ALASKA STATE LEGISLATURE  SENATE HEALTH AND SOCIAL SERVICES STANDING COMMITTEE  March 4, 2021 1:34 p.m. MEMBERS PRESENT Senator David Wilson, Chair Senator Shelley Hughes, Vice Chair Senator Mia Costello Senator Tom Begich MEMBERS ABSENT  Senator Lora Reinbold COMMITTEE CALENDAR  SENATE BILL NO. 21 "An Act relating to mobile intensive care paramedics; relating to duties of the State Medical Board and the Department of Health and Social Services; and providing for an effective date." - MOVED SB 21 OUT OF COMMITTEE CONFIRMATION(S) HEARINGS State Medical Board Marie Freeman - Wasilla Lydia Mielke - Big Lake Richard Wein - Sitka Alaska Mental Health Trust Authority Board of Trustees Rhonda Boyles - Anchorage Brent Fisher - Anchorage Annette Gwalthney-Jones - Anchorage Anita Halterman - Eagle River - CONFIRMATIONS ADVANCED PREVIOUS COMMITTEE ACTION  BILL: SB 21 SHORT TITLE: LICENSE MOBILE INTENSIVE CARE PARAMEDICS SPONSOR(s): SENATOR(s) REVAK 01/22/21 (S) PREFILE RELEASED 1/8/21 01/22/21 (S) READ THE FIRST TIME - REFERRALS 01/22/21 (S) HSS, L&C 03/02/21 (S) HSS AT 1:30 PM BUTROVICH 205 03/02/21 (S) Heard & Held 03/02/21 (S) MINUTE(HSS) WITNESS REGISTER DIRK CRAFT, Staff Senator Josh Revak Alaska State Legislature Juneau, Alaska POSITION STATEMENT: Presented information on behalf of the sponsor on SB 21. MARIE FREEMAN, M.D., Appointee Wasilla, Alaska POSITION STATEMENT: Testified as the governor's appointee to the State Medical Board. LYDIA MIELKE, Appointee Big Lake, Alaska POSITION STATEMENT: Testified as the governor's appointee to the State Medical Board. RICHARD WEIN, M.D., Appointee Sitka, Alaska POSITION STATEMENT: Testified as the governor's appointee to the State Medical Board. RHONDA BOYLES, Appointee Anchorage, Alaska POSITION STATEMENT: Testified as the governor's appointee to the Alaska Mental Health Trust Authority Board of Trustees. BRENT FISHER, Appointee Anchorage, Alaska POSITION STATEMENT: Testified as the governor's appointee to the Alaska Mental Health Trust Authority Board of Trustees. ANNETTE GWALTHNEY-JONES, Appointee Anchorage, Alaska POSITION STATEMENT: Testified as the governor's appointee to the Alaska Mental Health Trust Authority Board of Trustees. ANITA HALTERMAN, Appointee Eagle River, Alaska POSITION STATEMENT: Testified as the governor's appointee to the Alaska Mental Health Trust Authority Board of Trustees. ACTION NARRATIVE 1:34:43 PM CHAIR DAVID WILSON called the Senate Health and Social Services Standing Committee meeting to order at 1:34 p.m. Present at the call to order were Senators Hughes, Begich, Costello, and Chair Wilson. SB 21-LICENSE MOBILE INTENSIVE CARE PARAMEDICS  1:35:11 PM CHAIR WILSON announced the consideration of SENATE BILL NO. 21, "An Act relating to mobile intensive care paramedics; relating to duties of the State Medical Board and the Department of Health and Social Services; and providing for an effective date." He noted the committee heard an overview of the bill and took public testimony March 2. CHAIR WILSON asked for an overview of the letter received from the Chugiak Fire Department. 1:35:47 PM DIRK CRAFT, Staff, Senator Josh Revak, Alaska State Legislature, Juneau, Alaska, said that Senator Reinbold had asked Senator Revak's office to reach out to the Chugiak Fire Department and obtain a letter of support, which the committee has a copy of. SENATOR HUGHES said she appreciated Chugiak weighing in. The paramedics are very busy on the Glenn Highway. CHAIR WILSON asked the will of the committee. 1:36:58 PM SENATOR HUGHES moved to report SB 21 [work order 32-LS0207\B] from committee with individual recommendations and attached fiscal note(s). There being no objection SB 21 was reported from the Senate Health and Social Services Standing Committee. 1:37:15 PM At ease ^Confirmation Hearing(s) CONFIRMATION HEARING(S)  State Medical Board  Alaska Mental Health Trust Authority Board of Trustees  1:38:48 PM CHAIR WILSON reconvened the meeting and announced the consideration of the governor's appointees to the State Medical Board. He called on appointee Marie Freeman. 1:39:32 PM MARIE FREEMAN, M.D., Appointee, Wasilla, Alaska, said that he has been a family physician in Alaska for the past 27 years. She developed a medication-assisted treatment program for Algone, a pain clinic. She is a follower and believer in the teachings of Jesus Christ. The State Medical Board offers an opportunity to learn and serve community. She joined the board last year. It is a civic duty. She brings to the board over 30 years of medical practice and experience and hopefully common sense. CHAIR WILSON asked if Dr. Freeman had served on the medical board for the past year and she answered no. SENATOR BEGICH said he doesn't know the Algone Intervention Pain Group listed on her resume. DR. FREEMAN answered that it is an interventional pain clinic. It is for those with chronic pain issues, such as cancer or orthopedic pain. SENATOR BEGICH said that part of the work is disciplinary action for those who violate state law. That led to a contentious hearing last year. He asked if she has been involved in any processes that involve disciplinary action against people who violate state law. DR. FREEMAN replied not before joining the board, but since joining the board she has had a number of opportunities to serve in that capacity. That has been an interesting experience. SENATOR BEGICH clarified that she is familiar with state board statutes and regulations because she has had to apply them to cases that have come before the board. He noted in her opening statement she brought up her religious beliefs. He asked how she will separate those religious beliefs from her service on this secular, regulatory body if they conflict. DR. FREEMAN said she doesn't believe they will conflict. Her religious beliefs will be helpful to guide what she thinks the correct thing to do is based on the Alaska statutes. SENATOR BEGICH thanked her for her succinct and on-point answer. 