ALASKA STATE LEGISLATURE  HOUSE HEALTH AND SOCIAL SERVICES STANDING COMMITTEE  April 6, 2013 9:02 a.m. MEMBERS PRESENT  Representative Pete Higgins, Chair Representative Wes Keller, Vice Chair Representative Benjamin Nageak Representative Lance Pruitt Representative Lora Reinbold Representative Paul Seaton Representative Geran Tarr MEMBERS ABSENT  All members present COMMITTEE CALENDAR  HOUSE BILL NO. 134 "An Act requiring Medicaid payment for scheduled unit dose prescription drug packaging and dispensing services for specified recipients." - HEARD & HELD HOUSE BILL NO. 147 "An Act extending the reporting date for and the termination date of the Comprehensive Autism Early Diagnosis and Treatment Task Force; and providing for an effective date." - MOVED HB 147 OUT OF COMMITTEE HOUSE BILL NO. 184 "An Act requiring screening of newborns for congenital heart defects." - BILL HEARING CANCELED PREVIOUS COMMITTEE ACTION  BILL: HB 134 SHORT TITLE: MEDICAID PAYMENT FOR MEDISET PRESCRIPTION SPONSOR(s): REPRESENTATIVE(s) COSTELLO 02/20/13 (H) READ THE FIRST TIME - REFERRALS 02/20/13 (H) HSS, FIN 03/19/13 (H) HSS AT 3:00 PM CAPITOL 106 03/19/13 (H) Heard & Held 03/19/13 (H) MINUTE(HSS) 03/28/13 (H) HSS AT 3:00 PM CAPITOL 106 03/28/13 (H) Heard & Held 03/28/13 (H) MINUTE(HSS) 04/02/13 (H) HSS AT 3:00 PM CAPITOL 106 04/02/13 (H) Heard & Held 04/02/13 (H) MINUTE(HSS) 04/04/13 (H) HSS AT 3:00 PM CAPITOL 106 04/04/13 (H) Scheduled But Not Heard 04/06/13 (H) HSS AT 9:00 AM CAPITOL 106 BILL: HB 147 SHORT TITLE: EXTEND AUTISM EARLY DIAGNOSIS TASK FORCE SPONSOR(s): REPRESENTATIVE(s) SADDLER 03/01/13 (H) READ THE FIRST TIME - REFERRALS 03/01/13 (H) HSS 04/06/13 (H) HSS AT 9:00 AM CAPITOL 106 WITNESS REGISTER CHARLES GUINCHARD, Staff Representative Mia Costello Alaska State Legislature Juneau, Alaska POSITION STATEMENT: Presented HB 134 on behalf of Representative Costello, sponsor of the bill. REPRESENTATIVE DAN SADDLER Alaska State Legislature Juneau, Alaska POSITION STATEMENT: Presented HB 147 as the sponsor of the bill. PAUL VERHAGEN, Staff Representative Pete Higgins Alaska State Legislature Juneau, Alaska POSITION STATEMENT: Testified during discussion of HB 147. ACTION NARRATIVE 9:02:30 AM CHAIR PETE HIGGINS called the House Health and Social Services Standing Committee meeting to order at 9:02 a.m. Representatives Higgins, Seaton, Nageak, Keller, and Tarr were present at the call to order. Representatives Pruitt and Reinbold arrived as the meeting was in progress. HB 134-MEDICAID PAYMENT FOR MEDISET PRESCRIPTION  9:03:24 AM CHAIR HIGGINS announced that the first order of business would be HOUSE BILL NO. 134, "An Act requiring Medicaid payment for scheduled unit dose prescription drug packaging and dispensing services for specified recipients." [In front of the committee was Version 28-LS0303\R, Mischel, 4/1/13, adopted as the working document by the committee on April 2, 2013.] 9:03:50 AM CHARLES GUINCHARD, Staff, Representative Mia Costello, Alaska State Legislature, said that the sponsor, Representative Costello, recognized this was a complicated issue and was willing to spend time answering questions and concerns with committee members. He reported that there were no changes to the current working draft, Version R. 9:04:57 AM CHAIR HIGGINS offered his belief that the sponsor had agreed to hold the bill in the committee through the interim. 9:05:58 AM REPRESENTATIVE SEATON asked about the research requests. CHAIR HIGGINS agreed to distribute these responses from the department during the interim. 9:06:28 AM REPRESENTATIVE TARR extolled that the bill presentation had been especially educational regarding Medicaid expansion. [HB 134 was held over.] HB 147-EXTEND AUTISM EARLY DIAGNOSIS TASK FORCE  9:07:18 AM CHAIR HIGGINS announced that the next order of business would be HOUSE BILL NO. 147, "An Act extending the reporting date for and the termination date of the Comprehensive Autism Early Diagnosis and Treatment Task Force; and providing for an effective date." 9:07:42 AM REPRESENTATIVE DAN SADDLER, Alaska State Legislature, sponsor of HB 147, said that the purpose of the proposed bill was straightforward, as it would extend the authorization date of the Comprehensive Autism Early Diagnosis and Treatment Task Force. He explained that autism was a neural behavioral disorder, or disease, characterized by diminished communication and social skills, which was often manifested early in life. He stated that although it was incurable, it was treatable, and that treatment improved the life prospects of those with autism. He declared that treatment also reduced the cost for social services, and helped improve the outcomes. He noted that Senate Bill 74 [27th Alaska State Legislature] had established that private health insurers would cover the cost of effective treatment for autism; although it did not ensure insurance coverage for autism to every family, the task force provision had been added to investigate ways to extend coverage for more Alaska families. He listed the members of the task force. He declared that its mission was to make recommendations to the Alaska State Legislature for development of a statewide comprehensive plan to support early diagnosis and treatment of autism, for evaluation of the fiscal impact of its proposals, and for analysis of the effect of the Patient Protection and Affordable Care Act on the recommendations and policies of the task force. He reported that proposed HB 147 would extend the available time for the task force to January 15, 2015, the last day of the 28th Legislature. He asked for the committee's support in passage of the proposed bill. 9:10:10 AM REPRESENTATIVE SEATON asked whether the parameters of the task force were solely for reviewing insurance coverage, or was it also for reviewing effective treatment intervention. REPRESENTATIVE SADDLER, in response to Representative Seaton, said that the task force would review both issues, as it had a somewhat broad mandate for recommendation of ways to improve early diagnosis and treatment, and ways to implement these recommendations through legislation. 