Legislature(2023 - 2024)BUTROVICH 205
04/11/2024 03:30 PM Senate HEALTH & SOCIAL SERVICES
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| Audio | Topic |
|---|---|
| Start | |
| HCR15 | |
| Presentation: Behavorial Health Roadmap for Alaska Youth | |
| HB371 | |
| HB89 | |
| Adjourn |
* first hearing in first committee of referral
+ teleconferenced
= bill was previously heard/scheduled
+ teleconferenced
= bill was previously heard/scheduled
| + | TELECONFERENCED | ||
| *+ | HB 371 | TELECONFERENCED | |
| *+ | HCR 15 | TELECONFERENCED | |
| + | TELECONFERENCED | ||
| += | HB 89 | TELECONFERENCED | |
ALASKA STATE LEGISLATURE
SENATE HEALTH AND SOCIAL SERVICES STANDING COMMITTEE
April 11, 2024
3:35 p.m.
MEMBERS PRESENT
Senator David Wilson, Chair
Senator James Kaufman, Vice Chair
Senator Löki Tobin
Senator Forrest Dunbar
Senator Cathy Giessel
MEMBERS ABSENT
All members present
COMMITTEE CALENDAR
HOUSE CONCURRENT RESOLUTION NO. 15
Designating May 2024 as Mental Health Awareness Month; and
designating May 5 - 11, 2024, as Tardive Dyskinesia Awareness
Week.
- HEARD & HELD
PRESENTATION: BEHAVORIAL HEALTH ROADMAP FOR ALASKA YOUTH
- HEARD
HOUSE BILL NO. 371
"An Act relating to medical review organizations; relating to
the definitions of 'health care provider' and 'review
organization'; and relating to the duties of the chief medical
officer in the Department of Health."
- HEARD & HELD
COMMITTEE SUBSTITUTE FOR HOUSE BILL NO. 89(FIN)
"An Act relating to education tax credits for certain payments
and contributions for child care and child care facilities;
relating to the insurance tax education credit, the income tax
education credit, the oil or gas producer education credit, the
property tax education credit, the mining business education
credit, the fisheries business education credit, and the
fisheries resource landing tax education credit; renaming the
day care assistance program the child care assistance program;
relating to the child care assistance program and the child care
grant program; providing for an effective date by amending the
effective date of secs. 1, 2, and 21, ch. 61, SLA 2014; and
providing for an effective date."
- MOVED SCS CSHB 89(HSS) OUT OF COMMITTEE
PREVIOUS COMMITTEE ACTION
BILL: HCR 15
SHORT TITLE: MENTAL HEALTH MONTH; TARDIVE DYSK WEEK
SPONSOR(s): HEALTH & SOCIAL SERVICES
03/13/24 (H) READ THE FIRST TIME - REFERRALS
03/13/24 (H) HSS
03/21/24 (H) HSS AT 3:00 PM DAVIS 106
03/21/24 (H) Moved HCR 15 Out of Committee
03/21/24 (H) MINUTE(HSS)
03/22/24 (H) HSS RPT 7DP
03/22/24 (H) DP: FIELDS, SUMNER, RUFFRIDGE,
MCCORMICK, SADDLER, MINA, PRAX
04/03/24 (H) TRANSMITTED TO (S)
04/03/24 (H) VERSION: HCR 15
04/04/24 (S) READ THE FIRST TIME - REFERRALS
04/04/24 (S) HSS
04/11/24 (S) HSS AT 3:30 PM BUTROVICH 205
BILL: HB 371
SHORT TITLE: MEDICAL REVIEW ORGANIZATIONS
SPONSOR(s): RUFFRIDGE BY REQUEST
02/20/24 (H) READ THE FIRST TIME - REFERRALS
02/20/24 (H) HSS
02/29/24 (H) HSS AT 3:00 PM DAVIS 106
02/29/24 (H) Heard & Held
02/29/24 (H) MINUTE(HSS)
03/05/24 (H) HSS AT 3:00 PM DAVIS 106
03/05/24 (H) Moved HB 371 Out of Committee
03/05/24 (H) MINUTE(HSS)
03/06/24 (H) HSS RPT 4DP 1DNP 2NR
03/06/24 (H) DP: FIELDS, RUFFRIDGE, MINA, PRAX
03/06/24 (H) DNP: SUMNER
03/06/24 (H) NR: MCCORMICK, SADDLER
03/25/24 (H) TRANSMITTED TO (S)
03/25/24 (H) VERSION: HB 371
03/27/24 (S) READ THE FIRST TIME - REFERRALS
03/27/24 (S) HSS
04/11/24 (S) HSS AT 3:30 PM BUTROVICH 205
BILL: HB 89
SHORT TITLE: CHILD CARE: TAX CREDITS/ASSISTANCE/GRANTS
SPONSOR(s): COULOMBE
02/27/23 (H) READ THE FIRST TIME - REFERRALS
02/27/23 (H) HSS, FIN
03/14/23 (H) HSS AT 3:00 PM DAVIS 106
03/14/23 (H) Heard & Held
03/14/23 (H) MINUTE(HSS)
04/25/23 (H) HSS AT 3:00 PM DAVIS 106
04/25/23 (H) Moved CSHB 89(HSS) Out of Committee
04/25/23 (H) MINUTE(HSS)
05/01/23 (H) HSS RPT CS(HSS) NEW TITLE 7DP
05/01/23 (H) DP: FIELDS, SUMNER, RUFFRIDGE,
MCCORMICK, MINA, SADDLER, PRAX
05/10/23 (H) FIN AT 1:30 PM ADAMS 519
05/10/23 (H) -- MEETING CANCELED --
05/11/23 (H) FIN AT 1:30 PM ADAMS 519
05/11/23 (H) Heard & Held
05/11/23 (H) MINUTE(FIN)
05/12/23 (H) FIN AT 8:00 AM ADAMS 519
05/12/23 (H) -- MEETING CANCELED --
01/25/24 (H) FIN AT 1:30 PM ADAMS 519
01/25/24 (H) Heard & Held
01/25/24 (H) MINUTE(FIN)
02/08/24 (H) FIN AT 1:30 PM ADAMS 519
02/08/24 (H) Moved CSHB 89(FIN) Out of Committee
02/08/24 (H) MINUTE(FIN)
02/12/24 (H) FIN RPT CS(FIN) NEW TITLE 7DP 3NR 1AM
02/12/24 (H) DP: GALVIN, COULOMBE, CRONK,
TOMASZEWSKI, FOSTER, D.JOHNSON, EDGMON
02/12/24 (H) NR: STAPP, HANNAN, JOSEPHSON
02/12/24 (H) AM: ORTIZ
02/28/24 (H) FIN CS ADOPTED Y39 N1
02/29/24 (H) TRANSMITTED TO (S)
02/29/24 (H) VERSION: CSHB 89(FIN)
03/01/24 (S) READ THE FIRST TIME - REFERRALS
03/01/24 (S) HSS, FIN
03/21/24 (S) HSS AT 3:30 PM BUTROVICH 205
03/21/24 (S) Heard & Held
03/21/24 (S) MINUTE(HSS)
04/04/24 (S) HSS AT 3:30 PM BUTROVICH 205
04/04/24 (S) <Above Item Removed from Agenda>
04/04/24 (S) MINUTE(HSS)
04/11/24 (S) HSS AT 3:30 PM BUTROVICH 205
WITNESS REGISTER
MAGY ELLIOT, Staff
Representative Mike Prax
Alaska State Legislature
Juneau, Alaska
POSITION STATEMENT: Introduced HCR 15 on behalf of the sponsor.
