Legislature(2021 - 2022)BUTROVICH 205

09/07/2021 01:30 PM LABOR & COMMERCE

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Audio Topic
01:31:12 PM Start
01:31:50 PM SB3006
02:19:07 PM Adjourn
* first hearing in first committee of referral
+ teleconferenced
= bill was previously heard/scheduled
-- Please Note Location Change --
*+ SB3006 HEALTH CARE REQS; COVID-19; TELEHEALTH TELECONFERENCED
Heard & Held
-- Invited & Public Testimony --
**Streamed live on AKL.tv**
                    ALASKA STATE LEGISLATURE                                                                                  
          SENATE LABOR AND COMMERCE STANDING COMMITTEE                                                                        
                       September 7, 2021                                                                                        
                           1:31 p.m.                                                                                            
                                                                                                                                
                             DRAFT                                                                                            
                                                                                                                                
MEMBERS PRESENT                                                                                                               
                                                                                                                                
Senator Mia Costello, Chair                                                                                                     
Senator Joshua Revak, Vice Chair                                                                                                
Senator Gary Stevens                                                                                                            
Senator Elvi Gray-Jackson                                                                                                       
                                                                                                                                
MEMBERS ABSENT                                                                                                                
                                                                                                                                
Senator Peter Micciche                                                                                                          
                                                                                                                                
OTHER LEGISLATORS PRESENT                                                                                                     
                                                                                                                                
Senator Lora Reinbold                                                                                                           
                                                                                                                                
COMMITTEE CALENDAR                                                                                                            
                                                                                                                                
SENATE BILL NO. 3006                                                                                                            
"An  Act  relating  to utilization  review  requirements;  making                                                               
temporary  changes  to  state  law   in  response  to  the  novel                                                               
coronavirus  disease  (COVID-19);  relating to  telemedicine  and                                                               
telehealth; relating  to background checks; and  providing for an                                                               
effective date."                                                                                                                
                                                                                                                                
     - HEARD & HELD                                                                                                             
                                                                                                                              
PREVIOUS COMMITTEE ACTION                                                                                                     
                                                                                                                                
BILL: SB3006                                                                                                                  
SHORT TITLE: HEALTH CARE REQS; COVID-19; TELEHEALTH                                                                             
SPONSOR(s): RULES BY REQUEST OF THE GOVERNOR                                                                                    
                                                                                                                                
09/02/21       (S)       READ THE FIRST TIME - REFERRALS                                                                        
09/02/21       (S)       L&C                                                                                                    
09/07/21       (S)       L&C AT 1:30 PM BUTROVICH 205                                                                           
                                                                                                                                
WITNESS REGISTER                                                                                                              
                                                                                                                                
ADAM CRUM, Commissioner                                                                                                         
Department of Health and Social Services                                                                                        
Anchorage, Alaska                                                                                                               
POSITION STATEMENT: Introduced SB 3006 on behalf of the                                                                       
administration.                                                                                                                 
                                                                                                                                
SARA CHAMBERS, Director                                                                                                         
Division of Corporations, Business &Professional Licensing                                                                      
Department of Commerce, Community and Economic Development                                                                      
Juneau, Alaska                                                                                                                  
POSITION STATEMENT: Presented the sectional analysis for SB
3006.                                                                                                                           
                                                                                                                                
RENEE GAYHART, Director                                                                                                         
Division of Health Care Services                                                                                                
Department of Health and Social Services (DHSS)                                                                                 
Juneau, Alaska                                                                                                                  
POSITION STATEMENT: Answered questions during the hearing on SB
3006.                                                                                                                           
                                                                                                                                
STACIE KRALY, Chief Assistant Attorney General                                                                                  
Civil Division                                                                                                                  
Human Services Section                                                                                                          
Department of Law (DOL)                                                                                                         
Juneau, Alaska                                                                                                                  
POSITION STATEMENT: Answered questions during the hearing on SB
3006.                                                                                                                           
                                                                                                                                
ANNA LATHAM, Deputy Director                                                                                                    
Division of Insurance                                                                                                           
Department of Commerce, Community and Economic Development                                                                      
Juneau, Alaska                                                                                                                  
POSITION STATEMENT: Answered questions during the hearing on SB
3006.                                                                                                                           
                                                                                                                                
