03/01/2011 02:00 PM Senate LABOR & COMMERCE
| Audio | Topic |
|---|---|
| Start | |
| SB92 | |
| SB68 | |
| SB87 | |
| Adjourn |
+ teleconferenced
= bill was previously heard/scheduled
| *+ | SB 87 | TELECONFERENCED | |
| + | TELECONFERENCED | ||
| += | SB 68 | TELECONFERENCED | |
| += | SB 92 | TELECONFERENCED | |
ALASKA STATE LEGISLATURE
SENATE LABOR AND COMMERCE STANDING COMMITTEE
March 1, 2011
2:03 p.m.
MEMBERS PRESENT
Senator Dennis Egan, Chair
Senator Joe Paskvan, Vice Chair
Senator Bettye Davis
MEMBERS ABSENT
Senator Linda Menard
Senator Cathy Giessel
COMMITTEE CALENDAR
SENATE BILL NO. 92
"An Act relating to dental hygienists, dentists, dental
assistants, dental hygiene, and dentistry."
- MOVED CSSB 92(L&C) FROM COMMITTEE
SENATE BILL NO. 68
"An Act relating to the examinations, board, loans, records, and
lobbying contracts of the Alaska Commercial Fishing and
Agriculture Bank; and providing for an effective date."
- MOVED SB 68 FROM COMMITTEE
SENATE BILL NO. 87
"An Act establishing a program in the Department of Commerce,
Community, and Economic Development for payment of grants to
health care providers for care of patients who are 65 years of
age or older."
- HEARD AND HELD
PREVIOUS COMMITTEE ACTION
BILL: SB 92
SHORT TITLE: DENTISTS/DENTAL HYGIENISTS/ASSISTANTS
SPONSOR(s): SENATOR(s) EGAN
02/21/11 (S) READ THE FIRST TIME - REFERRALS
02/21/11 (S) L&C, FIN
02/24/11 (S) L&C AT 1:30 PM BELTZ 105 (TSBldg)
02/24/11 (S) Heard & Held
02/24/11 (S) MINUTE(L&C)
03/01/11 (S) L&C AT 2:00 PM BELTZ 105 (TSBldg)
BILL: SB 68
SHORT TITLE: COMMERCIAL FISHING & AGRICULTURE BANK
SPONSOR(s): SENATOR(s) COGHILL
01/26/11 (S) READ THE FIRST TIME - REFERRALS
01/26/11 (S) L&C, FIN
02/24/11 (S) L&C AT 1:30 PM BELTZ 105 (TSBldg)
02/24/11 (S) Heard & Held
02/24/11 (S) MINUTE(L&C)
03/01/11 (S) L&C AT 2:00 PM BELTZ 105 (TSBldg)
BILL: SB 87
SHORT TITLE: GRANTS FOR SENIORS' MEDICAL CARE
SPONSOR(s): SENATOR(s) FRENCH
02/11/11 (S) READ THE FIRST TIME - REFERRALS
02/11/11 (S) L&C, FIN
03/01/11 (S) L&C AT 2:00 PM BELTZ 105 (TSBldg)
WITNESS REGISTER
DANA OWEN
Staff to the Senate Labor and Commerce Committee
Alaska State Legislature
Juneau, AK
POSITION STATEMENT: Explained CSSB 92 (L&C) version D.
JOSH BANKS
Staff to Senator Coghill
Alaska State Legislature
Juneau, AK
POSITION STATEMENT: Available to answer questions on SB 68 for
the sponsor.
SENATOR FRENCH
Alaska State Legislature
Juneau, AK
POSITION STATEMENT: Sponsor of SB 87.
ANDY MODEROW
Staff to Senator French
Alaska State Legislature
Juneau, AK
POSITION STATEMENT: Provided sectional analysis of SB 87 for the
sponsor.
PAT LUBY, Advocacy Director
AARP Alaska
Anchorage, AK
POSITION STATEMENT: Supported SB 87.
JON SHERWOOD, Director
Medicaid Special Projects
Division of Health Care Services
Department of Health and Social Services (DHSS)
POSITION STATEMENT: Explained how SB 87 would work for his
department.
ACTION NARRATIVE
2:03:13 PM
CHAIR DENNIS EGAN called the Senate Labor and Commerce Standing
Committee meeting to order at 2:03 p.m. Present at the call to
order were Senators Paskvan, Davis, and Chair Egan.
