04/23/2024 03:30 PM Senate HEALTH & SOCIAL SERVICES
| Audio | Topic |
|---|---|
| Start | |
| HB17 | |
| HB371 | |
| SB231 | |
| Adjourn |
+ teleconferenced
= bill was previously heard/scheduled
| + | TELECONFERENCED | ||
| += | HB 17 | TELECONFERENCED | |
| += | HB 371 | TELECONFERENCED | |
| += | SB 231 | TELECONFERENCED | |
ALASKA STATE LEGISLATURE
SENATE HEALTH AND SOCIAL SERVICES STANDING COMMITTEE
April 23, 2024
3:31 p.m.
DRAFT
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
COMMITTEE SUBSTITUTE FOR HOUSE BILL NO. 17(HSS) AM(EFD FLD)
"An Act relating to insurance coverage for contraceptives and
related services; and relating to medical assistance coverage
for contraceptives and related services."
- MOVED SCS CSHB 17(HSS) OUT OF COMMITTEE
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."
- MOVED HB 371 OUT OF COMMITTEE
SENATE BILL NO. 231
"An Act relating to residential psychiatric treatment centers;
and providing for an effective date."
- HEARD & HELD
PREVIOUS COMMITTEE ACTION
BILL: HB 17
SHORT TITLE: CONTRACEPTIVES COVERAGE:INSURE;MED ASSIST
SPONSOR(s): REPRESENTATIVE(s) CARRICK
01/19/23 (H) PREFILE RELEASED 1/9/23
01/19/23 (H) READ THE FIRST TIME - REFERRALS
01/19/23 (H) HSS, CRA, L&C, FIN
02/07/23 (H) HSS AT 3:00 PM DAVIS 106
02/07/23 (H) Heard & Held
02/07/23 (H) MINUTE(HSS)
02/18/23 (H) HSS AT 3:00 PM DAVIS 106
02/18/23 (H) -- MEETING CANCELED --
03/02/23 (H) HSS AT 3:00 PM DAVIS 106
03/02/23 (H) Moved CSHB 17(HSS) Out of Committee
03/02/23 (H) MINUTE(HSS)
03/07/23 (H) HSS AT 3:00 PM DAVIS 106
03/07/23 (H) Moved CSHB 17(HSS) Out of Committee
03/07/23 (H) MINUTE(HSS)
03/08/23 (H) HSS RPT CS(HSS) 3DP 2NR
03/08/23 (H) DP: RUFFRIDGE, SUMNER, MINA
03/08/23 (H) NR: SADDLER, PRAX
03/16/23 (H) CRA AT 8:00 AM BARNES 124
03/16/23 (H) Heard & Held
03/16/23 (H) MINUTE(CRA)
03/17/23 (H) FIN REFERRAL REMOVED
03/17/23 (H) BILL REPRINTED
03/21/23 (H) CRA AT 8:00 AM BARNES 124
03/21/23 (H) Moved CSHB 17(HSS) Out of Committee
03/21/23 (H) MINUTE(CRA)
03/22/23 (H) CRA RPT CS(HSS) 5DP 1NR
03/22/23 (H) DP: HIMSCHOOT, MEARS, MCKAY, RUFFRIDGE,
MCCORMICK
03/22/23 (H) NR: MCCABE
03/27/23 (H) L&C AT 3:15 PM BARNES 124
03/27/23 (H) Heard & Held
03/27/23 (H) MINUTE(L&C)
03/31/23 (H) L&C AT 3:15 PM BARNES 124
03/31/23 (H) Moved CSHB 17(HSS) Out of Committee
03/31/23 (H) MINUTE(L&C)
04/03/23 (H) L&C RPT CS(HSS) 2DP 3NR
04/03/23 (H) DP: CARRICK, SUMNER
04/03/23 (H) NR: RUFFRIDGE, PRAX, WRIGHT
05/17/23 (H) ADJOURNED - ON 1/16/2024 CALENDAR
01/16/24 (H) RETURNED TO RLS COMMITTEE
03/22/24 (H) CALL FOR THE QUESTION
03/22/24 (H) TRANSMITTED TO (S)
03/22/24 (H) VERSION: CSHB 17(HSS) AM(EFD FLD)
03/25/24 (S) READ THE FIRST TIME - REFERRALS
03/25/24 (S) HSS, L&C
04/16/24 (S) HSS AT 3:30 PM BUTROVICH 205
04/16/24 (S) Heard & Held
04/16/24 (S) MINUTE(HSS)
04/23/24 (S) HSS AT 3:30 PM BUTROVICH 205
BILL: HB 371
SHORT TITLE: MEDICAL REVIEW ORGANIZATIONS
SPONSOR(s): REPRESENTATIVE(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
04/11/24 (S) Heard & Held
04/11/24 (S) MINUTE(HSS)
04/23/24 (S) HSS AT 3:30 PM BUTROVICH 205
BILL: SB 231
SHORT TITLE: MINORS & RESIDENT PSYCH TREATMENT CENTERS
SPONSOR(s): SENATOR(s) CLAMAN
02/14/24 (S) READ THE FIRST TIME - REFERRALS
02/14/24 (S) HSS
03/26/24 (S) HSS AT 3:30 PM BUTROVICH 205
03/26/24 (S) Heard & Held
03/26/24 (S) MINUTE(HSS)
04/23/24 (S) HSS AT 3:30 PM BUTROVICH 205
WITNESS REGISTER
REPRESENTATIVE ASHLEY CARRICK
District 35
Alaska State Legislature
Juneau, Alaska
POSITION STATEMENT: Sponsor of HB 17.