ALEXIS APPLE, Policy Associate                                                                                                  
American Telemedicine Association                                                                                               
Arlington, Virginia                                                                                                             
POSITION STATEMENT: Testified in support of SB 3006.                                                                          
                                                                                                                                
JARED KOSIN, President and CEO                                                                                                  
Alaska State Hospital and Nursing Home Association                                                                              
Anchorage, Alaska                                                                                                               
POSITION STATEMENT: Testified in support of SB 3006.                                                                          
                                                                                                                                
ACTION NARRATIVE                                                                                                              
                                                                                                                                
1:31:12 PM                                                                                                                    
CHAIR MIA COSTELLO called the  Senate Labor and Commerce Standing                                                             
Committee meeting  to order at 1:31  p.m. Present at the  call to                                                               
order  were Senators  Stevens (via  teleconference), Gray-Jackson                                                               
(via teleconference),  and Chair Costello. Senator  Revak arrived                                                               
soon thereafter.                                                                                                                
                                                                                                                                
         SB3006-HEALTH CARE REQS; COVID-19; TELEHEALTH                                                                      
                                                                                                                                
1:31:50 PM                                                                                                                    
CHAIR  MIA COSTELLO  announced the  consideration of  SENATE BILL                                                               
NO.  3006 "An  Act relating  to utilization  review requirements;                                                               
making temporary  changes to state  law in response to  the novel                                                               
coronavirus  disease  (COVID-19);  relating to  telemedicine  and                                                               
telehealth; relating  to background checks; and  providing for an                                                               
effective date."                                                                                                                
                                                                                                                                
She noted that this was the  first hearing of the governor's bill                                                               
that was introduced after the special session call was amended.                                                                 
                                                                                                                                
1:33:05 PM                                                                                                                    
ADAM  CRUM,   Commissioner,  Department  of  Health   and  Social                                                               
Services,  Anchorage,  Alaska,  stated   that  SB  3006  provides                                                               
specific  tools that  health care  leadership  has identified  as                                                               
necessary to  support Alaska's health  care system  and workforce                                                               
respond  to the  Delta  variant of  the  COVID-19 virus.  Despite                                                               
robust  testing, education,  and vaccines  for every  Alaskan who                                                               
wishes to  get vaccinated,  he said the  surge of  infections has                                                               
negatively  impacted the  already  fatigued  and stressed  health                                                               
care system  and workforce that  has been  on the front  line for                                                               
more than 19 months.                                                                                                            
                                                                                                                                
COMMISSIONER  CRUM said  specific tools  are required  to address                                                               
this  health  care emergency.  He  reported  that over  the  last                                                               
month,  the  executive  branch has  had  extensive  contact  with                                                               
Alaska's health  care providers and  facilities to  identify what                                                               
hospitals and caregivers need and  the most appropriate mechanism                                                               
to provide those  tools. He said these  partners have identified:                                                               
1)  the  need to  reduce  barriers  to training,  licensing,  and                                                               
employing  health  care  professionals,  2) the  need  to  reduce                                                               
barriers to telehealth and telemedicine  to Alaskans by providers                                                               
outside of Alaska, 3) the  need for insurers to waive utilization                                                               
review requirements and  for consenting patients to be  seen in a                                                               
lower acuity setting than an emergency department.                                                                              
                                                                                                                                
COMMISSIONER  CRUMB advised  that  a number  of  tools that  were                                                               
identified  could  be  accomplished  through  the  authority  the                                                               
legislature provided in  HB 76. Other tools  could be implemented                                                               
with the  emergency regulations for  programs that  are currently                                                               
in  place. For  example,  the Alaska  Board  of Nursing  recently                                                               
adopted  regulations to  amend  the  Certified Nursing  Assistant                                                               
(CNA) program  by establishing a  CNA emergency  curtesy license.                                                               
He  said  this  will  allow  additional  human  resources  to  be                                                               
deployed to strengthen the health care system safety net.                                                                       
                                                                                                                                