SB 92-DENTISTS/DENTAL HYGIENISTS/ASSISTANTS
CHAIR EGAN announced SB 92 to be up for consideration [CSSB
92(L&C) version I was before the committee.]
DANA OWEN, staff to the Senate Labor and Commerce Committee,
said there is a new committee substitute (CS), version D.
SENATOR PASKVAN moved to adopt CSSBL 92(L&C) 27-LS0403\D.
CHAIR EGAN objected for discussion purposes.
MR. OWEN explained that this version contains two recommendation
changes. On page 4, line 2, reference to the board requiring the
fees has been deleted; testimony said the department was
supposed to set the fees in consultation with the board. In
section 5, on page 4, lines 12-26, language has been updated to
make notification less specific than original language that had
the department notifying licensees by mail. New language allows
notification and renewal over the Internet.
CHAIR EGAN found no questions and moved to report CSSB 92(L&C),
version D, from committee with individual recommendations and
attached fiscal note(s). There were no objections and it was so
ordered.
2:06:32 PM
At ease from 2:06 to 2:07 p.m.
2:07:27 PM
SB 68-COMMERCIAL FISHING & AGRICULTURE BANK
CHAIR EGAN announced SB 68 to be up for consideration.
JOSH BANKS, staff to Senator Coghill, sponsor of SB 68, said he
would answer questions.
SENATOR PASKVAN moved to report SB 68 from committee with
individual recommendations and attached fiscal note(s). There
were no objections and it was so ordered.
2:08:16 PM
At ease from 2:08 to 2:09 p.m.
2:09:06 PM
SB 87-GRANTS FOR SENIORS' MEDICAL CARE
CHAIR EGAN announced SB 87 to be up for consideration.
SENATOR FRENCH, sponsor of SB 87, read the sponsor statement
into the record as follows:
Our Medicare system is broken in Alaska. Too many
seniors cannot find a primary care doctor. Physicians
who do accept Medicare patients are losing money with
each visit, as the cost of providing care exceeds the
federal reimbursement rate.
We can't wait for the federal government to fix
Medicare; instead, we need to act today. This
legislation will immediately improve seniors' access
to primary care services in Alaska.
SB 87 establishes a grant fund for health care
providers serving Alaskans who are sixty-five years of
age or over. The grants will be paid to medical
providers that increase primary care access for
Alaska's seniors. All health care providers -
including physicians, nurse practitioners, and
physician assistants - would be eligible for grants.
Access to primary care improves health outcomes and
reduces medical costs. Instead of waiting for small
ailments to become serious problems, primary care
prevents expensive medical treatments. Instead of
requiring an emergency room visit, primary care keeps
our seniors healthy.
Without this bill, doctors can't afford to provide
seniors with these crucial preventative services. For
most primary care visits, a physician receives $60
less from Medicare than they receive from private
health insurance. In some instances, physicians lose
well over $100 per visit.
This legislation is an ounce of prevention that will
prevent the need for a pound of cure. It makes fiscal
sense. Our seniors have paid into the Medicare system
all their life. I urge your support of this
legislation, to make sure that our seniors receive the
care that they deserve.
SENATOR FRENCH explained that Senator Begich was able to insert
a provision that states would be able to make up difference in
Medicare payments.
ANDY MODEROW, staff to Senator French, went through a sectional
analysis of SB 87 as follows:
-Section 1 of this bill, on page 1, lines 5-7,
provides a short title for the act. That title is the
Alaska Medical Care for Seniors Act.
-Section 2 of the bill, starting on page 1, line 8,
adds a new article in title 18, which pertains to
Health, Safety and Housing.
-Section 18.28.200 establishes this grant program in
the department of commerce, community and economic
development. The goal is outlined by the second part
of subsection (a), which states the purpose of the law
is to assist in the provision of primary medical care
for seniors by health care providers in this state.
-Health care provider is described on page 2 of the
bill, and includes physicians, osteopaths, physician
assistants, nurses, physical therapists, occupational
therapists or chiropractors licensed in Alaska and
qualified to provide primary care services.
-Section 18.28.200(b) on page 1 lines 13-14 directs
the department to award grant funding to eligible
providers, if funding is made available.