1:46:02 PM CHAIR WILSON called on appointee Lydia Mielke. 1:46:16 PM LYDIA MIELKE, Appointee, Big Lake, Alaska, said she was born and raised in Big Lake. She has worked in tourism and spent five sessions working in the legislature. She was appointed to the board a year ago and was able to spend a significant time learning about the board and jumping into her role as the public member. The board met weekly because of the COVID pandemic. The board passed emergency regulations to make sure the state had the physicians it needed during the pandemic. She is working for the Division of Community and Regional Affairs as a local government specialist. She brings a younger voice and perspective to the board. She does her research before the meetings. She is excited about the opportunity to serve. SENATOR BEGICH clarified that being on the board is voluntary and uncompensated. MS. MIELKE replied yes and the only compensation would be for travel expenses. SENATOR BEGICH asked how familiar she is now as a public member with the state board statutes and regulations. He asked if she had taken part in any disciplinary actions between December 15 and January 19. MS. MIELKE replied that she would need to check with the board staff about the dates of the last meeting, and Senator Begich replied the board will do that. She said that she has read through the statutes and reviews them as needed. CHAIR WILSON thanked her for her service and called on appointee Richard Wein. 1:50:58 PM RICHARD WEIN, M.D., Appointee, Sitka, Alaska, shared that the medical board had met more than any other board because of the pandemic and met the needs of the medical community. He has a master's in journalism from Columbia and a medical degree from Tufts. He was a physician surgeon for 40 years, 20 in New Jersey and 20 in Alaska. He has held many leadership roles in his career. He was on the staff of SEARCH-Mt. Edgecumbe Hospital in Sitka. He was also on the staff of Sitka Community Hospital. He has served as the chair of the board for the last year, which also involved attending many other meetings. His life has revolved around problem solving and working with people, taking complex information, synthesizing it, and crafting solutions. CHAIR WILSON asked if he is still practicing. DR. WEIN replied that he is not in the active practice of general surgery, but he practices medicine by helping people navigate through the medical system. He is an advocate. SENATOR BEGICH said he understood that Dr. Wein has no active medical license at this time. DR. WEIN answered that he does have an active medical license. He is due for renewal this year and will reapply. SENATOR BEGICH recalled that there was a fairly contentious hearing last year. He is not going to bring those issues up again. Dr. Wein has been leading the board for a full year. He asked if the board met between December 15 and January 19. DR. WEIN responded that to the best of his recollection the board did not. The leadership at the division was aware that things were changing with appointees and some of the issues. The good news is that the board met so many times that it accomplished a great deal of business. He thinks the board met January 29. He thinks the board met in early December and not during the time of concern. SENATOR BEGICH said that a lawsuit filed by the legislature and court has held that actions may not have been legal after December 15 and before January 19. It is not decided law yet. It is still contested in the courts; that is why he is asking. DR. WEIN said the board members were aware and were happy to be in full compliance. SENATOR BEGICH said that the other questions he would normally ask were answered by Dr. Wein last year. SENATOR COSTELLO thanked all who have been serving. Their service is appreciated. She has not served on the Health and Social Services Committee in prior years. She asked what he sees as the biggest challenge in 2021 for the board. She asked what vicarious liability is. This seems to have come up last year, but she wanted to give him a chance to explain that situation to her. DR. WEIN replied that vicarious liability is a legal technique. If someone is part of a medical group and a member of the group is successfully sued, other members of that incorporation are part of the suit and it is called vicarious. It is because of an association that occurred. Other than vicarious liability, he has had no malpractice suits in over 40 years. Regarding the greatest challenge, he wishes he could say there is one. There are a lot. The first one that comes to mind is the Prescription Drug