COMMISSIONER CRUMB stated that SB  3006 was selected instead of a                                                               
disaster  declaration because  the  latter does  not provide  the                                                               
specific  tools  needed or  the  authority  for the  governor  to                                                               
draft,  suspend,  or  amend  existing  statutes.  That  authority                                                               
resides  with  the legislative  branch.  He  concluded that  this                                                               
legislation is a critical component  in assisting Alaska's health                                                               
care network.                                                                                                                   
                                                                                                                                
1:37:36 PM                                                                                                                    
SENATOR REVAK joined the committee.                                                                                             
                                                                                                                                
1:38:01 PM                                                                                                                    
SARA  CHAMBERS, Director,  Division of  Corporations, Business  &                                                               
Professional  Licensing, Department  of  Commerce, Community  and                                                               
Economic  Development  (DCCED),  Juneau,  Alaska,  presented  the                                                               
sectional analysis for SB 3006 that read as follows:                                                                            
                                                                                                                                
     Section 1.                                                                                                               
     States  the  purpose of  this  Act  is to  provide  for                                                                    
     mitigation  measures  that  will  enhance  the  state's                                                                    
     ongoing efforts to reduce the  spread of COVID-19 under                                                                    
     the uncodified law.                                                                                                        
                                                                                                                                
     Section 2.                                                                                                               
     Allows the  DOI director to order  health care insurers                                                                    
     to waive  utilization review  requirements by  adding a                                                                    
     new  subsection (f)  to AS  21.06.080: General  Powers,                                                                    
     Duties; Catastrophes.                                                                                                      
                                                                                                                                
MS.  CHAMBERS  noted that  the  foregoing  would be  a  permanent                                                               
change.                                                                                                                         
                                                                                                                                
     Section 3.                                                                                                               
     Suspends   the   requirements,   under   AS   08.64.170                                                                    
     (medical) and  AS 08.68.160 (nursing), to  allow health                                                                    
     care  providers licensed,  permitted,  or certified  in                                                                    
     good  standing  in   another  jurisdiction  to  provide                                                                    
     telehealth  and telemedicine  services  to patients  in                                                                    
     Alaska  without  being  required to  obtain  an  Alaska                                                                    
     license or  first conduct an  in person  physical exam,                                                                    
     from the  effective date of  this Act to July  1, 2022.                                                                    
     This  does not  allow  a health  care professional  not                                                                    
     licensed in  Alaska to  provide in-person  treatment in                                                                    
     Alaska or to prescribe a controlled substance.                                                                             
                                                                                                                                
MS. CHAMBERS  advised that Section  3 contains the  same language                                                               
the legislature previously passed to address COVID-19.                                                                          
                                                                                                                                
     Section 4.                                                                                                               
     Suspends  the requirements,  under  AS  47.05.300    AS                                                                    
     47.05.390,  as  these  statutes pertain  to  background                                                                    
     checks   for  employees   of   hospitals  and   nursing                                                                    
     facilities,  from the  effective  date of  this Act  to                                                                    
     July  1,  2022.  It   requires  hospitals  and  nursing                                                                    
     facilities to provide  sufficient information to attest                                                                    
     to  the  hiring  process  for   all  employees  at  the                                                                    
     facility and  confirm that a background  check has been                                                                    
     conducted as part of the hiring process.                                                                                   
                                                                                                                                
     Section 5.                                                                                                               
     Provides for an immediate effective date.                                                                                  
                                                                                                                                
1:41:06 PM                                                                                                                    
SENATOR   STEVENS  referenced   [page  1]   line  11   and  asked                                                               
Commissioner  Crum to  clarify where  the  state is  in terms  of                                                               
either a disaster or emergency.                                                                                                 
                                                                                                                                
COMMISSION CRUM replied  that is referring to  the federal public                                                               
health emergency  that the  U.S. Department  of Health  and Human                                                               
Services put in place, some provisions  of which will be in place                                                               
until the  end of calendar year  2021. He noted that  some health                                                               
departments have requested extensions,  particularly for the 1135                                                               
blanket  waivers  that  provide flexibility  for  alternate  care                                                               
sites.                                                                                                                          
                                                                                                                                
SENATOR STEVENS summarized his  understanding that subsection (f)                                                               
allows  DHSS  to  move  ahead under  the  federal  public  health                                                               
emergency so there  is no need for a state  disaster or emergency                                                               
declaration.                                                                                                                    
                                                                                                                                