LORI WING-HEIER, Director
Division of Insurance
Department of Commerce, Community and
Economic Development (DCCED)
Anchorage, Alaska
POSITION STATEMENT: Explained Amendment 1 (U.1).
REPRESENTATIVE JUSTIN RUFFRIDGE, District 7
Alaska State Legislature
Juneau, Alaska
POSITION STATEMENT: Sponsor of HB 371
SABINA BRAUN, Staff
Representative Justin Ruffridge
Alaska State Legislature
Juneau, Alaska
POSITION STATEMENT: Commented on HB 371.
SENATOR MATT CLAMAN, District H
Alaska State Legislature
Juneau, Alaska
POSITION STATEMENT: Sponsor of SB 231
TRACY DOMPELING, Director
Division of Behavioral Health
Department of Health
Juneau, Alaska
POSITION STATEMENT: Testified on SB 231
RENEE GAYHART, Director
Division of Health Care Services
Department of Health
Juneau, Alaska
POSITION STATEMENT: Testified on SB 231.
ACTION NARRATIVE
3:31:44 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 Tobin, Kaufman, Giessel, Dunbar, and
Chair Wilson.
HB 17-CONTRACEPTIVES COVERAGE:INSURE;MED ASSIST
3:32:29 PM
CHAIR WILSON announced the consideration of CS FOR HOUSE BILL
NO. 17(HSS) am(efd fld) "An Act relating to insurance coverage
for contraceptives and related services; and relating to medical
assistance coverage for contraceptives and related services."
CHAIR WILSON stated that on March 12, 2024, the committee
adopted SCS CSHB 17, work order 33-LS0222\U, as the working
document.
3:33:11 PM
REPRESENTATIVE ASHLEY CARRICK, District 35, Alaska State
Legislature, Juneau, Alaska, explained that HB 17 reduces
barriers to contraceptive access by extending the current
coverage duration from one to three months up to 12 months.
3:33:53 PM
CHAIR WILSON solicited a motion.
3:33:56 PM
SENATOR TOBIN moved to adopt Amendment 1, work order 33-
LS0222\U.1, to SCS CSHB 17.
33-LS0222\U.1
Wallace
4/22/24
AMENDMENT 1
OFFERED IN THE SENATE
TO: SCS CSHB 17(HSS), Draft Version "U"
Page 1, line 1:
Delete the second occurrence of "and"
Page 1, line 2, following "services":
Insert "; and providing for an effective date"
Page 2, lines 7 - 9:
Delete all material and insert:
"(c) Except as provided in (d) of this section,
a health care insurer may not require cost sharing for
contraceptives or services covered under (a) of this
section when provided by a participating health care
provider or dispensing entity."
Page 2, lines 14 - 23:
Delete all material and insert:
"(e) A health care insurer that applies medical
management techniques, including step therapy or prior
authorization, must provide without delay a simple and
easy to understand exception procedure for a covered
person to access contraceptives covered under (a) of
this section."
Page 2, line 28, following "prescribed":
Insert "by a participating health care provider"
Page 3, lines 6 - 13:
Delete "A religious employer that opposes
coverage under this subsection shall provide a list of
the contraceptives or services described in (a) of
this section for which the religious employer opposes
coverage
(1) to each prospective enrollee in the
religious employer's health care insurance plan before
the enrollee's enrollment in the plan; and
(2) annually to all insureds enrolled in
the religious employer's health care insurance plan."