TRACY DOMPELING, Director
Division of Behavioral Health
Department of Health
Juneau, Alaska
POSITION STATEMENT: Co-delivered the presentation Behavioral
Health Roadmap for Alaska Youth.
LEAH VAN KIRK, Health Care Policy Advisor
Office of the Commissioner
Department of Health
Juneau, Alaska
POSITION STATEMENT: Co-delivered a presentation Behavioral
Health Roadmap for Alaska Youth.
JAMES SEXTON, Staff
Representative Justin Ruffridge
Alaska State Legislature
Juneau, Alaska
POSITION STATEMENT: Introduced HB 371 on behalf of the sponsor.
SABINA BRAUN, Staff
Representative Justin Ruffridge
Alaska State Legislature
Juneau, Alaska
POSITION STATEMENT: Provided the sectional analysis and a brief
presentation for HB 371.
LINDSEY KATO, Director
Division of Public Health
Department of Health
Juneau, Alaska
POSITION STATEMENT: Invited testimony for SB 371.
CARMEN WENGER, Director of Programs
All Alaska Pediatric Partnership
Anchorage, Alaska
POSITION STATEMENT: Testified in support of HB 371.
EDRA MORLEDGE, Staff
Representative Julie Coulombe
Alaska State Legislature
Juneau, Alaska
POSITION STATEMENT: Introduced HB 89 on behalf of the sponsor.
LEAH VAN KIRK, Health Care Policy Advisor
Office of the Commissioner
Department of Health
Juneau, Alaska
POSITION STATEMENT: Provided a brief overview of Amendment 2 to
HB 89.
ELEILIA PRESTON, Staff
Representative Julie Coulombe
Alaska State Legislature
Juneau, Alaska
POSITION STATEMENT: Provided comments on Amendment 3 to HB 89 on
behalf of the sponsor.
ACTION NARRATIVE
3:35:38 PM
CHAIR DAVID WILSON called the Senate Health and Social Services
Standing Committee meeting to order at 3:35 p.m. Present at the
call to order were Senators Tobin, Kaufman, Dunbar, Giessel, and
Chair Wilson.
HCR 15-MENTAL HEALTH MONTH; TARDIVE DYSK WEEK
3:36:36 PM
CHAIR WILSON announced the consideration of HOUSE CONCURRENT
RESOLUTION NO. 15 Designating May 2024 as Mental Health
Awareness Month; and designating May 5 - 11, 2024, as Tardive
Dyskinesia Awareness Week.
3:37:03 PM
MAGY ELLIOT, Staff, Representative Mike Prax, Alaska State
Legislature, Juneau, Alaska, Introduced HCR 15 on behalf of the
sponsor:
[Original punctuation provided.]
HCR 15
Sponsor Statement
"Designating May 2024 as Mental Health Awareness
Month; and designating May 5-11, 2024, as Tardive
Dyskinesia Awareness Week."
In Alaska, as across the nation, mental illness and
its negative impacts stretch far and wide, touching
families in every community and across all walks of
life. HCR 15 shines a light on the importance of
mental health awareness and the challenges of Tardive
Dyskinesia.
It is estimated that over 108,000 adults in the state
have mental health conditions such as major
depression, bipolar disorder, schizophrenia, and other
debilitating behavioral health conditions. The onset
of mental health disorders peaks during adolescence
and early adulthood, marking a critical period for
intervention and support. Yet many Alaskans do not
receive the treatment they need due to a variety of
barriers, including cost and access to professionals.
Complicating the landscape is the prevalence of
Tardive Dyskinesia (TD), a movement disorder. induced
by long-term use of antipsychotic medications. TD
affects 10 to 30 percent of Individuals taking these
medications can significantly impact their quality of
life.
HCR 15 will designate May 2024 as Mental Health
Awareness Month and May 5-11 as Tardive Dyskinesia
Awareness Week. By doing this, we support those
battling mental health conditions, advocate for
comprehensive care and challenge the stigma that
discourages seeking help.
Let us make mental health a priority in Alaska,
ensuring that our policies, resources, [and
communities are aligned and support those who face
these challenges everyday.]
3:38:52 PM
CHAIR TOBIN asked if HCR 15 would make every May 5th - 11th
Tardive Dyskinesia Awareness week.
MS. ELLIOTT replied that the awareness week was just for this
May. The hope is to present the resolution before the
legislature every session to bring more awareness to metal
health.
3:39:27 PM
CHAIR WILSON opened public testimony on HCR 15; finding none, he
closed public testimony.
3:39:56 PM
MS. ELLIOTT thanked the committee for hearing HCR 15.
3:40:02 PM
CHAIR WILSON held HCR 15 in committee.
3:40:15 PM
At ease
^PRESENTATION: BEHAVORIAL HEALTH ROADMAP FOR ALASKA YOUTH
PRESENTATION: BEHAVORIAL HEALTH ROADMAP FOR ALASKA YOUTH
3:41:24 PM
CHAIR WILSON reconvened the meeting and announced the
presentation Behavioral Health Roadmap for Alaska Youth by the
Department of Health.
3:41:55 PM
TRACY DOMPELING, Director, Division of Behavioral Health,
Department of Health, Juneau, Alaska, moved to slide 2 and said
she and Ms. Van Kirk would co-deliver the presentation
Behavioral Health Roadmap for Alaska Youth. She stated that the
Roadmap project provided an opportunity to engage with Alaskans,
stakeholders, community members, and family members of children
navigating the behavioral healthcare system. The presentation
will outline Alaska's youth behavioral health risk factors and
needs that prompted this project. She explained that it will
also cover the framework of the Roadmap project, insights from
regional work conducted, and how this effort influences ongoing
activities within the behavioral health system, while helping
prioritize future actions.