1:43:36 PM                                                                                                                    
COMMISSIONER CRUM  replied subsection (f)  has to do  with things                                                               
that  fall  under  the  Department  of  Commerce,  Community  and                                                               
Economic   Development,   particularly   related   to   insurance                                                               
preauthorizations.                                                                                                              
                                                                                                                                
SENATOR COSTELLO referenced  page 2 lines 29-30 and  asked for an                                                               
example of  a law or  regulation that the commissioner  of health                                                               
and social services might waive.                                                                                                
                                                                                                                                
COMMISSIONER  CRUM cited  the example  of a  regulation requiring                                                               
finger printing. If  that is an impediment to  hiring health care                                                               
providers that come  from outside and enter  Alaska's health care                                                               
system,  he would  consult  the Department  of  Law to  determine                                                               
whether or not that requirement should be temporarily waived.                                                                   
                                                                                                                                
CHAIR COSTELLO noted that Section  4 suspends the requirement for                                                               
individuals hired to  work in hospitals or  nursing facilities to                                                               
undergo background  checks, but  the facility has  to be  able to                                                               
confirm  that a  background check  was conducted  as part  of the                                                               
hiring process. She asked if that was correct.                                                                                  
                                                                                                                                
1:46:22 PM                                                                                                                    
COMMISSIONER  CRUM  answered  yes;   Alaska  State  Hospital  and                                                               
Nursing Home  Association (ASHNHA) facilities typically  check an                                                               
applicant's background  as part  of the  hiring process  and then                                                               
send  the  application  to  the  state [for  DHSS  to  conduct  a                                                               
background check,  as provided  by statute]. He  said this  is an                                                               
extra hurdle that SB 3006 temporarily suspends.                                                                                 
                                                                                                                                
He also  clarified that when  he responded to her  first question                                                               
he failed  to recognize that  the provision that allows  the DHSS                                                               
commissioner to waive  a state law or  regulation is specifically                                                               
related to telemedicine  and telehealth. The example  he cited to                                                               
waive  the  fingerprinting requirement  was  not  in the  correct                                                               
context. He apologized for the misstatement.                                                                                    
                                                                                                                                
CHAIR COSTELLO asked how many  individuals work on the background                                                               
check  team  and   what  the  time  frame  is   for  turning  the                                                               
information around.                                                                                                             
                                                                                                                                
COMMISSIONER CRUM deferred the question to Renee Gayhart.                                                                       
                                                                                                                                
1:48:03 PM                                                                                                                    
RENEE  GAYHART,  Director,  Division  of  Health  Care  Services,                                                               
Department of Health and Social  Services (DHSS), Juneau, Alaska,                                                               
explained  that  the  DHSS background  unit  currently  has  five                                                               
permanent  fulltime employees  and  two  short term  nonpermanent                                                               
employees.  The division  is also  in the  process of  hiring one                                                               
long  term   nonpermanent  employee.  Other  people   within  the                                                               
division  are  also  assisting with  certain  components  of  the                                                               
background  check. Regarding  flow,  she said  it  is taking  the                                                               
division about 12  business days to complete  an application with                                                               
fingerprints and payment, which is within the allotted 15 days.                                                                 
                                                                                                                                
1:49:31 PM                                                                                                                    
CHAIR COSTELLO  how many  applications are  being processed  in a                                                               
month.                                                                                                                          
                                                                                                                                
MS.  GAYHART  replied the  division  is  processing about  30,000                                                               
background checks over the course  of a year, which translates to                                                               
an average of 2,500 per month.                                                                                                  
                                                                                                                                
CHAIR  COSTELLO asked  what  the process  is  when an  individual                                                               
fails a background check.                                                                                                       
                                                                                                                                
MS. GAYHART replied  the applicant is notified  that they failed.                                                               
The  employer may  request a  waiver and  the variance  committee                                                               
will review  the request and  evaluate the barring  crime(s). The                                                               
request may  be approved, denied,  or approved  with limitations.                                                               
For example,  an individual may be  able to work in  the facility                                                               
for a certain number  of hours per day as long  as they are under                                                               
supervision.                                                                                                                    
                                                                                                                                
