HJR 32: Expressing commitment to the rural health transformation program and articulating priorities for the program; acknowledging the critical health care challenges facing rural areas of the state; urging action by the Governor and the Alaska delegation in Congress to continue to advocate for the state's interests and advance the rural health transformation program; and expressing legislative intent to enact comprehensive legislation relating to the rural health transformation program and the state's medical care and critical health care needs.
00 HOUSE JOINT RESOLUTION NO. 32 01 Expressing commitment to the rural health transformation program and articulating 02 priorities for the program; acknowledging the critical health care challenges facing 03 rural areas of the state; urging action by the Governor and the Alaska delegation in 04 Congress to continue to advocate for the state's interests and advance the rural health 05 transformation program; and expressing legislative intent to enact comprehensive 06 legislation relating to the rural health transformation program and the state's medical 07 care and critical health care needs. 08 BE IT RESOLVED BY THE LEGISLATURE OF THE STATE OF ALASKA: 09 WHEREAS, on December 29, 2025, the federal Centers for Medicare and Medicaid 10 Services awarded the state $272,174,856 for the first year of the rural health transformation 11 program to support targeted, systemwide investments that improve access to health care and 12 strengthen the long-term stability of the state's health care system; and 13 WHEREAS Alaska received the second-highest total funding allocation and the 14 highest per capita funding of any state in the United States, reflecting the critical health care
01 needs of the state and the state's rural frontier and the dedication of those individuals who 02 advocated for those resources; and 03 WHEREAS the efforts of the Alaska delegation in Congress have created an 04 unprecedented opportunity to address longstanding health care disparities and build a more 05 sustainable and accessible health care system for all residents of the state, particularly those 06 individuals living in rural areas of the state and Alaska Native communities; and 07 WHEREAS the challenges of living in Alaska require innovative solutions specific to 08 this state that may differ significantly from approaches used in the contiguous United States; 09 and 10 WHEREAS the rural health transformation program provides considerable assistance 11 to the state's health care system by enabling investments in the following six critical priority 12 areas: 13 (1) healthy beginnings, including strengthening maternal and child health 14 services to reduce preventable deaths and improve birth outcomes; 15 (2) health care access, including expanding essential health services in rural, 16 remote, and frontier communities where access is currently limited or nonexistent; 17 (3) healthy communities, including promoting healthy lifestyles, preventive 18 care, and community-based wellness initiatives; 19 (4) fiscal sustainability and value-based care, including pursuing innovative 20 payment models and sustainable financing mechanisms; 21 (5) workforce strengthening, including recruiting, training, retaining, and 22 supporting skilled health care professionals across the state; 23 (6) technology and innovation, including modernizing health care 24 infrastructure, expanding telehealth capacity, and implementing innovative care delivery 25 models; and 26 WHEREAS federal law requires the state to enact enabling legislation by 27 December 31, 2027, to maintain access to the full $272,174,856 allocation, and failure to meet 28 policy commitments or obligate funds appropriately may result in redistribution of the state's 29 allocation to other states beginning March 31, 2028; 30 BE IT RESOLVED that the Alaska State Legislature recognizes that prudent 31 stewardship of those federal funds requires careful planning, stakeholder engagement, and
01 clear federal guidance; and be it 02 FURTHER RESOLVED that the Alaska State Legislature wishes to signal its strong 03 commitment to the rural health transformation program and to establish clear priorities to 04 guide program implementation; and be it 05 FURTHER RESOLVED that the Alaska State Legislature proposes to enact 06 comprehensive enabling legislation to fully authorize and implement the state's participation 07 in the rural health transformation program; and be it 08 FURTHER RESOLVED that the Alaska State Legislature articulates the following 09 legislative priorities for the rural health transformation program: 10 (1) maximum investment in health care access for all residents of the state, but 11 especially for communities that are currently most lacking adequate services; 12 (2) aggressive expansion of telehealth infrastructure, including broadband and 13 telecommunications improvements, recognizing that delivery of technology-enabled care is 14 essential for the state's geographic reality; 15 (3) substantial workforce development, including competitive retention 16 incentives, relocation assistance, housing support, professional development, and scope of 17 practice reforms, to maximize the capabilities of available health care professionals; 18 (4) maternal and child health services to address the state's unacceptably high 19 maternal and infant mortality rates; 20 (5) health care facility infrastructure improvements, including renovations, 21 equipment modernization, and technology upgrades necessary to provide quality care; 22 (6) integration and coordination between tribal health systems, the federal 23 Indian Health Service, and state health care providers to create a seamless, culturally 24 competent health care system; and 25 (7) sustainable financing models that ensure program benefits continue 26 beyond the five-year federal funding period; and be it 27 FURTHER RESOLVED that the Alaska State Legislature urges the Governor to 28 (1) work expeditiously with the federal Centers for Medicare and Medicaid 29 Services to obtain clarification on all uncertain aspects of allowable fund uses, particularly 30 regarding infrastructure investments, broadband purchases, and workforce incentive 31 structures;
01 (2) provide interim reports to the Alaska State Legislature on implementation, 02 fund distribution, and federal guidance received on the rural health transformation program; 03 and 04 (3) identify any barriers to the success of the rural health transformation 05 program that require legislative action or advocacy with federal authorities; and be it 06 FURTHER RESOLVED that the Alaska State Legislature urges the Alaska 07 delegation in Congress to 08 (1) continue advocating for the state's interests with the federal Centers for 09 Medicare and Medicaid Services; 10 (2) support maximum flexibility for the state given the state's unique 11 geographic and health care challenges; and 12 (3) defend the state's full funding allocation against any efforts to reduce or 13 redistribute those critical resources; and be it 14 FURTHER RESOLVED that the Alaska State Legislature recognizes that the health 15 and well-being of all residents of the state depends on the successful implementation of the 16 rural health transformation program and that the Alaska State Legislature will work 17 cooperatively with the state and federal administrations to authorize and guide the use of 18 those transformative federal resources; and be it 19 FURTHER RESOLVED that the Alaska State Legislature affirms that improving 20 health care access in the state is a priority transcending political differences and commits to 21 working cooperatively across party lines to maximize the rural health transformation 22 program's benefit to all residents of the state; and be it 23 FURTHER RESOLVED that the Alaska State Legislature declares that this 24 resolution expresses the will of the Alaska State Legislature and provides guidance to state 25 agencies, the federal Centers for Medicare and Medicaid Services, and the public regarding 26 legislative priorities and intentions for the rural health transformation program. 27 COPIES of this resolution shall be sent to the Honorable Mike Dunleavy, Governor 28 of Alaska; the Honorable Heidi Hedberg, Commissioner, Department of Health; Alina 29 Czekai, Director, Office of Rural Health Transformation, Centers for Medicare and Medicaid 30 Services, United States Department of Health and Human Services; and the Honorable Lisa 31 Murkowski and the Honorable Dan Sullivan, U.S. Senators, and the Honorable Nicholas
01 Begich, U.S. Representative, members of the Alaska delegation in Congress.