Monitoring Program (PDMP). This giant challenge represents a great deal of time, effort, and energy and as Dr. Daugherty mentioned [in his confirmation hearing], it has potential problems which ensnares well-meaning physicians. There are a number of solutions. His solution is developing a push notification system for the PDMP, which would eliminate many problems and save physicians a great deal of time. Some issues are related to the application procedures. None of these things are straightforward. This is a new age and in going through applications, the staff is very busy. Although it may seem things are slow, physicians are applying with numerous licenses, some with 40. All of these have to be evaluated. There are lots of curveballs occurring in the regulatory process. The state has its own in-state issues, such as with telehealth. Many people from out of state are delivering medication with oversight that is difficult. One of the goals of the board is to promote safe practice for the citizens of Alaska. Telemedicine within the state is perfect and should be expanded, but corporations are inundating Alaska, which can adversely affect Alaska physicians. On the one hand it is needed. Telemedicine is a great technology, but the state must understand it. There are many issues facing the medical board. The board is a good, responsive group who meet when necessary, not just quarterly. The board has been good at solving problems. 2:03:20 PM At ease 2:04:55 PM CHAIR WILSON reconvened the meeting. He asked if the Medical Board has sought to work with the Board of Pharmacy on regulations for the PDMP. DR. WEIN answered absolutely. There are six groups within the state of Alaska that write prescriptions. A group has been formed with Richard Holt, the head of the Board of Pharmacy as the lead, to discuss PDMP issues. That group routinely is invited to Medical Board meetings. Members of PDMP group present during the Medical Board's quarterly meetings. 2:06:20 PM At ease 2:06:43 PM CHAIR WILSON reconvened the meeting. SENATOR BEGICH stated that at the last committee hearing, two members of the board said there was increased engagement with the PDMP. He asked what that meant. DR. WEIN replied said the last report showed 94 percent compliance with the PDMP. Compliance means that people have registered with the PDMP, which had been a problem and issue with the legislative audit. SENATOR BEGICH said that was the quantified answer he was looking for. He is curious about the role of Medical Board in the pandemic approach in terms of vaccines. Dr. Wein has made public statements questioning the efficacy on vaccines. He asked what Dr. Wein's position is on the vaccines. DR. WEIN answered that he must backstep one moment. He has a master's in journalism and knows a lot about journalistic standards. Journalists are not allowed to complete someone's sentences or thoughts. There was a complete misrepresentation because he was not allowed to complete his thought. A news organization completed it for him. He made no statement. He made one sentence and was interrupted. He is a big supporter of vaccines. They are very important, whether they come from Edward Jenner with the smallpox vaccine to the Messenger RNA-based vaccines. He is also a supporter of the promotion of safe and appropriately studied medications, including vaccines. Nobody knew what he was going to say. He finds that interesting. He is a supporter in general of vaccines but especially of those that have been studied and are safe. He has gotten many vaccines himself. SENATOR BEGICH said he appreciated the clarification of the press mistake on the record, but Dr. Wein qualified his statements. He asked if Dr. Wein believes in the efficacy and safety of the Pfizer, Moderna, and Johnson and Johnson vaccines that are now being promoted in the state of Alaska to deal with COVID-19. DR. WEIN responded that data that has presented has made it very effective. That data is appropriate and he believes in that data. He would also like to point out that pregnant women and those under 16 were not included in the studies. Very few over 65 were included and comorbidities were eliminated. His full answer is that it is a great technological advance, utilizing Messenger RNA as a vaccine. That being said, he looks forward to more data coming out. Right now a significant percentage of people are concerned about receiving the vaccine. As time goes on, the data will come out and there will be greater support for it. SENATOR BEGICH asked to avoid putting words in his mouth, is it fair to say that his is a qualified endorsement of the vaccines. DR. WEIN replied that he does support the vaccine, especially for those who are at risk. The data is bifurcated between those at great risk and those at lesser risk. He has always been for public health measures that protect people at risk and that includes getting the vaccine and making sure those individuals who are at the greatest risk "are first in line." SENATOR BEGICH said that Dr. Wein is the chair of the Medical Board and his position carries great weight. That is why he is asking if it is fair to say that Dr. Wein's is a qualified endorsement of the vaccines. DR. WEIN answered that he endorses the vaccine and anxiously awaits additional data because it is an emergency-use medication. It is not an approved medication. Every day more data is accumulated, which he thinks is a good thing. 