Page 7, following line 31:
Insert a new bill section to read:
"* Sec. 9. Section 1 of this Act takes effect
January 1, 2025."
3:34:00 PM
CHAIR WILSON objected for purposes of discussion.
3:34:03 PM
CHAIR TOBIN said that she wanted to ensure accurate information
was placed on the public record regarding Amendment 1 and may
seek assistance from Ms. Wing-Heier to answer questions. She
explained that Amendment 1 aligns HB 17 with Medicaid
regulations and highlighted that the substantive changes begin
on page 2, lines 7-9, as recommended by the Division of
Insurance. These changes help create a zero fiscal note,
eliminating any fiscal impact related to HB 17's intersection
with Medicaid. She also pointed out that changes to page 2,
lines 14-23 would remove the indeterminate fiscal note
previously attached to HB 17. Lastly, she stated that Amendment
1 would require religious employers to provide a list of
contraceptives or services they oppose to healthcare enrollees
before enrollment and annually thereafter, as outlined on page
3, lines 6-13.
3:37:25 PM
LORI WING-HEIER, Director, Division of Insurance, Department of
Commerce, Community and Economic Development (DCCED), Anchorage,
Alaska, explained the division's recommended changes in
Amendment 1 (U.1). She referred to HB 17, page 2, lines 7-9 and
14-23, explaining that under the Affordable Care Act, states
adopted essential health benefits, and adding to these benefits
such as proposed in HB 17requires the state to defray costs.
She noted that an indeterminate fiscal note was attached because
the Centers for Medicare and Medicaid Services (CMS) might
require the state to cover these costs. She noted that in
previous legislative sessions there were extensive discussions
to this point. Regarding changes for religious employers, she
stated that the division does not oppose the language but lacks
statutory authority to regulate religious employers or mandate
them to provide lists of covered contraceptive options to
employees. She emphasized that the division regulates insurance
companies, not employers, and these limitations informed the
recommended changes.
3:39:04 PM
REPRESENTATIVE CARRICK stated she supports the changes in
Amendment 1 (U.1). She said the changes are technical but
substantive and allow Hb 17 to take effect. She emphasized that
HB 17 was not intended to generate a fiscal note, and the change
in language will help it advance.
CHAIR WILSON removed his objection, found no further objection
and Amendment 1 (U.1) was adopted.
3:40:15 PM
CHAIR WILSON solicited the will of the committee.
3:40:19 PM
SENATOR KAUFMAN moved to report SCS CSHB 17, work order 33-
LS0222\U, as amended, from committee with individual
recommendations and attached fiscal note(s).
3:40:34 PM
CHAIR WILSON found no objection and SCS CSHB 17(HSS) was
reported from the Senate Health and Social Services Standing
Committee.
3:40:43 PM
At ease
HB 371-MEDICAL REVIEW ORGANIZATIONS
3:42:10 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."
3:42:42 PM
REPRESENTATIVE JUSTIN RUFFRIDGE, District 7, Alaska State
Legislature, Juneau, Alaska, explained that HB 371 aims to
adjust components of medical review organizations, which provide
recommendations and data on deaths, particularly those outside
the norm. He noted three such review boards currently exist in
the state, and mentioned maternal and childhood deaths, and
overdose deaths. The HB 371 seeks to expand eligibility for
board membership to individuals serving in medical roles and
transfers oversight from the state medical board to the chief
medical officer to enhance flexibility and efficiency. He added
that the HB 371 also mandates the creation of reports with
redacted confidential information, making data more accessible
to the public and relevant departments.
3:45:09 PM
SABINA BRAUN, Staff, Representative Justin Ruffridge, Alaska
State Legislature, Juneau, Alaska, added that the third review
organization in Alaska focuses on congenital syphilis.
3:45:33 PM
CHAIR WILSON solicited the will of the committee.
3:45:35 PM
SENATOR KAUFMAN moved to report HB 371, work order LS-331366\A,
from committee with individual recommendations and attached
fiscal note(s).
3:45:50 PM
CHAIR WILSON found no objection and HB 371 was reported from the
Senate Health and Social Services Standing Committee.
