03/22/2018 08:15 AM Senate RULES
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ALASKA STATE LEGISLATURE SENATE RULES STANDING COMMITTEE March 22, 2018 8:14 a.m. MEMBERS PRESENT Senator Kevin Meyer, Chair Senator Pete Kelly Senator Peter Micciche Senator Anna MacKinnon Senator Berta Gardner MEMBERS ABSENT All members present COMMITTEE CALENDAR SENATE BILL NO. 169 "An Act relating to the definition of 'supervision or direct supervision' for purposes of medical assistance coverage of behavioral health clinic services." - MOVED CSSB 169(RLS) OUT OF COMMITTEE PREVIOUS COMMITTEE ACTION BILL: SB 169 SHORT TITLE: MEDICAID: BEHAVIORAL HEALTH COVERAGE SPONSOR(s): SENATOR(s) GIESSEL 01/31/18 (S) READ THE FIRST TIME - REFERRALS
01/31/18 (S) HSS 03/05/18 (S) HSS AT 1:30 PM BUTROVICH 205 03/05/18 (S) Heard & Held 03/05/18 (S) MINUTE(HSS) 03/07/18 (S) HSS AT 1:30 PM BUTROVICH 205 03/07/18 (S) Moved CSSB 169(HSS) Out of Committee 03/07/18 (S) MINUTE(HSS) 03/12/18 (S) HSS RPT CS 5DP NEW TITLE 03/12/18 (S) DP: WILSON, BEGICH, VON IMHOF, MICCICHE, GIESSEL 03/21/18 (S) RULES WAIVED PUBLIC HEARING NOTICE,RULE 23 03/22/18 (S) RLS AT 8:15 AM FAHRENKAMP 203 WITNESS REGISTER SENATOR GIESSEL Alaska State Legislature Juneau, Alaska POSITION STATEMENT: Sponsor of SB 169. ACTION NARRATIVE 8:14:27 AM CHAIR KEVIN MEYER called the Senate Rules Standing Committee meeting to order at 8:14 a.m. Present at the call to order were Senators MacKinnon, Gardner, Micciche, and Chair Meyer. Senator Kelly joined the committee soon thereafter. SB 169-MEDICAID: BEHAVIORAL HEALTH COVERAGE 8:14:53 AM CHAIR MEYER announced consideration of SB 169. SENATOR MACKINNON moved to adopt CSSB 169(RLS), version 30- LS1283\U, as the working document. There were no objections and it was so ordered. 8:15:36 AM SENATOR GIESSEL, sponsor of SB 169, Alaska State Legislature, explained that the Rules [version \U] committee substitute (CS) removes a phrase "or an advanced practice registered nurse (APRN) licensed under AS 08.68 who is certified to provide psychiatric or mental health services" in two locations of the bill: on page 1, line 7, and on page 1, line 10. She explained that these changes are being proposed because it was noted in the Department of Health and Social Services (DHSS) under the Division of Behavioral new fiscal note, dated 3/14/18, that Federal Rule 42 CFR 440.90 only allows clinic services to be supervised only by a physician or a dentist. So, the addition of the licensed advanced practice registered nurse certified in psychiatric or mental health practice language does not affect the fiscal note that is zero. Currently, it is not possible for an APRN who owns a clinic providing behavioral health clinic services to enroll the clinic and bill Medicaid under the clinic license, which was the purpose of the addition of the APRN. 8:16:14 AM SENATOR KELLY joined committee. 8:16:48 AM CHAIR MEYER asked if this amendment was made in the Health and Social Services Committee. SENATOR GIESSEL replied no; it was in her original bill whose purpose was to open the doors for more behavioral health clinicians in the state. She has multiple document of how short the state is; it was topic of huge interest under SB 74, Medicaid reform. Alaska has a rule that requires a psychiatrist to be physically present in a clinic 30 percent of the time that the clinic is open. The original bill would remove that requirement and replace the word "psychiatrist" with the word "physician" and included a psych-mental health nurse practitioner as one of the supervisory folks. This would open the door for a lot more clinicians to provide mental health services in the state. Because of the federal reimbursement restrictions, the nurse practitioner needed to be removed from the bill. SENATOR MACKINNON asked if it is fair to say this will align the state definition with federal requirements. SENATOR GIESSEL replied that this language will be complying with federal requirements. She added that she spoke with U.S. Senator Dan Sullivan 10 days ago and sent a letter to the secretary of the U.S. Department of Health and Human Services pointing out this huge flaw in federal law that is restricting Alaska's mental health services and requesting an exemption. But that will be some time in coming. SENATOR GARDNER asked if the remainder of the bill allows a physician who is not a psychiatrist to supervise in a behavioral health clinic. SENATOR GIESSEL answered yes, or a dentist, as the federal law states. 8:19:09 AM SENATOR MACKINNON moved to report CSSB 169(RLS), version 30- LS1283\U from committee with individual recommendations and forthcoming corrected zero fiscal note(s). There were no objections and it was so ordered. 8:19:47 AM CHAIR MEYER adjourned the Senate Rules Standing Committee meeting at 8:19 a.m.