2:13:41 PM CHAIR WILSON opened public testimony and after ascertaining there was none, closed public testimony. He moved to nominees for the Alaska Mental Health Trust Authority Board of Trustees. He called on Rhonda Boyles. 2:14:35 PM RHONDA BOYLES, Appointee, Anchorage, Alaska, said she has lived 44 years in Fairbanks with much public service. She owned and sold four restaurants. She was mayor of the Fairbanks North Star Borough. She moved out of state in 2017 because of the need for medical support for her husband. After he passed away, she sold her house in Fairbanks and relocated to Anchorage. She has a diversified resume. As a retiree, she has the time and resources to volunteer in this capacity. Over the last 14 months, she has learned how time-consuming serving on the board is. There is a lot of reading and homework that is directly relative to the need of managing the trust with diversified skills. CHAIR WILSON noted the upcoming budget has an overdraw of the Mental Health Trust Authority funds into general operations. He asked her thoughts about the trust funding $60 million this upcoming year for the Alaska Psychiatric Institute (API). MS. BOYLES replied that she believes in process and cannot speak for the other trustees. The trust beneficiaries are served by API as well as other people. The process used to move the money around was the issue for many board members, at least for her. She does not want to be held liable for making an inappropriate decision based on how the trust was established in 94 and how and who has access to the money. She looks forward to seeing that situation discussed further and how the staff brings it forward for the board to reconsider it. CHAIR WILSON clarified for her and the other trustees online that he is asking for personal thoughts and opinions on that. SENATOR BEGICH said that Ms. Boyles is legally appointed on whatever day the governor read over the appointments most recently. The court case only covered from December 15 to January 19. She is considered a legitimate reappointment at this point. CHAIR WILSON called on Brent Fisher. 2:20:20 PM BRENT FISHER, Appointee, Anchorage, Alaska, said he is veteran of the U.S. Army Medical Corps. He is board certified in hospital and medical group management. He is a fellow in the American College of Healthcare Executives and the American College of Medical Practice Executives. His career has been primarily associated with healthcare but includes a wide variety of organizations. He has published in numerous journals, trade magazines, and newspapers. He is a big believer in giving back to the community. He has served on several boards of directors for professional association as well as civic, business, and religious organizations. CHAIR WILSON asked for his viewpoint on using the trust funds to fund operations at API. MR. FISHER replied that he is a new member. He was appointed effective January 18. He is getting up to speed on these issues. He is reading a lot of material about the settlements and how the process was defined at that time about the use of funds. There is a process to use the funds for state initiatives, and that has been beneficial for starting new programs within the state. But there is a process that has been defined. As a new member, he is still evaluating whether that process was followed. It appears that maybe the process was not followed as outlined. His concern is that the trust follows whatever the settlement identified. The trust must sustain the trust fund for the beneficiaries for the long term and must meet the needs of state programs as well. That is an ambivalent answer but his position at this point. SENATOR BEGICH shared that he was a staff assistant during those years of negotiation. The idea was that it would be a trust fund, not a slush fund. That is his editorial. The point of the lawsuit was the misuse of lands that had been set aside to serve a population. He asked Mr. Fisher to take the time to read the extensive history about why the trust was founded. That will be a critical component for who he supports or does not support for the trust board because that is what the word trust means. It is about a trust for the beneficiary groups. The statute that governs the board, AS 47.30.016, states that a member may not be an officer or employee of the state of Alaska or within the preceding two years or during the member's term of office have an interest in, served on the governing board of, or been employed by an organization that has received money from the Mental Health Trust settlement, under grant or contract. He asked if that is true for Mr. Fisher. MR. FISHER replied yes, to the best of his knowledge. CHAIR WILSON called on Annette Gwalthney-Jones. 