3:45:59 PM
At ease
SB 231-MINORS & RESIDENT PSYCH TREATMENT CENTERS
3:47:57 PM3:47:59 PM
CHAIR WILSON reconvened the meeting and announced the
consideration of SENATE BILL NO. 231 "An Act relating to
residential psychiatric treatment centers; and providing for an
effective date."
3:48:41 PM
SENATOR MATT CLAMAN, District H, Alaska State Legislature,
Juneau, Alaska, provided an overview of SB 231 and stated that
the legislation seeks to enhance the rights of minors receiving
inpatient psychiatric care in Alaska. It includes provisions for
one hour of weekly communication with a parent or guardian,
semi-annual inspections by the department, and reporting on the
use of seclusion and restraint in these facilities.
CHAIR WILSON said the sponsor of SB 231 requested a committee
substitute.
3:49:33 PM
CHAIR WILSON solicited a motion.
3:49:36 PM
SENATOR KAUFMAN moved to adopt the committee substitute (CS) for
SB 231, work order 33-LS1196\S, as the working document.
3:49:47 PM
CHAIR WILSON objected for purposes of discussion.
3:49:53 PM
SENATOR CLAMAN stated the following concerning changes to SB
231, versions A, B, and S:
[Original punctuation provided.]
There are three versions of SB 231 in front of you
today. Version A, which we discussed in the first
hearing on March 26th, Version B and Version S.
Version B integrated the feedback that came from the
first hearing but included an unintended limitation on
the applicability of SB 231. We corrected that
limitation in Version S.
3:50:17 PM
SENATOR CLAMAN continued:
[Original punctuation provided.]
Version A of SB 231 only applied to minors receiving
treatment at facilities licensed as residential
psychiatric treatment centers. In discussion with the
Department and other stakeholders, we learned that
residential psychiatric treatment centers are only one
type of license for facilities that provide inpatient
mental health care to minors. Some facilities are
currently licensed as specialty hospitals or
psychiatric hospitals. We wanted to ensure that all
facilities providing in-patient mental health
evaluation or treatment to minors are included in SB
231, regardless of a facility's current or future type
of license.
Version B of SB 231 expanded the bills application to
"treatment facilities"defined in AS 47.30.915 as a
hospital, clinic, institution, center, or other health
care facility that has been designated by the
department for the treatment or rehabilitation of
mentally ill persons. Then we received feedback from
the Department of Health and the Department of Family
& Community Services that the definition for treatment
facility in AS 47.30.915 is used specifically in
designating psychiatric treatment facilities for
involuntary admission. Using this definition of
treatment facility could unintentionally limit the
scope of SB 231.
Version S of SB 231 creates a new definition in
statute, defining treatment facility as a hospital,
clinic, institution, center, or other healthcare
facility licensed to provide inpatient mental health
evaluation or treatment to minors.
Both Version B and Version S include clarifications on
a minor patient's rights to confidential communication
while at a treatment facility. First, the weekly, one-
hour requirement can be waived due to law or court
order or if it's considered therapeutically
unadvisable by an overseeing physician. Second, the
communication can be between a patient and their
parent, guardian, or another adult approved by an
overseeing physician. Third, communication can be via
video or telephone and the weekly, one-hour
requirement can be satisfied by cumulative sessions at
no more than four occasions.
3:52:36 PM
SENATOR CLAMAN continued:
[Original punctuation provided.]
Both Version B and Version S add a requirement that
the Department of Health annually publish a report on
their Internet website on the aggregate total uses of
seclusion and restraint at each treatment facility.
Finally, Version S differs from Version B in a
modification to the requirement for the Department of
Health to conduct unannounced inspections of treatment
facilities twice each year. In Version S, this
provision only applies to treatment facilities in
which a minor spends more than three nights in the
preceding year. This change prevents excessive
inspection of facilities that provide short-term,
inpatient psychiatric treatment for minors in a mental
health crisis, such as hospital emergency rooms.
In summary, Version S of SB 231 provides the most
clarified and inclusive application of the bill's
provisions. I encourage the Committee to adopt Version
S of SB 231 today.
SENATOR CLAMAN mentioned that the summary of changes for all
versions are in the committee's bill packet and at the
committee's request his staff could read them for the record.
3:53:43 PM
CHAIR WILSON asked if any committee member would like the
summary of changes read. Seeing no response, he asked for
comments from the departments present.