3:43:21 PM
LEAH VAN KIRK, Health Care Policy Advisor, Office of the
Commissioner, Department of Health, Juneau, Alaska, moved to
slide 3 and highlighted the challenges Alaska's youth face,
framing the importance of the project's work. She noted that
Alaska consistently ranks among the highest in the nation for
suicide rates, double the national average, with youth suicide
as the leading cause of death and a high percentage of high
school students reporting or attempting suicide. Hospital
emergency department data show an increase in visits for
behavioral health issues among younger youth, ages 11 to 14,
with adolescence often marking the onset of mental health
issues, which families struggle to navigate.
3:44:27 PM
MS. VAN KIRK added that health facility data indicate depressive
disorders, suicidality, bipolar disorder, and related issues as
the leading causes of hospitalization for youth ages 15 to 24.
Despite a decrease in the overall suicide rate in 2022, suicide
remains the leading cause of death for Alaska's youth,
underscoring the need for a system that intervenes earlier and
supports youth and families to prevent these outcomes. She
stressed that this is not only an Alaska issue; nationally,
youth behavioral health struggles are so significant that the
U.S. Surgeon General issued an advisory in 2021 to address the
urgent youth mental health crisis.
3:45:51 PM
MS. VAN KIRK moved to slide 4 and explained that as the
department began the Behavioral Health Roadmap work, various
prior initiatives and assessments guided the project's
direction. She highlighted ongoing targeted efforts statewide
aimed at building stronger support systems specifically for
youth. She identified the Department of Education, Department of
Family and Community Services, Department of Health, and the
Alaska Hospital and Healthcare Association as key contributors
in conducting comprehensive reports of behavioral health
offerings in schools, the hospital system, and inpatient
residential systems. Through these reports, the department
recognized distinct regional characteristics, gaps, and
challenges, making stakeholder and community input essential to
inform next steps.
3:47:10 PM
MS. DOMPELING moved to slide 5 and provided an overview of how
crucial input was gathered for the process, emphasizing the need
for feedback from stakeholders statewide, including tribes,
service providers, communities, and especially families with
children facing unmet behavioral health needs. She noted the
importance of ensuring broad participation, which extended
beyond in-person meetings to include virtual attendance options,
enabling wider access and input.
3:48:01 PM
MS. DOMPELING moved to slide 6 and stated that the Roadmap
project began with a steering committee to provide guidance and
act in an advisory capacity for ongoing work. She noted that the
committee included representatives from individuals and
organizations involved in authoring key reports and initiatives
referenced earlier. Participating state agencies included the
Departments of Health, Family and Community Services, and
Education and Early Development. She acknowledged Senator Wilson
and Representative Coulombe for joining the committee, along
with representatives from tribal health organizations, the
Alaska Native Health Board, Alaska Tribal Health Consortium,
tribal child welfare organizations, the Alaska Mental Health
Trust Authority, and advocacy groups representing youth-serving
organizations across behavioral health, developmental
disabilities, healthcare, and primary healthcare organizations.
3:49:27 PM
MS. VAN KIRK moved to slide 7 and reported that five regional
events were held in late 2022 across diverse locations:
• Fairbanks (Interior) - 66 attendees
• Nome (Northern) - 46 attendees
• Bethel (Southwest) - 46 attendees
• Mat-Su (Southcentral) - 86 attendees
• Ketchikan (Southeast) - 86 attendees
MS VAN KIRK said these events aimed to recognize regional and
cultural differences, assess service gaps, identify community
needs, and highlight effective practices in each area. She
emphasized the importance of empowering each community to take
ownership of their approach to youth services. Attendees
included behavioral health providers, school staff, after-school
programs, advocates, coalitions, prevention and early
intervention programs, state departments, courts, child
protection, juvenile justice, law enforcement, and
representatives from tribal health organizations. Tribal
Behavioral Health Directors also helped organize each event,
ensuring tribal perspectives were represented across the state.
3:51:19 PM
MS. VAN KIRK explained that a neutral facilitator was used to
encourage honest and constructive dialogue about system gaps and
solutions, recognizing that effective solutions may lie beyond
state-funded services. Each two-day event included resource
inventories, gap identification, solution prioritization, and
action planning. Evening community listening sessions engaged
families and youth with lived experience in the behavioral
health system, highlighting common challenges such as
difficulties accessing care, the emotional and financial impacts
on families, shared successful resources, and the complexities
of navigating the systemeven for those familiar with it
professionally.
3:53:14 PM
CHAIR WILSON mentioned that an off-net meeting option was
available for those unable to attend the regional events,
allowing additional opportunities for participation.
3:53:28 PM
MS. VAN KIRK added that virtual attendance for the in-person
meetings, as well as a sixth virtual meeting, was offered.
3:53:38 PM
MS. DOMPELING moved to slide 8 and shared that the regional
events engaged participants across five areas within the
continuum of care, spanning from prevention and early
intervention to step-down services post-residential care. Over
the two-day sessions, participants were eventually asked to
focus on one of these areas most relevant to their organization,
community, or region, allowing for a deeper exploration of
existing services, gaps, solutions, and potential partners for
addressing those gaps.
3:54:30 PM
MS. DOMPELING noted that participants valued these in-person
interactions, especially after pandemic-related isolation, which
allowed them to meet colleagues face-to-face and learn about
additional community services. Throughout the discussions, three
recurring "cross-cutting" focus areas emerged: data needs, care
coordination, and provider support. The regional engagement
produced not only a clearer understanding of service gaps but
also a set of actionable recommendations aligned with community
priorities. The work concluded with 47 distinct recommendations
across the continuum of care and these cross-cutting areas, and
the presentation would next highlight key recommendations from
each section.
3:56:03 PM
MS. VAN KIRK moved to slide 9 and stated that recommendations
focused on prevention and early intervention, noting that every
region emphasized the importance of prioritizing prevention for
achieving the most effective long-term outcomes. She stressed
the need to include prevention and early intervention in
discussions across the continuum of care. A key recommendation
from each meeting was the importance of supporting mental health
services in schools, specifically by increasing access to
school-based Medicaid services. She highlighted schools as
natural settings for children to receive services, as they are
places of daily attendance. She acknowledged the committee's
support for SB 240, which has advanced some of this work to
enhance mental health support in schools.
3:57:26 PM
MS. DOMPELING moved to slide 10 and shared that, within
outpatient support discussions, providers expressed significant
concerns about financial difficulties, largely tied to claims
processing challenges. She informed attendees that the Division
of Behavioral Health will end its contract with the current
administrative services organization at the end of the year,
transitioning claims processing to the Medicaid Management
Information System. This change aims to streamline the claims
process by providing providers with a single submission
location, improving payment timeliness and accuracy, and
enhancing financial stability. She noted that while providers
wish to expand services, there is hesitancy due to uncertainty
around payment reliability.
3:58:38 PM
CHAIR WILSON said that for online listeners the state is looking
at getting rid of Optum.
