level of acuity for those services to be provided in the school
setting. She explained that SB 240 would allow and improve
access to services for children who currently do not meet that
level of need.
4:18:38 PM
DEBORAH RIDDLE, Operations Manager, Division of Innovation and
Education Excellence, Department of Education and Early
Development (DEED), Juneau, Alaska, explained that there are
different levels of funding for special education. Intensive
special education funding is allocated for students with the
most significant disabilities at a rate of 13 times the base
student allocation, but most students do not fall into this
intensive category. She indicated that allowing students who do
not qualify for an IEP to receive needed services would not
constitute bypassing the IEP process.
CHAIR WILSON asked if there is a difference in the funding rate
for students who are not classified at the intensive level of
special needs compared to those who are.
4:19:35 PM
MS. RIDDLE replied no, they're counted as special education
students. That is one of the multipliers. However, the 13 times
the base student allocation applies only to students who are two
standard deviations away from the norm for their specific
disability.
CHAIR WILSON asked if there is a multiplier for a special needs
child who qualifies for an IEP.
MS. RIDDLE replied that is true.
4:20:07 PM
CHAIR WILSON asked whether the availability of an easier process
for obtaining services might result in fewer children being
placed on IEPs, given whatever the rate multiplier is for those
children.
MS. RIDDLE explained that the Individuals with Disabilities
Education Act (IDEA) has specific rules for identifying children
and the services provided through an IEP. She offered to follow
up with more detailed information but suggested that services
like speech therapy would still be provided through an IEP.
However, if additional services are needed, such as in the case
of her autistic grandson who receives both in-school and outside
services, it would be beneficial if all services could be
provided within the school setting. She used this as a scenario
to illustrate the potential benefits.
4:21:05 PM
CHAIR WILSON clarified that his question focused on simpler
behavioral health modifications for which some children have
IEPs. He noted that the IEP process is not easy to administer,
especially in schools with limited resources. Drawing from his
experience as a substitute teacher, he observed that teachers
often spend significant time on IEP conferences and related
tasks, sometimes wishing they could instead focus on teaching
while other professionals provide the necessary services. He
asked how SB 240 might address the administration of such
services to ease the burden on teachers.
4:21:44 PM
SENATOR DUNBAR said he found the IEP question intriguing and
shared his limited experience with a different school district
where too many IEPs were issued, sometimes inappropriately, as a
pressure release valve for the district. He clarified that this
experience was outside of Alaska and hoped such practices would
not occur in Alaska.
4:22:14 PM
SENATOR DUNBAR commented on the drafting of SB 240, noting that
issues can arise with non-exhaustive lists in legislation. He
suggested that in Section 1, line 6, rather than using the
phrase "including a child with a disability," it might be
clearer to simply delete "with a disability." This change would
avoid implying that only children with disabilities are eligible
for the services, aligning with the bill's intent to make
services available to any eligible child. He clarified that
while this was just a drafting note and not significant enough
to propose an amendment, he wanted it on record to ensure the
correct interpretationthat any eligible child, with or without
a disability, can access these services. He asked if he was
misinterpreting the intent of that line.
4:23:23 PM
MS. VAN KIRK replied that Senator Dunbar was not misinterpreting
line 6.
SENATOR DUNBAR sought confirmation that deleting the phrase
would have had the same effect.
4:23:34 PM
MS. VAN KIRK explained that the phrasing in the drafting was
intentional to avoid any unintended impact on children with
disabilities. The goal was to clearly reference both children
with and without disabilities, ensuring that the bill does not
negatively affect any existing guidelines or protections for
children with disabilities.
SENATOR DUNBAR asked for clarification, emphasizing that the
dispositive point is whether the child is eligible for the
services, regardless of whether they have a disability. He
sought confirmation that eligibility, not the presence of a
disability, is the key consideration.
MS. VAN KIRK replied that is correct.
4:24:24 PM
CHAIR WILSON opened public testimony on SB 240.
4:24:49 PM
TREVOR STORRS, President, Alaska Children's Trust, Anchorage,
Alaska, testified in support of SB 240, which would expand
school-based services to all Medicaid-eligible children. As an
organization focused on preventing child abuse and neglect, he
emphasized that SB 240 would promote the health and well-being
of Alaska's children by providing families with better access to
healthcare resources, reducing the risk of abuse and neglect. SB
240 aligns state law with federal guidance, allowing schools to
be reimbursed for services provided to all Medicaid-eligible
students, not just those with an IEP. This expansion supports
parent directed services within the school setting, early
intervention, prevention, and increased healthcare access, which
are vital for Alaska's children and families.
4:27:08 PM
CHAIR WILSON closed public testimony on SB 240.
4:27:31 PM
MS. RICCI thanked the committee for hearing SB 240.
4:27:59 PM
CHAIR WILSON [held SB 240 in committee.]
4:28:34 PM
There being no further business to come before the committee,
Chair Wilson adjourned the Senate Health and Social Services
Standing Committee meeting at 4:28 p.m.
| Document Name | Date/Time | Subjects |
|---|---|---|
| FY25 LBA SHSS Presentation 2.27.24.pdf |
SHSS 2/27/2024 3:30:00 PM |
SHSS 2.27.24 - LBA Audit Findings DOH Response |
| SB 240 Version A.pdf |
SHSS 2/27/2024 3:30:00 PM |
SB 240 |
| SB 240 Sponsor Statement Version A.pdf |
SHSS 2/27/2024 3:30:00 PM |
SB 240 |
| SB240 Sectional Analysis.pdf |
SHSS 2/27/2024 3:30:00 PM |
SB 240 |
| SB 240 Fiscal Note 1.pdf |
SHSS 2/27/2024 3:30:00 PM |
SB 240 |
| SB 240 Fiscal Note 2.pdf |
SHSS 2/27/2024 3:30:00 PM |
SB 240 |
| SB 240 Fiscal Note 3.pdf |
SHSS 2/27/2024 3:30:00 PM |
SB 240 |
| SB240 Summary Version A.pdf |
SHSS 2/27/2024 3:30:00 PM |
SB 240 |
| SB 240 Final SHSS 2_27_24.pptx - Read-Only.pdf |
SHSS 2/27/2024 3:30:00 PM |
SB 240 |
| SB240 AMHT LOS 2.26.24.pdf |
SHSS 2/27/2024 3:30:00 PM |
SB 240 |
| SB 240 HB343 Letter of Support - ACT.pdf |
SHSS 2/27/2024 3:30:00 PM |
HB 343 SB 240 |
| SB 240 VOA Alaska - Letter of Support.pdf |
SHSS 2/27/2024 3:30:00 PM |
SB 240 |
| SB240 HB343_ASD Support Letter.pdf |
SHSS 2/27/2024 3:30:00 PM |
HB 343 SB 240 |
| Leg Audit Recommendations SHSS 1.19.24.pdf |
SHSS 2/27/2024 3:30:00 PM |
SHSS Feb. 27, 2024 - LB&A Audit Findings for Dept of Health |