CHAIR COSTELLO  asked how many individuals  are currently working                                                               
under a variance.                                                                                                               
                                                                                                                                
MS. GAYHART  replied the national  background system  that tracks                                                               
the status  of all applications  is down so  she did not  have an                                                               
accurate  report.  She  offered  to provide  the  information  by                                                               
running a manual report.                                                                                                        
                                                                                                                                
CHAIR COSTELLO asked  if that was the reason for  this portion of                                                               
the bill.                                                                                                                       
                                                                                                                                
MS.  GAYHART  answered  no;  the  intention  is  to  relieve  the                                                               
administrative burden  from hospitals and nursing  facilities and                                                               
keep them fully staffed during the surge of infections.                                                                         
                                                                                                                                
1:52:14 PM                                                                                                                    
CHAIR  COSTELLO highlighted  the disparity  between her  comments                                                               
and  the language  on page  3,  lines 11-12  that indicates  that                                                               
hospitals and  nursing facilities  will be  conducting background                                                               
checks.                                                                                                                         
                                                                                                                                
MS. GAYHART clarified that many  hospitals and nursing facilities                                                               
use  a  third  party  to  do  certain  registry  checks  and  the                                                               
hospitals and nursing facilities  are attesting that those checks                                                               
have  been done.  This is  tracked at  the commissioner's  office                                                               
where  a determination  is made  regarding a  suspension. If  the                                                               
commissioner  makes  the  determination to  end  the  suspension,                                                               
those individuals  may go through  the application  process. That                                                               
means that those nurses and  skilled professionals, and with this                                                               
extension some  non-Title 8 providers,  will have to  attest that                                                               
they  have  done that  third-party  check.  She noted  that  this                                                               
bypasses some civil registries within the state.                                                                                
                                                                                                                                
CHAIR COSTELLO  asked how  this legislation  helps a  hospital or                                                               
nursing  facility that  has a  nursing shortage.  She added  that                                                               
this  indicates that  a number  of people  are waiting  for their                                                               
background checks to be processed so they can be hired.                                                                         
                                                                                                                                
MS. GAYHART  answered that what  happens now is  that individuals                                                               
coming  to the  state  or  already in  Alaska  would  have to  go                                                               
through  the  background  check   process.  That  takes  from  12                                                               
business days to several weeks  after an individual has submitted                                                               
their completed  application. With the suspension,  hospitals may                                                               
hire and immediately put to  work those individuals who have gone                                                               
through that  third-party background  work. They  do not  need to                                                               
wait to go through the department's background process.                                                                         
                                                                                                                                
CHAIR COSTELLO asked  her to state on the record  what the public                                                               
value is to having background checks  and why they have been done                                                               
in the past.                                                                                                                    
                                                                                                                                
MS. GAYHART answered  that, "The reality of  the background check                                                               
is really just  trying to protect our  most vulnerable recipients                                                               
that are on  Medicaid." She suggested that  Commissioner Crum and                                                               
Stacie Kraly may want to supplement her answer.                                                                                 
                                                                                                                                
CHAIR  COSTELLO  asked  Commissioner  Crum if  he  supported  the                                                               
legislation completely.                                                                                                         
                                                                                                                                
1:56:24 PM                                                                                                                    
COMMISSIONER CRUM answered yes because  the more fully a hospital                                                               
is staffed, the  faster it can turn over beds.  He said the surge                                                               
in COVID-19 cases is the  big reason for wanting this legislation                                                               
but the cyberattack  is also a factor. That slowed  the system as                                                               
a  whole  and affected  smaller  groups  that  may not  have  the                                                               
capacity to do third-party background checks.                                                                                   
                                                                                                                                
CHAIR COSTELLO asked  if the state would be  exposed to increased                                                               
liability if it suspended the department's background checks.                                                                   
                                                                                                                                
COMMISSIONER CRUM deferred the question to Stacie Kraly.                                                                        
                                                                                                                                