2:25:42 PM ANNETTE GWALTHNEY-JONES, Appointee, Anchorage, Alaska, said that she is a lifelong Alaskan whose father was in the Army. Her parents gave her the core value of serving her community and giving back. She has more than 25 years of managerial experience and leadership in human resources and social services. She has worked for trust beneficiary-serving organizations, including the Arc of Anchorage, the Salvation Army-Booth Memorial Home, and Covenant House. She has a master's in business organizational management. In 1992 she took a certified course at the University of Alaska Anchorage and became an emergency medical technician and a certified instructor in basic lifesaving, CPR, and first aid, and became part of the Alaska professional volunteers. She has been a court appointed special advocate and a foster parent to teens. She married an Air Force officer and served at various posts. She was part of the Air Force Key Spouse Program, which is a vital resource for Air Force families. In 2014 she and her husband returned to Alaska, and she continued her career as a human resources professional and continued her volunteer work. These experiences with her extensive background in human resources bring a relevant perspective to the work of the trust. She wants to be part of the board because she felt she had more to offer and could make more of an impact on her community. She understands the appointment as trustee is a five-year commitment. Since September of 2020 she has demonstrated her commitment by making it to scheduled meetings. She has added insight to a board working to advance the trust's critical efforts to improve the lives and circumstances of beneficiaries. She brings her duty of care ethos to the board. 2:32:35 PM SENATOR BEGICH asked if the trust met between December 15 and January 19. MS. GWALTHNEY-JONES answered that she believes that they did. SENATOR BEGICH said the decisions made during that time may be legally questionable because of a court case between the legislature and the administration on the legitimacy of appointments. He clarified that her appointment was made in November. MS. GWALTHNEY-JONES said November of 2020 was when she came on board and does not think her appointment is affected. SENATOR BEGICH said she would not fall into that category because her appointment was made before the legislature adjourned. The statute that governs the board, AS 47.30.016, states that a member may not be an officer or employee of the state of Alaska or within the preceding two years or during the member's term of office have an interest in, served on the governing board of, or been employed by an organization that has received money from the Mental Health Trust settlement, under grant or contract. He asked if that is true for Ms. Gwalthney- Jones. MS. GWALTHNEY-JONES answered that she has not worked for any agency the Mental Health Trust supports in the last two years. CHAIR WILSON called on Anita Halterman, who was also appointed last year and has served on the board for a year. 2:35:10 PM ANITA HALTERMAN, Appointee, Eagle River, Alaska, said that she is happy to be considered for renewal appointment to the trust. She started in August of 2019. She has held several leadership roles on the trust. She has been anxiously awaiting confirmation. Serving on the board has been an amazing journey that has expanded her knowledge of the mental health needs for Alaska, budgets, and the many programs offered throughout Alaska. She enjoys giving back to the community. On the board she has learned about new strategies and funding opportunities that can help shape meaningful reform for mental health programs. She wants to continue the journey. She worked for the legislature for the 29th session and has been reaching out to legislators' offices. Sher earned a master's in business. She worked mainly with the Medicaid program with the Department of Health and Social Services (DHSS) in Iowa and Alaska. In the 1990s the Alaska food stamp program was sanctioned for high error rates. She trained staff and developed programs to reduce error rates. She has devoted her lifework to working with populations that are underserved. She finds it rewarding to improve programs and systems. She started her own consulting business and obtained licenses as an insurance producer. She worked as an information technology sales accountant for a brief time and now works with a media production company doing sales and administration work. She has gained a new perspective about healthcare needs for privately insured individuals and expanded her understanding of more global workforce issues that Alaska faces. With her experience, she hopes to reform programs so that they can be sustained for the populations that need them the most. She looks forward to improving the lives of beneficiaries as the trust works in partnership with DHSS and other stakeholders to build an integrated, comprehensive mental health program that better meets the needs of trust beneficiaries. 