3:58:52 PM
MS. DOMPELING moved to slide 10 and said that within crisis and
sub-acute care, stakeholders emphasized the need to strengthen
Alaska's crisis service continuum by expanding mobile crisis
teams, 23-hour crisis stabilization, and crisis residential
programs. She noted that Behavioral Health has engaged
contractor Milliman to help design a more comprehensive crisis
care system statewide. Milliman has analyzed claims processing
for both the 1115 waiver and state plan services and has
conducted extensive stakeholder engagement with tribes, current
and potential crisis service providers, and behavioral health
organizations to gather insights and review existing research.
The goal is to create flexible crisis service models that suit
smaller and rural communities, enabling individualsespecially
childrento stay close to home, family, and support networks
during crises. She added that efforts are underway with the
Department of Family and Community Services to expand
therapeutic treatment homes by refining licensing and claims
criteria, creating more opportunities for youth to receive
residential care within their communities, close to family and
support systems.
4:01:03 PM
MS. VAN KIRK moved to slide 11 highlighted the importance of
step-down services in the continuum of care, specifically
recommending improvements for individuals with complex needs. To
address this, the Department of Family and Community Services
and the Department of Health established a Complex Care
Committee to find solutions and close system gaps for
individuals needing specialized access to care. This initiative
has three tiers: first, a system-wide focus on complex care;
second, individual case reviews to find appropriate care for
those whose needs aren't met by standard levels; and third, a
planned Complex Care Coalition to enhance care coordination and
provider collaboration. She identified cross-cutting themes
across the continuum, specifically data, care coordination and
navigation, and provider support. For data, she recommended
leveraging Emergency Department data to identify youth who
frequently visit due to behavioral health crises, such as
suicidal ideation or self-harm, to proactively develop
supportive interventions. Care coordination was a top priority,
as navigating the behavioral health system is challenging, and
coordinating care for high-need youth could prevent their
escalation to higher levels of care. Provider support was also a
key focus. Many providers expressed needs to better serve youth,
and Alaska's commitment to improving behavioral health systems
was evident through active participation. To bolster provider
capacity, the Division of Behavioral Health plans to secure a
behavioral health organization contract, which will expand
training for existing providers, support new providers, and help
add services to address regional capacity gaps across the state.
4:03:32 PM
MS. VAN KIRK moved to slide 12 and emphasized the critical
importance of care coordination and navigation in the behavioral
health system. She noted that the challenges identified in
reports and community feedback highlight this as a fundamental
area for progress. Utilizing Emergency Department data, the goal
is to assign care coordinators to high-need youth and young
adults, ensuring timely connection to services and preventing
the escalation to higher levels of care due to gaps in support.
Provider support was also a central theme. Providers statewide
expressed the need to enhance their capacity to serve youth
effectively. She commended Alaskans' commitment to improving
youth services, highlighting the value of this collaborative
process. To address these needs, the Division of Behavioral
Health plans to procure a contract with a behavioral health
organization to expand training and support for current
providers, assist new providers, and add services statewide.
This contract will focus on addressing regional gaps by building
capacity to meet specific local needs, ensuring providers have
the resources to effectively support their communities.
4:05:41 PM
CHAIR WILSON asked if the Department still maintains a platform
where licensed Residential Child Care and Youth (RCCY) providers
can log in to update their daily bed census, noting that such a
system existed previously. He inquired if this process has since
changed or been discontinued.
MS. VAN KIRK explained that the Division of Public Health
previously had a contract allowing providers to enter bed
registry and utilization information. She noted that a new
Request for Proposals (RFP) was issued, and the Department is
currently finalizing a provider for the bed registry service.
This system is considered important for enabling providers to
share real-time information, serving as a referral access point.
CHAIR WILSON asked if there is currently an active website or
link where one can view bed utilization and availability
statewide, or if this service is presently on pause. He then
commented that the department's reaction is indicating the
answer is yes.
4:07:06 PM
MS. VAN KIRK moved to slide 13 and emphasized that this project
aimed to create a clear, informed path forward by integrating
insights from background assessments and input from providers,
tribal health representatives, stakeholders, parents, and State
Departments to identify system gaps. She announced that the
Behavioral Health Roadmap for Alaska's youth will be published
on May 1 and expressed optimism about the upcoming work to build
a system that effectively meets the needs of Alaska's youth.
CHAIR WILSON thanked the presenters.
4:08:10 PM
At ease
HB 371-MEDICAL REVIEW ORGANIZATIONS
4:09:52 PM
CHAIR WILSON reconvened the meeting and announced the
consideration of HOUSE BILL NO. 371 "An Act relating to medical
review organizations; relating to the definitions of 'health
care provider' and 'review organization'; and relating to the
duties of the chief medical officer in the Department of
Health."
4:10:20 PM
JAMES SEXTON, Staff, Representative Justin Ruffridge, Alaska
State Legislature, Juneau, Alaska, introduced HB 371 on behalf
of the sponsor, paraphrasing the sponsor statement:
[Original punctuation provided.]
HB 371 Sponsor Statement
"An Act relating to medical review organizations;
relating to the definition of 'health care provider'
and 'review organization'; and relating to the duties
of the chief medical officer in the Department of
Health."
The purpose of House Bill 371 is to modify public
health review organizations to improve the review
committee process and prevent and reduce avoidable
deaths, injuries, and illnesses of Alaskans.
Review organizations (also known as review committees)
conduct a thorough review of deaths, injuries, and
illnesses by examining clinical and other records to
identify areas of concern and recommend interventions
and improvements to services to improve health
outcomes of Alaskans. Review organizations that are
recognized in Alaska law (AS 18.23) include hospitals,
clinics, associations of health care providers,
professional standards organizations, the State
Medical Board, health care accreditation
organizations, and those established by the
Commissioner of Health to review public health issues
regarding morbidity and mortality.
This bill clarifies the sharing of information from
the review organizations if it does not violate
federal or state confidentiality laws; provides a
definition of health care provider rather than a
specific list of provider types; changes the
designation of who can approve Department of Health
morbidity or mortality review committees from the
Alaska State Medical Board to the Department of Health
Chief Medical Officer; modifies the membership of
Department of Health review committees by removing the
requirement that composition of the committee be 75
percent health care providers; and allows all
nationally-recognized groups that accredit health care
organizations to have review organizations.
This bill over time will improve the composition of
the review organizations to better inform public
policy and improve Alaskan's health.
Please join me in support of House Bill 371.
4:12:33 PM
SABINA BRAUN, Staff, Representative Justin Ruffridge, Alaska
State Legislature, Juneau, Alaska, a brief presentation for HB
371. She moved to slide 2 discussed the why, how, and who of
medical review organizations:
[Original punctuation provided.]
Medical Review Organizations
Why To review injuries, deaths, and illness in order
to provide insight for public policy and health
interventions to improve Alaskan's health.
How In-depth review of deaths, injuries, and
illnesses by examining clinical records and additional
data.
