CS FOR SENATE BILL NO. 169(FIN) "An Act establishing in the Department of Health and Social Services a statewide immunization program and the State Vaccine Assessment Council; creating a vaccine assessment account; requiring a vaccine assessment from assessable entities and other program participants for statewide immunization purchases; repealing the temporary child and adult immunization program; and providing for an effective date." 9:40:13 AM SENATOR CATHY GEISSEL, SPONSOR, spoke to the graphic, "SB 169 Vaccine Assessment Program" (copy on file). The graphic charted the various fund transfers that would occur as a result of the vaccine assessment program. She turned committee attention to another graphic, "SB 169 Statewide Immunization Program"(copy on file), which emphasized that the program was optional for all providers, with an additional provision to opt out of the program within the first 3 years. She said that one of the goals of the Alaska Healthcare Commission was to purchase healthcare services with public funds and the bill was a representation of that goal. She stated that homeless teens and young adults would benefit from the legislation. She added that community healthcare clinics in rural Alaska would also benefit from the bill. 9:45:41 AM Senator Geissel discussed her response memo to Representative Wilson's question in the last hearing (copy on file): Dear Finance Committee Members: I was asked by Representative Tammy Wilson's aide how many Alaskans would be affected of SB 169 fails and received the below information from the Division of Public Health. The impact would be huge: Without SB169 and once HB310 funds fun out, providers will have to purchase vaccine for 50 percent of the children and 100 percent of the adults. That is estimated to be about 310,000 individuals of which 80,000 are children and 230,000 are adults. This is based on current population and immunization rates. Only the 50 percent of children covered by federal Vaccines for Children and a small number of high-risk children and adults covered with other state and federal funds will continue to receive state-supplied vaccine. In terms of dollars, without SB169, the providers' share of vaccine spending will increase from about 50 percent currently to about 75 percent, or an extra $12 million, increasing from $23 million to $35 million. This assumes immunization rates stay steady and that providers continue to purchase vaccine for the insured and uninsured. Senator Giessel spoke to the cost of vaccinations. She stated that the measles, mumps, rubella (MMR) vaccination for children, under the Center for Disease Control (CDC) purchasing plan, costs $20 per dose. She shared that individual providers purchasing the same dosage on the open market paid $56 per dose. She said that one adult vaccine dose for pneumonia purchased through the CDC purchasing would be $23; individual providers would pay $68. She discussed the cost discrepancies for various vaccinations. 9:49:39 AM Representative Wilson asked whether the current bill version required mandatory participation after 3 years. Senator Giessel replied that no one would be mandated to be part of the program. Representative Wilson understood that private insurance companies would also have the ability to opt in, but that the state was exempt. Senator Giessel replied requests for the program from insurance companies had led to the legislation. 9:51:22 AM Representative Munoz asked if all providers would be charged the same rate per vaccine. Senator Giessel replied yes. 9:52:14 AM Representative Holmes discussed the 5 fiscal notes attached to the bill. 9:55:07 AM JILL LEWIS, DEPUTY DIRECTOR, DIVISION OF PUBLIC HEALTH, DEPARTMENT OF HEALTH AND SOCIAL SERVICES, stated that the fiscal notes netted to zero because for every dollar that was spent, there was a new dollar coming in of new assessment fees. She directed committee attention to the hand out, "SB 169 Vaccine Assessment Program." She recommended comparing the first two fiscal notes side-by- side. She said that the money would flow between the two notes and net to zero. She stated that the first note was for informational purposes only and likened to a deposit slip from the bank, the "checking account" being the fiscal note for epidemiology. She relayed that the $4 million from note 2 would be subtracted under the fund source and would be moved into an account outside of the department's budget. She furthered that assessments would be collected in advance from the assessable entities and the money would be used to purchase additional vaccine. 9:59:57 AM Representative Wilson surmised that there was no request being made for new revenue. Ms. Lewis replied in the affirmative. 10:01:32 AM Representative Wilson said that the other figures in the notes appeared in anticipation of the best mathematical estimates. Ms. Lewis said that there was a lot of math involved in calculating and estimating the costs involved in the program. She stated that entities would phase in during the first 3 years and that some could opt out. She added that there could be providers that might want to opt in for vaccine that they would otherwise have to purchase on their own. Representative Wilson asked whether the change could have negative impact on the department. Ms. Lewis replied no. She acknowledged that federally funded entities had additional obstacles, which had been accounted for by allowing the 3 year phase in option. Representative Holmes MOVED to REPORT HCS CSSB 169(HSS) out of committee with individual recommendations and the accompanying fiscal notes. There being NO OBJECTION, it was so ordered. HCS CSSB 169(HSS) was REPORTED out of committee with a "do pass" recommendation and with one new fiscal note from Fund Transfers for the Department of Health and Social Services, one new fiscal note from the Department of Health and Social Services, one new indeterminate fiscal note from the Department of Health and Social Services, one previously published zero fiscal note: FN4 (CED), and one previously published indeterminate fiscal note: FN5 (ADM).