2:15:35 PM
-Section 18.28.200(c) starts on page two line 1, and
requires the department to adopt regulations that
carry out the program. It requires that these
regulations match federal law, and include (in the
order listed in the bill):
An application and award procedure
Eligibility requirements based on the lack
of ability for the provider to receive
adequate compensation for their services
Proof that a grant is necessary to increase
primary care availability
A priority for providers that serve a high
percentage of medically underserved
populations where patients over 65 have been
turned away.
A 'bang for your buck' provision that gives
priority to providers which will show the
greatest increase of patients for the lowest
grant amounts
Any other requirements to carry out this
program.
-Section 18.28.200(d) - now we are on page 2, lines
16-20 - specifically disallows grant funds being used
to supplement the care of patients with public or
private health coverage that adequately compensates an
applicant for primary care, as defined by the
Department of Health and Social Services commissioner.
-Section 18.28.200(e) allows for DCCED to consult with
and enter agreements to DHSS, to the extent permitted
by law.
-Section 18.28.200(f) provides definitions in this
legislation - we've discussed them above.
Finally on page 3, line 1, Section 3 of the bill
provides Revisor instructions.
2:17:01 PM
SENATOR PASKVAN, focusing on language on page 2, lines 13-14,
asked if the health care provider charges just $10 more, wuold
they have a higher priority to get the grant than another
provider that wants $50 more. He wanted to know how that would
work.
SENATOR FRENCH replied it's not just the lowest price that they
are willing to do the job for, but someone who can demonstrate
the greatest increase in service for the lowest grant amounts.
So, it's a combination of, "I'll see X many more patients for X
many dollars."
2:17:41 PM
PAT LUBY, Advocacy Director, AARP Alaska, supported SB 87
creating a grant system that would provide a method for the
state to supplement federal Medicare reimbursement. He said many
Medicare beneficiaries cannot find a primary care provider.
Physicians and advanced nurse practitioners lose money when they
see a Medicare beneficiary. They hope SB 87 will provide enough
of an incentive so that primary care providers will see more
Medicare beneficiaries and stop turning patients away when they
reach their 65th birthday.
SENATOR DAVIS asked the Department of Health and Social Services
(DHSS) representative how he felt about the bill.
2:19:51 PM
JON SHERWOOD, Medicaid Special Projects, Division of Health Care
Services, Department of Health and Social Services (DHSS), said
he was prepared to talk about the DHSS' role in this bill. Under
SB 87 the primary responsibility is with Department of Commerce,
Community and Economic Development (DCCED). A specific provision
in the federal law the sponsor referenced would prohibit the
State Medicaid Agency (his department) from operating this grant
program. The bill gives them a role to help identify medically
underserved populations and look at adequate reimbursement. They
are comfortable in working with DCCED to fulfill those
functions.
SENATOR DAVIS asked him why federal law prohibits DHSS from
administering this.
MR. SHERWOOD answered that the federal Affordable Care Act and
its amendments provide that the grant program cannot be operated
by the state Medicaid agency.
SENATOR DAVIS asked if it could be done now because the law was
changed, that it has to be done by some other agency.
MR. SHERWOOD said that was correct.
SENATOR PASKVAN asked if he saw a need for this type of service
- to increase the number of people who might receive care.
MR. SHERWOOD replies yes. They have received complaints and
observations from dual eligible Medicaid/Medicare beneficiaries
that they have trouble accessing primary care in many of the
major communities. Typically for doctors in the state of Alaska,
Medicaid pays more than Medicare, but under the rules for
Medicare, the state can't pay a Medicare provider more than the
Medicare-allowed amount. So, it limits the state even for their
dual eligibles.
2:23:28 PM
CHAIR EGAN thanked him for testifying and said he would hold the
bill for further hearing. Finding no further business to come
before the committee, he adjourned the meeting at 2:24 p.m.
| Document Name | Date/Time | Subjects |
|---|---|---|
| SB 87 Sponsor Statement.PDF |
SFIN 3/28/2011 9:00:00 AM SL&C 3/1/2011 2:00:00 PM |
SB 87 |
| SB 87 Sponsor lttr to Parnell.PDF |
SL&C 3/1/2011 2:00:00 PM |
SB 87 |
| SB 87 ISER analysis.PDF |
SL&C 3/1/2011 2:00:00 PM |
SB 87 |