Who Hospitals, clinics, associations of health care
providers, professional standards organizations, the
State Medical Board, health care accreditation
organizations, and those established by the
Commissioner of Health to review public health issues.
4:13:13 PM
MS. BRAUN moved to slide 3 and said Alaska has 3 medical review
organizations:
[Original punctuation provided.]
Public Health Review Committee
Examples
Maternal Child Death Review Committee
All cases of infant, child, and maternal death.
Overdose Fatality Review Committee
Sample of cases where primary cause of death was drug-
related.
Congenital Syphilis Review Board
Sample of congenital syphilis cases.
4:13:32 PM
MS. BRAUN moved to slide 4 and said the intent of HB 371 is to
streamline the medical review organizations review process
making it more effective, with the goal of reducing avoidable
death and injury among Alaskans:
[Original punctuation provided.]
Intent
Modify public health organizations to improve the
committee process.
Support a more efficient process that ensures
appropriate representation of staff, partners, and
external experts.
Better utilize the review committee process to prevent
and reduce avoidable deaths and injuries.
4:13:43 PM
MS. BRAUN moved to slide 5 and discussed the following point
regarding current statute:
[Original punctuation provided.]
Current Statutes
• Current statute is ambiguous as to whether medical
review organizations can publish reports.
• Current definition of healthcare provider in the bill
is very narrow.
• The Alaska State Medical Board approves medical review
organizations.
• Current statute requires 75 percent of membership be
healthcare providers.
• Current statute only allows one accrediting
organization to accredit medical review organizations.
4:14:36 PM
MS. BRAUN moved to slide 6 and said HB 371 would do the
following:
[Original punctuation provided.]
HB 371
• Allows a review organization to publish a report
containing data or information acquired in the
exercise of its duties, ensuring the report does
not violate federal or state law regarding
confidentiality of a person or decedent.
• This bill removes the current list of healthcare
providers allowed to be on the review committee.
• This bill modifies the requirement of the health
care committee of having 75 percent health care
providers.
• Changes who can approve Department of Health
morbidity or mortality review organizations from
the Alaska State Medical Board to the Chief
Medical Officer in the Department of Health.
• Broadens who can establish review organizations.
4:15:57 PM
CHAIR WILSON clarified that HB 371, on page 2, line 17, proposes
replacing the current, narrow list of healthcare providers with
a broader definition: "a person licensed, certified, or
otherwise permitted by law to provide health care services in
the ordinary course of business or practices of the profession."
He emphasized that this change still applies to healthcare
providers but broadens the definition to include more healthcare
providers. He wanted the public to understand that the intent is
not to expand beyond healthcare professionals to unrelated
fields, such as attorneys or others on the committee.
4:16:36 PM
MS. BRAUN agreed.
4:16:46 PM
MS. BRAUN provided the sectional analysis for HB 371:
[Original punctuation provided.]
House Bill 371
Sectional Analysis
"An Act relating to medical review organizations;
relating to the definitions of 'health care provider'
and 'review organization'; and relating to the duties
of the chief medical officer in the Department of
Health."
Section 1 AS 18.23.030(a) is amended to add an
exemption to disclosure of data and is
described in Sec 2.
Section 2 AS 18.23.030 is amended to add a new
subsection allowing a review organization
to publish a report containing data or
information acquired in the exercise of its
duties, ensuring the report does not
violate federal or state law regarding
confidentiality of a person or decedent.
Section 3 AS 18.23.070(3) Changes the definition of
healthcare provider in reference to a
review organization to mean a person
licensed, certified, or otherwise permitted
by law to provide health care services in
the ordinary course of business or practice
of a profession and removes the list of
specific provider types.
Section 4 AS 18.23.070(5)(A) and AS.18.23.070(5)(B)
are not modified by HB 371.
AS 18.23.070(5)(C) The review organization
membership is approved by the Chief Medical
Officer in the Department of Health and
removes the provision that at least 75
percent of the committee members must be
health care providers.
AS 18.23.070(5)(D) Allows all nationally-
recognized groups that accredit health care
organizations to have review organizations.
Current law limits this to the Joint
Commission on Accreditation of Healthcare
Organizations (JCAHO).
4:18:25 PM
CHAIR TOBIN asked whether there is currently a review
organization that evaluates deaths within the Division of
Corrections; and whether Section 2, if applied to an existing or
future review organization, could aid in understanding the
significant number of inmate deaths occurring within the
Division of Corrections.
MS. BRAUN stated that there is currently no medical review
organization dedicated to evaluating deaths within the
Department of Corrections. She expressed hope that HB 371 might
help streamline the process and potentially enable the
establishment of such a review organization and deferred the
question.
4:19:52 PM
LINDSEY KATO, Director, Division of Public Health, Department of
Health, Juneau, Alaska, explained that HB 371 aims to expand
participation in review organizations. Under current statute,
requiring the review organization be 75 percent healthcare
providers limits the ability to form a comprehensive assessment
team for a Department of Corrections review. Expanding
eligibility would allow involvement from non-healthcare
providers, such as correctional officers, reentry coalition
members, and individuals with lived experience, whose
perspectives could significantly enhance the review process.
4:21:02 PM
CHAIR WILSON opened public testimony on HB 371.
4:21:23 PM
CARMEN WENGER, Director of Programs, All Alaska Pediatric
Partnership (A2P2), Anchorage, Alaska, testified in support of
HB 371. Representing a statewide nonprofit focused on health and
wellness solutions for Alaska's children and families, she
expressed support for HB 371. She stated that HB 371 will help
prevent and reduce avoidable deaths, injuries, and illnesses,
benefiting Alaskan's overall health, particularly for mothers
and children. HB 371 clarifies the protocols for sharing and
publishing reports and recommendations from medical review
organizations while ensuring compliance with federal and state
confidentiality laws. Additionally, removing the 75 percent
healthcare provider composition requirement allows for a more
interdisciplinary team approach, aligning with best practices in
medical and public health fields. A2P2 supports HB 371 for its
potential to enhance health outcomes, inform policy, and reduce
preventable harm to Alaskan families.
4:23:09 PM
CHAIR WILSON closed public testimony on HB 371.
4:23:21 PM
CHAIR WILSON held HB 371 in committee.
4:23:35 PM
At ease
HB 89-CHILD CARE: TAX CREDITS/ASSISTANCE/GRANTS
4:26:10 PM
CHAIR WILSON reconvened the meeting and announced the
consideration of CS FOR HOUSE BILL NO. 89(FIN) "An Act relating
to education tax credits for certain payments and contributions
for child care and child care facilities; relating to the
insurance tax education credit, the income tax education credit,
the oil or gas producer education credit, the property tax
education credit, the mining business education credit, the
fisheries business education credit, and the fisheries resource
landing tax education credit; renaming the day care assistance
program the child care assistance program; relating to the child
care assistance program and the child care grant program;
providing for an effective date by amending the effective date
of secs. 1, 2, and 21, ch. 61, SLA 2014; and providing for an
effective date."