9:10:48 AM REPRESENTATIVE SEATON asked to clarify that emerging recommendations of prevention and treatment of autism were to be incorporated into existing programs, or if the task force was solely to review current insurance coverage. REPRESENTATIVE SADDLER offered his belief that the intent was to focus on effecting current insurance policies by including state of the art autism treatment into these policies. He noted that the task force was not designed to "push the frontiers of treatment programs," but to implement what was currently available. 9:11:55 AM REPRESENTATIVE REINBOLD directed attention to page 1, line 9, of the proposed bill, and asked for the intent of the legislation. REPRESENTATIVE SADDLER expressed his agreement that it was broad and comprehensive coverage. He opined that the focus would be to integrate the state of the art treatment of autism with current insurance policies and coverage. He commented that the coverage in Alaska was a patchwork of insurance providers, and was very complicated. He shared that an effort of the task force would be to "try and meld those systems with the treatment options available for autism." REPRESENTATIVE REINBOLD asked how many patients this would affect, and she inquired about any fiscal note. REPRESENTATIVE SADDLER replied that the majority of the task force work would be via teleconference, hence there would not be a fiscal note. In response, he reported that research indicated that 1 in 88 children in Alaska were affected with autism spectrum disorder, and that this was a "rather significant public health problem." REPRESENTATIVE REINBOLD asked for a total number of affected individuals. REPRESENTATIVE SADDLER replied that he was unsure of the exact numbers. 9:14:55 AM REPRESENTATIVE KELLER stated his support for HB 147. He offered some clarification as he had been involved with the original bill. He stated that the proposed bill was to explore the options for extending treatment opportunities equally across the state, as opposed to simply directing it toward private insurance. He relayed that there were still questions outstanding, as there was a desire for the coverage for autistic children. He pointed out the range of diagnostic estimations for autism spectrum disorder, and what it covered. He stated that autism was included in autism spectrum disorder, and he expressed his desire for more information regarding the diagnostic definition from the task force. He stated that he was also concerned for the level of Medicaid expansion which would result from this proposed bill. 9:17:23 AM REPRESENTATIVE SADDLER, in response, explained that Asperger's Syndrome was no longer included in the autism definition. He pointed out that autism spectrum disorder ranged from low to high function. He reported that the State of Washington was making progress for autism coverage, and that the State of Alaska was also reviewing its coverage. He agreed that there was a patchwork of autism coverage, noting that Tricare also offered coverage. 9:18:44 AM REPRESENTATIVE TARR shared her support for the proposed bill. She discussed environmental health research, which underscored the need to learn a lot more about autism spectrum disorder and early interventions. She welcomed the upcoming reports from the proposed task force. 9:19:23 AM REPRESENTATIVE SEATON asked if the task force meetings would be available for listening. REPRESENTATIVE SADDLER replied that the task force would welcome any input and suggestions. 9:20:41 AM CHAIR HIGGINS commented that he had been learning about the Alaska Governor's Council on Disabilities and Special Education. He reported that these council members were paid, and, as one of its jobs was for the same work as this task force, he recommended that the groups work together. He pointed out that, often, the various groups were not collaborative with the information. 9:22:04 AM REPRESENTATIVE SADDLER remarked that his wife had been on that council for two terms, and he was very aware of the issues. 9:22:43 AM CHAIR HIGGINS opened public testimony. 9:22:52 AM PAUL VERHAGEN, Staff, Representative Pete Higgins, Alaska State Legislature, shared a personal anecdote about the effects of autism on his immediate family. He explained that his daughter had four children who were autistic. He stated the difficulties for finding any support, and that the State of [Oregon] offered the most assistance. He reported that the state's assistance brought her a base of knowledge for help with the children, which she used to write a children's book for teaching kids with autism. He expressed gratitude for all the work and support for autism. He reported that the children were now thriving and at grade level in school. He declared that it was more difficult to discern that the kids had autism. 9:27:03 AM REPRESENTATIVE KELLER moved to report HB 147 out of committee with individual recommendations and the accompanying zero fiscal notes. There being no objection, HB 147 was moved from the House Health and Social Services Standing Committee. 9:27:30 AM The committee took an at-ease from 9:27 a.m. to 9:30 a.m. 9:30:26 AM CHAIR HIGGINS brought the committee back to order. 9:31:32 AM ADJOURNMENT  There being no further business before the committee, the House Health and Social Services Standing Committee meeting was adjourned at 9:31 a.m.