3:54:26 PM
TRACY DOMPELING, Director, Division of Behavioral Health,
Department of Health, Juneau, Alaska, stated that the department
supports the spirit of SB 231, emphasizing the importance of
ensuring minors in high-level inpatient care have rights and
receive appropriate, safe, and rehabilitative treatment. She
noted ongoing discussions within the Department of Health and
the Department of Family and Community Services to clarify the
new committee substitute (CS) and the types of facilities it
encompasses. She highlighted concerns about creating confusion
with an additional definition of treatment facilities in
statutes and the need for clarity on which facilities SB 231
aims to address. She referenced Senator Claman's discussion
about emergency rooms, noting that they are not licensed as
inpatient psychiatric treatment facilities, and stressed the
importance of identifying and monitoring higher-level care
facilities that engage in practices such as seclusion and
restraint.
3:56:28 PM
RENEE GAYHART, Director, Division of Health Care Services,
Department of Health, Juneau, Alaska, clarified that the term
"treatment facility" spans two statutes, and during licensing,
the focus is on licensing the facility itself rather than the
services provided. She emphasized that for higher levels [of
inpatient care], policies are crucial to ensuring the safety of
individuals in those facilities.
3:57:02 PM
CHAIR TOBIN said she is focusing on the definition of "facility"
that was added to the CS [version S], noting that it includes
hospitals. She asked if this means the Department of Health
would conduct inspections on a Department of Child and Family
Services facility, such as the Chilkat Unit of Alaska
Psychiatric Institute (API).
3:57:35 PM
MS. DOMPELING responded that her understanding was correct and
acknowledged that it raises the question of whether the
Department of Health would conduct surprise inspections at
another department's facility. She noted that such facilities,
like hospitals, already adhere to their own accreditation
standards.
SENATOR TOBIN responded that it is an interesting dynamic.
3:58:11 PM
CHAIR WILSON asked if Senator Claman had any opposition to
adjusting definitions.
3:58:29 PM
SENATOR CLAMAN replied that his office has been working on
creating a CS to provide a narrower definition without excluding
hospitals that provide inpatient psychiatric care to minors. He
addressed the department's comment about emergency rooms,
clarifying that under the current definition, even with the
three-day provision, emergency rooms still would not qualify
because they are not licensed to provide impatient mental health
evaluation and treatment. He expressed openness to refining the
definition further to include current facilities providing
psychiatric care to minors and those that may be licensed in the
future.
3:59:21 PM
CHAIR WILSON stated he is not concerned about one department
reviewing another department. For example, the Department of
Corrections' treatment programs could benefit from review by the
Division of Behavioral Health.
3:59:48 PM
CHAIR WILSON removed his objection; found no further objection
and CSSB 231, version S, was adopted as the committee's working
document.
4:00:56 PM
CHAIR WILSON held SB 231 in committee.
4:01:36 PM
There being no further business to come before the committee,
Chair Wilson adjourned the Senate Health and Social Services
Standing Committee meeting at 4:01 p.m.
| Document Name | Date/Time | Subjects |
|---|---|---|
| HB 17 Beveridge.pdf |
SHSS 4/23/2024 3:30:00 PM |
HB 17 |
| HB 17 LOS Lance.pdf |
SHSS 4/23/2024 3:30:00 PM |
HB 17 |
| HB 371 LOS Allmeroth.pdf |
SHSS 4/23/2024 3:30:00 PM |
HB 371 |
| SB 231 CS Work Draft 33-LS0496 v B.pdf |
SHSS 4/23/2024 3:30:00 PM |
SB 231 |
| SB231 SHSS 3.26.24 response.pdf |
SHSS 4/23/2024 3:30:00 PM |
SB 231 |
| SB 231 AK Child and Family 4.4.24.pdf |
SHSS 4/23/2024 3:30:00 PM |
SB 231 |
| SB231 Support Slaikeu.pdf |
SHSS 4/23/2024 3:30:00 PM |
SB 231 |
| SB 231 Version S.pdf |
SHSS 4/23/2024 3:30:00 PM |
SB 231 |
| SB 231 Summary of Changes Version A to Version S.pdf |
SHSS 4/23/2024 3:30:00 PM |
SB 231 |
| SB 231 Summary of Changes Version A to Version B.pdf |
SHSS 4/23/2024 3:30:00 PM |
SB 231 |
| SB 231 Summary of Changes Version B to Version S.pdf |
SHSS 4/23/2024 3:30:00 PM |
SB 231 |
| HB 17 Amdmt U.1.Tobin - Adopted UC 4.23.24.pdf |
SHSS 4/23/2024 3:30:00 PM |
HB 17 |