4:26:49 PM
EDRA MORLEDGE, Staff, Representative Julie Coulombe, Alaska
State Legislature, Juneau, Alaska, provided a brief overview by
sharing the first paragraph of the sponsor statement:
[Original punctuation provided.]
House Bill 89 is a workforce bill that aligns with the
Governor's Child Care Task Force on Child Care
recommendations. This bill will incentivize the
private sector to offer child care benefits to their
employees to fill jobs essential for economic growth,
expand the number of families that can access
assistance, and aligns funding to the actual cost of
care.
4:27:49 PM
CHAIR WILSON found no questions and solicited a motion.
4:27:57 PM
SENATOR TOBIN moved to adopt Amendment 1, work order 33-
LS0518\U.8, to HB 89.
33-LS0518\U.8
Dunmire/Bergerud
4/1/24
AMENDMENT 1
OFFERED IN THE SENATE BY SENATOR TOBIN
TO: CSHB 89(FIN)
Page 20, line 31:
Delete "Each"
Insert "A [EACH]"
Page 21, line 1, following "shall":
Insert "(1)"
Page 21, line 4, following "only":
Insert ";
(2) give priority to children from low-
income families when filling available child
care spaces in the facility"
Page 21, line 5:
Delete "a new subsection"
Insert "new subsections"
Page 21, following line 12:
Insert a new subsection to read:
"(j) A child care facility receiving a
grant under (a) or (d) of this section may not
deny a child acceptance to the facility based on
disability or socioeconomic status or suspend or
expel a child from the facility."
4:28:05 PM
CHAIR WILSON objected for purposes of discussion.
4:28:07 PM
SENATOR TOBIN explained that Amendment 1 makes several changes
to HB 371 and began with a general overview of tax credits. She
clarified that tax credits allow a company to use funds it would
owe in taxes for the public good, essentially turning these
funds into public dollars. Drawing a comparison to Multnomah
County's preschool-for-all model, she described how the county
uses a public-voted tax to subsidize child care for all
children, with specific stipulations for equitable access
regardless of background, language, developmental needs, income,
or housing stability. She noted that while HB 89 supports
employers establishing childcare facilities for employees.
4:31:06 PM
SENATOR TOBIN said Amendment 1 adds a provision to HB 89 on page
21, line 17, by prioritizing access for low-income families to
any unfilled slots. This is particularly important for children
in her district, many of whom are from low-income families
unable to benefit from the proposed subsidies. The amendment
also adds language to prevent childcare facilities using public
funds from denying access to children based on disability or
socioeconomic status, and it prohibits suspensions or expulsions
from these facilities. Citing Multnomah County's model, she
emphasized that prohibiting suspensions and expulsions provides
stability for families and prevents discrimination, asserting
that these conditions are essential when public dollars support
a facility.
4:32:05 PM
SENATOR GIESSEL expressed concern that Amendment 1 would prevent
childcare facilities from expelling or suspending a child who is
causing harm to others. She emphasized that this is a serious
issue for her and stated she could not support the amendment
under these conditions.
SENATOR TOBIN said she would be happy to consider an amendment
to the amendment.
4:32:42 PM
At ease
4:33:43 PM
CHAIR WILSON reconvened the meeting.
4:33:48 PM
SENATOR GIESSEL moved to adopt a Conceptual Amendment to
Amendment 1 (U.8). She proposed the removal of line 21, which
reads "or suspend or expel a child from the facility."
4:34:07 PM
CHAIR WILSON found no objection and the Conceptual Amendment to
Amendment 1 was adopted.
4:34:12 PM
CHAIR WILSON asked if there was further discussion on Amendment
1, as amended.
4:34:27 PM
CHAIR WILSON said for reference purposes he hoped that the next
committee of referral would create an amendment defining low-
income for the purpose of giving priority to low-income families
when filling available slots at facilities.
4:35:08 PM
SENATOR WILSON removed his objection and found no further
objection.
4:35:18 PM
CHAIR WILSON announced that Amendment 1 (U.8), as amended, was
adopted.
4:35:25 PM
CHAIR WILSON moved to adopt Amendment 2, work order 33-
LS0518\U.9, to HB 89.
33-LS0518\U.9
Bergerud
3/29/24
AMENDMENT 2
OFFERED IN THE SENATE BY SENATOR WILSON
TO: CSHB 89(FIN)
Page 19, line 2, following "size":
Insert ", unless the family is otherwise exempt
from income eligibility requirements"
4:35:41 PM
SENATOR KAUFMAN object for purpose of discussion.
4:35:59 PM
LEAH VAN KIRK, Health Care Policy Advisor, Office of the
Commissioner, Department of Health, Juneau, Alaska, explained
that Amendment 2 aims to align the current system with proposed
changes. She noted that some families qualify for eligibility
based on federal criteria, such as foster care status or receipt
of public benefits. Amendment 2 is intended to preserve these
federally regulated eligibility criteria, ensuring that these
families continue to qualify under the updated system.
4:37:04 PM
SENATOR KAUFMAN removed his objection.
4:37:12 PM
CHAIR WILSON found no further objection and Amendment 2 (U.9)
was adopted.
4:37:16 PM
CHAIR WILSON solicited a motion.
4:37:17 PM
SENATOR TOBIN moved to adopt Amendment 3, work order 33-
LS0518\U.10, to HB 89.
33-LS0518\U.10
Bergerud
4/9/24
AMENDMENT 3
OFFERED IN THE SENATE BY SENATOR TOBIN
TO: CSHB 89(FIN)
Page 20, line 27:
Delete "and"
Insert "[AND]"
Page 20, line 29, following "section":
Insert "; and
(4) be designated as a quality child care
facility by the department"
Page 21, following line 4:
Insert a new bill section to read:
"* Sec. 33. AS 47.25.071(h) is amended to read:
(h) The department shall, in consultation with a
child care resource and referral agency in the state
[INTERESTED CHILD CARE PROVIDERS] and parents, adopt
regulations to carry out the purposes of this section,
including criteria used to designate a child care
facility as a quality child care facility under (b)(4)
of this section."
Renumber the following bill sections accordingly.
Page 22, line 21:
Delete "sec. 40"
Insert "sec. 41"
4:37:21 PM
CHAIR WILSON objected for purposes of discussion.