1:58:14 PM                                                                                                                    
STACIE KRALY,  Chief Assistant Attorney General,  Civil Division,                                                               
Human  Services   Section,  Juneau,  Alaska,  advised   that  the                                                               
provision  articulated  in  Section  4  mitigates  any  liability                                                               
because  it  requires the  attestation  by  the facility  that  a                                                               
third-party  background  check  was conducted  for  the  doctors,                                                               
nurses, and  other medical professionals licensed  under Title 8.                                                               
She  opined that  the  need for  this  flexibility outweighs  the                                                               
liability at this time.                                                                                                         
                                                                                                                                
She referenced  a question posed earlier  regarding variances and                                                               
further advised that the majority  of individuals are not tied to                                                               
facilities but to  different types of providers  that must submit                                                               
to background checks.                                                                                                           
                                                                                                                                
CHAIR COSTELLO  referenced subsection  (c) on  page 2  that gives                                                               
the DHSS commissioner  the authority to waive  certain state laws                                                               
or regulations.  She asked  Commissioner Crum if  he said  he was                                                               
considering waiving fingerprinting for telemedicine.                                                                            
                                                                                                                                
2:00:05 PM                                                                                                                    
COMMISSIONER CRUM  apologized that  when he  used the  example of                                                               
waiving fingerprinting it was not  in the context of telemedicine                                                               
and telehealth. He  was referring to something else  that did not                                                               
move forward.                                                                                                                   
                                                                                                                                
CHAIR COSTELLO invited Anna Latham to provide her testimony.                                                                    
                                                                                                                                
2:01:05 PM                                                                                                                    
ANNA LATHAM,  Deputy Director, Division of  Insurance, Department                                                               
of Commerce, Community and  Economic Development (DCCED), Juneau,                                                               
Alaska, advised that she would speak  to Section 2 that gives the                                                               
director of insurance  the ability to order  health care insurers                                                               
to  waive  utilization requirements  during  a  federal or  state                                                               
public health  disaster or emergency.  She said the  division did                                                               
this  previously  when  the  governor   issued  a  public  health                                                               
disaster emergency  declaration in December 2020.  She added that                                                               
while  the  division's  regulatory   authority  of  insurance  is                                                               
nominal, SB  3006 does  allow any  preauthorization to  be waived                                                               
during a public health emergency.                                                                                               
                                                                                                                                
CHAIR  COSTELLO asked  if this  applies to  a federally  declared                                                               
emergency.                                                                                                                      
                                                                                                                                
MS. LATHAM answered yes; it  would be a federal emergency through                                                               
the U.S. Department of Health and Human Services.                                                                               
                                                                                                                                
2:02:51 PM                                                                                                                    
CHAIR  COSTELLO asked  for confirmation  that there  is no  state                                                               
voice in a declaration that is made at the federal level.                                                                       
                                                                                                                                
MS.  LATHAM  answered  that  the  director  of  the  Division  of                                                               
Insurance would have  that authority in both  a federal emergency                                                               
and a state public health disaster.                                                                                             
                                                                                                                                
CHAIR  COSTELLO  asked for  an  explanation  of  the value  of  a                                                               
utilization review that this legislation waives.                                                                                
                                                                                                                                
MS. LATHAM explained that the  statutes governing the Division of                                                               
Insurance  allow insurers  to require  a utilization  review (UR)                                                               
before a procedure.  For example, before hip  surgery the insurer                                                               
would  receive  medical  documentation   that  the  procedure  is                                                               
appropriate  or   required  so   insurance  would  pay   for  the                                                               
procedure.                                                                                                                      
                                                                                                                                
CHAIR COSTELLO asked  if individuals have found in  the past when                                                               
UR  was  waived  that  their  insurance would  not  pay  for  the                                                               
procedure because it was not preauthorized.                                                                                     
                                                                                                                                
2:04:15 PM                                                                                                                    
MS.  LATHAM  answered  no;  the Division  of  Insurance  has  not                                                               
received any  complaints or heard  from insurers  that procedures                                                               
were denied when the preauthorization was suspended or waived.                                                                  
                                                                                                                                
CHAIR  COSTELLO  asked  for  an explanation  of  the  purpose  of                                                               
Section 2 other than speeding  the process for procedures and the                                                               
release of patients from the hospital.                                                                                          
                                                                                                                                