2:39:45 PM CHAIR WILSON thanked her for her time on the board. Since she has been on the board longer, she probably understands the difference in the fund types of the trust. He asked her viewpoint on using trust funds for API. MS. HALTERMAN replied that it is a precedent-setting decision. It has not been done before. She has concerns about statutory obligations and, frankly, intends to follow state statutes. If the state statues are not working well for all the parties involved, then those statutes need to be revisited. The board must meet obligations as outlined in state statutes. The board has an obligation to current and future beneficiaries. She is concerned that inflation-proofing for the trust has not taken place for many years and the trust does not have the buying power it would have had had it maintained inflation-proofing practices. She looks forward to listening to continued conversations in the legislature about the budget. She is troubled with the fact that excessive funds in the department are being returned to general funds at a time that the trust is being asked to meet some obligations that were met by other government funding sources in the past. Her hope is that all can work together to find an agreeable solution, including improving state statutes that work for all if the statutes are not doing that. SENATOR BEGICH said he just received information that on January 14 there was a special meeting of the trust. He asked if anything was voted on that might be subject to the potential lawsuit between the legislature and the governor about the power of appointment. MS. HALTERMAN answered that there have been no actions of the full board. There have been committee decisions that have not been advanced to the full board. The board has unanimous consent for most issues that come before the board. Even if the legal challenge were to continue and the two votes stripped subject to that time period, there would still be the support of the full board if there was a questionable vote. Since there has been no meeting and action of the full board, she does not think there will be any issues subject to that legal challenge. SENATOR BEGICH said that is encouraging. Her resume states that from 2016 to the present, she has offered advice to members of the legislature. To him that is close to state employment. He asked whether since her appointment on August 2, 2019, she has engaged in any of that activity, where she says she researched public policy and budget issues for members of the Alaska legislature and public officials. MS. HALTERMAN replied that she has not received any compensation for any research she has done or any of the input she has given on any legislative issue. She was involved in the telemedicine legislation that has been carried in the last couple of years, primarily weighing in as part of another board in a voluntary capacity. SENATOR BEGICH said that is encouraging. The statute that governs the board, AS 47.30.016, states that a member may not be an officer or employee of the state of Alaska or within the preceding two years or during the member's term of office have an interest in, served on the governing board of, or been employed by an organization that has received money from the Mental Health Trust settlement, under grant or contract. He asked if that is true for Ms. Halterman. MS. HALTERMAN responded that is true for her. 2:45:02 PM SENATOR COSTELLO pointed out that page 3 of her resume states that she advised legislators as needed on a pro bono basis. She asked what offices Ms. Halterman has been involved in and will she continue that as she sits on the board. MS. HALTERMAN replied that she has not taken any paid assignments for her consulting with legislative offices since she has been on the board or prior to that. She has done some research for a good number of legislators and weighed in during legislative hearings on issues about telemedicine. For example, Representative Ken McCarty has been considering introducing a telemedicine bill. She has been talking to his staff about that legislation in her capacity as a board member for the Alaska Collaborative for Telemedicine and Telehealth. She gave public testimony about legislation carried last year by Representative Spohnholz and answered questions from that office about that legislation prior to its passage. She did some research on Medicaid issues for Representative Eastman years ago. She hasn't had any other involvement that she can recall off the top of her head. SENATOR BEGICH said that for a clarifying comment to all appointees, the issue of the use of the money was raised. There was a multiyear lawsuit with the trust. He would hate to think that a potential violation might lead to reopening litigation around the trust. That must be kept in mind and perhaps the trustees should have that discussion with legal counsel. 2:47:59 PM CHAIR WILSON opened public testimony and after ascertaining there was none, closed public testimony. He entertained a motion. 2:48:28 PM SENATOR HUGHES stated that in accordance with AS 39.05.080, the Senate Health and Social Studies Standing Committee reviewed the following and recommends the appointments be forwarded to a joint session for consideration: State Medical Board Marie Freeman - Wasilla Lydia Mielke - Big Lake Richard Wein - Sitka Alaska Mental Health Trust Authority Board of Trustees Rhonda Boyles - Anchorage Brent Fisher - Anchorage Annette Gwalthney-Jones - Anchorage Anita Halterman - Eagle River She reminded members that signing the reports regarding appointments to boards and commissions in no way reflects individual members' approval or disapproval of the appointees; the nominations are merely forwarded to the full legislature for confirmation or rejection. 2:49:42 PM There being no further business to come before the committee, Chair Wilson adjourned the Senate Health and Social Services Standing Committee meeting at 2:49 p.m.