4:37:24 PM
SENATOR TOBIN explained that Amendment 3 incorporates
discussions from the Child Care Task Force regarding the
definition of "quality" in child care facilities. She noted that
while "quality" is frequently emphasized by child care providers
and Department of Health representatives, a clear and measurable
definition is still under development in regulation. Amendment 3
ensures that any facility receiving subsidies must be designated
as a quality child care facility by the department. She
clarified that Amendment 3 does not define "quality" directly;
instead, it ensures that the Department of Health, in
consultation with child care resource and referral agencies,
develops the definition collaboratively, based on stakeholder
expertise and experience. She reiterated that as public funds in
the form of tax credits are used, it is important to set a high
standard, requiring facilities receiving subsidies to meet a
defined quality level that reflects the community's needs and
expectations.
4:39:46 PM
CHAIR WILSON said the bill sponsor had statements.
4:39:55 PM
ELEILIA PRESTON, Staff, Representative Julie Coulombe, Alaska
State Legislature, Juneau, Alaska, acknowledged that the intent
of Amendment 3 is to ensure high-quality childcare because it is
beneficial, and everyone wants children to have the best
possible experience. However, she expressed concern that adding
new regulations could exacerbate challenges in areas already
experiencing a childcare shortage, or "childcare desert." She
said her hesitation stemmed from the possibility that these
additional requirements might impose unnecessary regulatory
burdens.
4:41:03 PM
MS. VAN KIRK shared insights from the recent in-person
Governor's Task Force meeting, where there was a robust
discussion on integrating quality into the childcare licensing
process. She emphasized that the childcare grant being discussed
applies to providers who are already licensed or approved, with
grant funds based on child attendance. Licensing itself serves
as a baseline indicator of quality, and since 2016, the
Department has further supported quality through the "Learn &
Grow" system, a quality recognition and improvement program that
has standards built into it. Different from accreditation, the
system provides coaching, cohort support, and incentives based
on achievement levels. She noted that during the Task Force
discussion, members emphasized the importance of not undermining
existing supports that providers depend on. The Child Care
Grant, while small (capped at $50 per child), is essential to
many providers. The Task Force recommended maintaining the
current grant formula but adding incentives for providers
participating in "Learn & Grow," allowing them to qualify for
additional funding if they meet Level 1 criteria of the program
delivered by Thread.
4:43:44 PM
SENATOR DUNBAR expressed support for the Amendment 3, noting it
addresses some of his areas of interest. He shared that he
recently met with childcare providers in critical need of
additional funding, who advocated for Amendment 90 to
significantly raise the grant amount. He asked if Amendment 90
passed on the floor.
MS. VAN KIRK indicated that it did not pass.
4:44:18 PM
SENATOR DUNBAR stated that is unfortunate that it did not pass,
noting that there has been opportunity to directly increase
funding as described, but it has not yet passed. He said he
finds this concerning. He also inquired about the source of the
current $50 per child, asking where the money comes from.
4:44:49 PM
MS. VAN KIRK explained that funding for the Child Care grant is
sourced from federal funds, with some money set aside
specifically for quality initiatives.
4:45:16 PM
CHAIR WILSON pointed out that in HB 89, Section 34, the
eligibility criteria for childcare facility grants could include
home childcare providers who are not family members or
relatives. He emphasized the importance of ensuring that these
grants and quality-related resources are also accessible to
smaller home-based providers who may lack the financial
resources available to larger daycare centers.
4:45:58 PM
MS. VAN KIRK clarified that this funding supports both licensed
childcare homes and childcare centers. She noted that the Child
Care grant is available to all licensed facilities, provided
they accept children who receive a subsidy.
4:46:27 PM
SENATOR DUNBAR expressed his support for Amendment 3,
emphasizing the importance of maintaining quality in childcare.
While he acknowledged concerns about the supply of childcare
services, he noted that there are other strategies to increase
supply alongside quality improvements. He mentioned a recent
measure aimed at expanding supply that unfortunately did not
pass but expressed optimism about future opportunities to
address these issues.
4:47:07 PM
CHAIR WILSON expressed concern that Amendment 3 might lead to
additional costs added to the Department of Education's fiscal
notes. He noted that HB 89 already includes regulatory
requirements and hopes DEED can absorb these costs within the
current fiscal notes attached to the legislation. He cautioned
that the Department often seeks extra funding for tasks it is
already handling.
4:47:57 PM
SENATOR TOBIN clarified that Amendment 3 requires facilities to
be designated as "quality childcare facilities" without
mandating a specific definition of quality. She noted that the
department currently views licensure as the first level of
quality, meaning that licensed facilities already meet initial
expectations. She added that the department is actively working
with early childhood organizations to develop the Alaska System
for Early Education Development (SEED) Program, which really
helps build levels of quality. She suggested that a recognition
program, such as a system of stickers indicating different
levels of achievement, could incentivize facilities to progress
through tiers of quality. This would encourage ongoing
professional development and adherence to standards while
showcasing commitment to high-quality care. She emphasized that
Amendment 3 should not impose additional burdens, as it aligns
with existing efforts that she would like codified to encourage
childcare providers to seek additional levels of quality
standards.
4:49:44 PM
CHAIR WILSON removed his objection; finding no further
objection, Amendment 3 (U.10) was adopted.
4:50:00 PM
SENATOR DUNBAR said he distributed to members a legal memo that
he received at 3:00 pm. He said the memo made some assumptions.
He noted that HB 89 has a $6 million fiscal note and asked for
clarification on whether HB 89 includes only tax credits or also
increases the amount of direct subsidy provided through the
grant program.
4:50:41 PM
MS. VAN KIRK clarified that HB 89 does increase the amount of
subsidies. The current subsidy program, which administers
federal funds, operates through an indirect approach; federal
assistance is considered indirect because eligibility is
determined by the beneficiary, who then selects their provider.
SENATOR DUNBAR acknowledged the information and asked if the
expanded program using state dollars will continue with the
indirect approach or adopt a more direct approach with
providers.
4:51:33 PM
MS. VAN KIRK said it would it the same mechanism and approach
currently used.
SENATOR DUNBAR asked if HB 89 passes, would the program have
state dollars in addition to federal dollars.
4:51:54 PM
MS. VAN KIRK explained that federal funds currently provide
approximately $17 million in subsidies, and the state general
funds indicated in the fiscal note would be an addition.
4:52:10 PM
SENATOR DUNBAR expressed support for supplementing the program
with state general funds but noted that it changes the "color"
of the funding. He highlighted that the legal memo addresses
only the constitutionality of tax credits, noting that while tax
credits are confirmed constitutional, the memo does not fully
apply to the direct subsidy aspect introduced by state funds. He
then inquired about the nature of services provided by these
childcare facilities, asking if they include educational
instruction or simply focus on child supervision and safety
during care hours.
MS. VAN KIRK explained that childcare facilities operate under
licensing requirements focused on health, safety, and
maintaining a quality environment. She clarified that there is
no defined or required educational curriculum for childcare
facilities.
4:53:28 PM
SENATOR DUNBAR asked even if educational instruction is not
required does it does it occur in child care facilities.