MS. LATHAM answered  that Section 2 allows  health care providers                                                               
to deliver service without  first fulfilling the preauthorization                                                               
requirements.  For  example,  before  a surgery  an  insurer  may                                                               
require a  specific diagnosis and  additional tests such  as MRIs                                                               
and  ultrasounds.   With  the  waiver,  those   tests  would  not                                                               
absolutely be required before the patient is treated.                                                                           
                                                                                                                                
SENATOR STEVENS  asked when the  current federal waiver  ends and                                                               
how it would be extended if needed.                                                                                             
                                                                                                                                
2:04:48 PM                                                                                                                    
MS.  LATHAM offered  her understanding  that the  current federal                                                               
health emergency ends  on October 15, 2021 unless  it is extended                                                               
at the federal level.                                                                                                           
                                                                                                                                
CHAIR  COSTELLO asked  if she  was  saying that  Section 2  would                                                               
remain  in  effect as  long  as  there  is a  federally  declared                                                               
disaster or emergency that extends beyond July 1, 2022.                                                                         
                                                                                                                                
MS. LATHAM offered her understanding  that the dates in Section 3                                                               
pertain to  telemedicine, whereas  Section 2 pertains  to waiving                                                               
the utilization  review and  that ends on  October 15,  2021 with                                                               
the federal emergency declaration.                                                                                              
                                                                                                                                
CHAIR COSTLLO  summarized that Section  2 is tied to  the federal                                                               
declaration whereas  the other sections are  effective until July                                                               
1, 2022.                                                                                                                        
                                                                                                                                
She advised that because this  was the only committee of referral                                                               
for the legislation, the committee  would review the fiscal notes                                                               
once they were all available.                                                                                                   
                                                                                                                                
2:08:11 PM                                                                                                                    
CHAIR COSTELLO opened public testimony on SB 3006.                                                                              
                                                                                                                                
2:08:24 PM                                                                                                                    
ALEXIS   APPLE,    Policy   Associate,    American   Telemedicine                                                               
Association  (ATA), Arlington,  Virginia, stated  support for  SB
3006 on  behalf of  ATA and  the more  than 400  organizations it                                                               
represents.  She   reported  that   ATA  is  the   only  national                                                               
organization  whose sole  mission is  to advance  telemedicine in                                                               
the U.S.  Ensuring access to  affordable quality healthcare  is a                                                               
priority. She  said ATA members  believe that SB 3006  will serve                                                               
as  a rational  and  timely supplement  to Alaska's  telemedicine                                                               
statutes. It  would permit  a licensure  waiver until  January 1,                                                               
2022 for out  of state physicians and nurses  who use appropriate                                                               
telemedicine technologies  to treat  patients located  in Alaska.                                                               
She  listed the  reasons  to support  the legislation,  including                                                               
that  it expands  all  Alaskans' access  to  high quality  health                                                               
care.  She concluded  that this  is  appropriate as  long as  the                                                               
practitioners  are using  appropriate  technology  to uphold  the                                                               
established standard of care and  can be held accountable for the                                                               
care they render by their  respective regulatory boards and state                                                               
agencies.                                                                                                                       
                                                                                                                                
2:11:21 PM                                                                                                                    
CHAIR COSTELLO asked if other  states are addressing telemedicine                                                               
and telehealth with legislation that is similar to SB 3006.                                                                     
                                                                                                                                
MS.  APPLE answered  yes; more  than 23  states have  permanently                                                               
implemented similar legislation  and others are looking  at it on                                                               
a temporary  basis. She offered  to follow  up with the  names of                                                               
the individual states.                                                                                                          
                                                                                                                                
2:12:17 PM                                                                                                                    
CHAIR COSTELLO  asked if any  licensed professionals  residing in                                                               
those states are pushing back.                                                                                                  
                                                                                                                                
MS. APPLE  replied some hospital  systems have pushed back  in an                                                               
effort to control  competition but ATA has  not received negative                                                               
feedback  from   practitioners.  In  fact,  a   large  number  of                                                               
physicians have  said they would  like to practice  outside their                                                               
state of licensure to meet patient needs.                                                                                       
                                                                                                                                
2:12:56 PM                                                                                                                    
JARED  KOSIN,  President  and  CEO,  Alaska  State  Hospital  and                                                               
Nursing  Home  Association  (ASHNA),  Anchorage,  Alaska,  stated                                                               
support  for SB  3006 and  urged its  swift passage.  He reported                                                               
that  Alaska  has  risen  to  the worst  point  of  the  COVID-19                                                               
pandemic.  Health   care  staffing   is  severely   strained  and                                                               
caregivers are  exhausted. SB 3006  offers important  measures to                                                               
accelerate   background  checks   for   health  care   employees,                                                               
reinstate  telehealth flexibility,  and create  opportunities for                                                               
more efficient  patient throughput  to maximize  limited hospital                                                               
resources.                                                                                                                      
                                                                                                                                
2:14:13 PM                                                                                                                    
CHAIR  COSTELLO  asked  if  he   could  provide  details  to  the                                                               
legislature  about  the  extent   and  nature  of  the  emergency                                                               
situation in  hospitals that  the bill  is addressing.  She noted                                                               
that  while the  bill provides  extensive authority  to the  DHSS                                                               
commissioner to  waive relevant state  laws and  regulations, the                                                               
legislature has not received any specific data.                                                                                 
                                                                                                                                
MR. KOSIN  offered his belief  that the public testimony  and the                                                               
public dialog  from hospital operators has  painted a transparent                                                               
picture of  the challenges hospitals  and nursing  facilities are                                                               
experiencing. Nevertheless, he said he  was willing to respond to                                                               
specific  questions and  requests for  information. He  suggested                                                               
the members email him directly.                                                                                                 
                                                                                                                                
CHAIR COSTELLO  asked for details  about the hospitals  in Alaska                                                               
including the number of beds  and whether people are being turned                                                               
away.                                                                                                                           
                                                                                                                                
2:16:37 PM                                                                                                                    
MR. KOSIN  agreed to  provide initial  information in  writing to                                                               
her office  and the legislature in  general and to share  more as                                                               
needed.                                                                                                                         
                                                                                                                                
2:17:22 PM                                                                                                                    
CHAIR COSTELLO closed public testimony on SB 3006.                                                                              
                                                                                                                                
SENATOR STEVENS asked  how quickly she intended to  move the bill                                                               
because he would  be traveling on Thursday and he  didn't want to                                                               
miss an important meeting.                                                                                                      
                                                                                                                                
CHAIR COSTELLO  replied the  intention is  to thoroughly  vet the                                                               
bill  and work  with  the administration  to  get missing  fiscal                                                               
notes. She  noted that meetings  were scheduled for  tomorrow and                                                               
Thursday.                                                                                                                       
                                                                                                                                
SENATOR STEVENS said he looked forward to the next two meetings.                                                                
                                                                                                                                
[SB 3006 was held in committee.]                                                                                                
                                                                                                                                
2:19:07 PM                                                                                                                    
There being  no further  business to  come before  the committee,                                                               
Chair Costello  adjourned the Senate Labor  and Commerce Standing                                                               
Committee meeting at 2:19 p.m.                                                                                                  

Document Name Date/Time Subjects
SB 3006 Transmittal Letter.pdf HHSS 9/11/2021 3:00:00 PM
SL&C 9/7/2021 1:30:00 PM
SB3006
SB 3006 Sectional Analysis (Version A).pdf HHSS 9/11/2021 3:00:00 PM
SL&C 9/7/2021 1:30:00 PM
SB3006
SB 3006 Fiscal Note 1 DCCED - CBPL.pdf HHSS 9/11/2021 3:00:00 PM
SL&C 9/7/2021 1:30:00 PM
SB3006
SB 3006 Fiscal Note 3 DCCED - Insurance.pdf HHSS 9/11/2021 3:00:00 PM
SL&C 9/7/2021 1:30:00 PM
SB3006
SB 3006 Governor Letter to Presiding Officers 9.3.21.pdf HHSS 9/11/2021 3:00:00 PM
SL&C 9/7/2021 1:30:00 PM
SB3006
SB 3006 Letter of Support - ATA.pdf HHSS 9/11/2021 3:00:00 PM
SL&C 9/7/2021 1:30:00 PM
SB3006