MS. VAN KIRK explained that early childhood education in
childcare facilities is less formal and does not involve a
structured curriculum as seen in schools. Instead, learning
happens through activities like play, motor skill development,
and engaging with stimulating environments, all of which support
children's growth and readiness for school. While childcare
facilities are not classified as educational institutions and
are not regulated by the Department of Education and Early
Development, they still foster foundational learning through
these developmental activities.
4:55:03 PM
SENATOR DUNBAR noted that, according to the legal memo,
childcare facilities are not considered educational
institutions, though he finds it interesting that they
essentially function as preschools. He stated that although he
is not on the task force, his experience, including his role on
the Anchorage Assembly, suggests a shift toward making these
facilities more instructional and school-preparatory. He shared
that a childcare provider he recently met uses a curriculum,
indicating a move toward structured early education. He asked if
encouraging more instructional elements and moving beyond mere
supervision accurately represents the intent behind these
efforts.
4:56:05 PM
MS. VAN KIRK responded that the goal is to create an environment
for children that is healthy, safe, and supportive of their
developmental stages, providing a critical foundation for future
learning and school readiness. She clarified that there are no
formal educational requirements in childcare licensing or within
the childcare sector.
4:56:45 PM
CHAIR WILSON asked Senator Dunbar if he is focusing more on pre-
K rather than general childcare, noting that childcare typically
serves children from infancy onward. He suggested that pre-K,
which some school districts offer, may differ from general
childcare in its educational intent and structure.
4:57:08 PM
SENATOR DUNBAR asked what for the age range of child care.
4:57:16 PM
MS. VAN KIRK replied that the age range for child care is zero
to 12 years old.
SENATOR DUNBAR raised concerns about the constitutionality of
using public funds for religious schools through this program,
noting that Alaska's constitution strongly prohibits public
dollars from funding religious education, even more so than
federal guidelines. He pointed out that while tax credits are
constitutionally permissible, the inclusion of direct subsidies
could raise issues if funds go toward religious instruction in a
school-like setting. He said after researching and consulting
with others, he found that while most providers are influenced
by religious valueswhich he believes is constitutionally
acceptablesome might engage in direct religious instruction. He
proposed a potential amendment to specify that grant funding
from this program may not be used for religious instruction. He
asked if this type of amendment would impact providers, as it
seems that most do not currently engage in direct religious
instruction.
4:59:29 PM
MS. VAN KIRK noted that she may need to consult additional
resources to fully address the question, emphasizing that she is
not a lawyer. She explained that, under the federal subsidy
system, funds are allocated indirectly, with the parent or
beneficiary selecting the provider, which aligns with federal
guidelines. She added that childcare licensing is regulated by
the Department of Health rather than the Department of
Education. She offered to gather more information and follow up
on the legal aspects raised.
5:00:34 PM
SENATOR DUNBAR clarified that he is not questioning the ability
of religious organizations to provide childcare or general
education. His concern is specifically about public funds being
used for religious instruction. He asked for the Department's
perspective on whether this practice aligns with constitutional
guidelines and suggested that input from the Department of Law
might be helpful.
5:01:08 PM
SENATOR GIESEL shared her perspective as a parent of three and a
volunteer with foster care organizations, emphasizing that
childcare inherently involves teaching and supporting
developmental milestones, even if the facility is not formally
labeled as educational. She noted that infants, for example,
learn trust, while toddlers learn boundaries, all of which
constitute developmental guidance. She highlighted the
importance of cultural and religious alignment, noting that
families often choose childcare providers that reflect their
values and beliefs, creating a substitute environment that feels
like an extension of their own. She urged the department,
directing her comments to Ms. Van Kirk, to consider these
factors in drafting regulations and policies, balancing the need
for quality standards with respect for parental choice. She
emphasized that families should be able to select a provider
that aligns with their cultural and developmental needs while
still qualifying for financial support.
5:04:02 PM
CHAIR WILSON solicited the will of the committee.
5:04:09 PM
SENATOR KAUFMAN moved to report HB 89, work order 33-LS0518\U,
as amended, from committee with individual recommendations and
attached fiscal note(s).
5:04:24 PM
CHAIR WILSON found no further objection and SCS CSHB 89(HSS),
was reported from the Senate Health and Social Services Standing
Committee.
5:04:51 PM
There being no further business to come before the committee,
Chair Wilson adjourned the Senate Health and Social Services
Standing Committee meeting at 5:04 p.m.
| Document Name | Date/Time | Subjects |
|---|---|---|
| HB 371 v. A.pdf |
SHSS 4/11/2024 3:30:00 PM |
HB 371 |
| HB 371 Sponsor Presentation.pdf |
SHSS 4/11/2024 3:30:00 PM |
HB 371 |
| HB 371 Sponsor Statement.pdf |
SHSS 4/11/2024 3:30:00 PM |
HB 371 |
| HB 371 Sectional Analysis.pdf |
SHSS 4/11/2024 3:30:00 PM |
HB 371 |
| HB 371 Fiscal Note.pdf |
SHSS 4/11/2024 3:30:00 PM |
HB 371 |
| HB 371 LOS ANTHC.PDF |
SHSS 4/11/2024 3:30:00 PM |
HB 371 |
| HCR015A.pdf |
SHSS 4/11/2024 3:30:00 PM |
HCR 15 |
| HCR15 Sponsor Statement 04.01.24.pdf |
SHSS 4/11/2024 3:30:00 PM |
HCR 15 |
| HCR 15 Fiscal Note LEG-SESS.pdf |
SHSS 4/11/2024 3:30:00 PM |
HCR 15 |
| HCR 15 Support Document TDAW Infographic.pdf |
SHSS 4/11/2024 3:30:00 PM |
HCR 15 |
| HCR 15 Support Document Mental Health and TD Factsheet.pdf |
SHSS 4/11/2024 3:30:00 PM |
HCR 15 |
| 4.11.24 DOH Presentation BH Roadmap.pdf |
SHSS 4/11/2024 3:30:00 PM |
SHSS 4.11.24 DOH Behavioral Health Roadmap for Alaska Youth |
| HB89 DOH responses to SHSS questions.pdf |
SHSS 4/11/2024 3:30:00 PM |
HB 89 |
| HB 89 Legal Memo to Dunbar (24-192mis).pdf |
SHSS 4/11/2024 3:30:00 PM |
HB 89 |
| HB 89 LOS Allmeroth.pdf |
SFIN 4/23/2024 9:00:00 AM SHSS 4/11/2024 3:30:00 PM |
HB 89 |
| HCR 15 NAMI Alaska testimony 4.11.24.pdf |
SHSS 4/11/2024 3:30:00 PM |
HCR 15 |
| HB 89 Amendments Nos. 1-3 - adopted 4.11.24.pdf |
SHSS 4/11/2024 3:30:00 PM |
HB 89 |