Legislature(2021 - 2022)BY TELECONFERENCE
03/02/2021 03:00 PM House HEALTH & SOCIAL SERVICES
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| Audio | Topic |
|---|---|
| Start | |
| Executive Order 119 - Dhss Reorganization | |
| HB76 | |
| Adjourn |
* first hearing in first committee of referral
+ teleconferenced
= bill was previously heard/scheduled
+ teleconferenced
= bill was previously heard/scheduled
| + | TELECONFERENCED | ||
| + | HB 76 | TELECONFERENCED | |
HB 76-EXTENDING COVID 19 DISASTER EMERGENCY
4:29:39 PM
CO-CHAIR ZULKOSKY announced that the final order of business
would be HOUSE BILL NO. 76, "An Act extending the January 15,
2021, governor's declaration of a public health disaster
emergency in response to the novel coronavirus disease (COVID-
19) pandemic; providing for a financing plan; making temporary
changes to state law in response to the COVID-19 outbreak in the
following areas: occupational and professional licensing,
practice, and billing; telehealth; fingerprinting requirements
for health care providers; charitable gaming and online ticket
sales; access to federal stabilization funds; wills; unfair or
deceptive trade practices; and meetings of shareholders; and
providing for an effective date."
4:30:17 PM
ADAM CRUM, Commissioner, Department of Health and Social
Services, presented HB 76 on behalf of the bill sponsor, House
Rules by request of the governor. He explained that HB 76 was
introduced by the governor pursuant to AS.26.23.020 and AS
26.23.025. He explained that these two statues provide that a
disaster proclamation may not remain in effect longer than 30
days unless extended by the legislature and provides what
information is required to the legislature when the governor
declares a condition of disaster emergency concurrently with the
issue of a proclamation.
COMMISSIONER CRUM said that on January 15, 2021, the governor
issued a proclamation of a public health disaster emergency in
response to the COVID-19 pandemic. He noted that a bill was
transmitted to the House on January 21, 2021, proposing to
extend the public health disaster emergency to September 30,
2021, or until the commissioner of DHSS certified that there is
no longer an outbreak of COVID-19. The bill also includes other
provisions to protect the public and economic health of the
state. He explained that absent legislative action, the public
health emergency expired on February 14, 2021.
COMMISSONER CRUM shared that the administration evaluated the
current COVID-19 response. He said this involved evaluating
previous response efforts authorities provided under the Alaska
Disaster Act and the current statutory authority under the
Alaska Public Health Emergency. He shared that DHSS also met
with numerous stakeholders and providers to discuss operations
and response efforts if the disaster declaration wasn't
extended, and the department received feedback.
COMISSIONER CRUM paraphrased the beginning of subsection (e) of
AS 26.23.020, which read as follows:
(e) A proclamation of a disaster emergency activates
the disaster response and recovery aspects of the
state, local, and interjurisdictional disaster
emergency plans applicable to the political
subdivisions or areas in question
COMMISSIONER CRUM explained this allowed for unified command
structure to support local jurisdictions and the statewide
public healthcare system and response to the pandemic.
4:34:47 PM
COMMISSIONER CRUM continued in explaining the impact of HB 76.
He paraphrased subsection (f), which read as follows:
(f) During the effective period of a disaster
emergency, the governor is commander in chief of the
organized and unorganized militia and of all other
forces available for emergency duty. The governor may
delegate or assign command authority by appropriate
orders or regulations.
COMMISSIONER CRUM said this allowed the administration to use
the National Guard for certain response purposes such as contact
tracing.
COMMISSIONER CRUM paraphrased subsection (g), paragraph (1),
which read as follows:
(g) In addition to any other powers conferred upon the
governor by law, the governor may, under AS 26.23.010
- 26.23.220,
(1) suspend the provisions of any regulatory
statute prescribing procedures for the conduct of
state business, or the orders or regulations of any
state agency, if compliance with the provisions of the
statute, order, or regulation would prevent, or
substantially impede or delay, action necessary to
cope with the disaster emergency;
COMMISSIONER CRUM explained this was used for emergency
procurement contracts for additional cold chain shippers of
testing and supplies and hiring of personnel to support public
health plans. He shared that it also allowed for increased
flexibility in how the state cared for and provided services to
populations in congregate settings and facilities.
COMMISSIONER CRUM said the state did not use the authority from
paragraph (2) of subsection (g). He drew attention to paragraph
(3), which read as follows:
(3) transfer personnel or alter the functions of state
departments and agencies or units of them for the
purpose of performing or facilitating the performance
of disaster emergency services;
COMMISISONER CRUM explained that the state repurposed the
Division of Public Health to respond to COVID-19.
COMMISSIONOR CRUM skimmed through the rest of subsection (g) and
highlighted paragraphs used in response to the COVID-19
pandemic. He explained that paragraph (7) was the authority
used to implement testing requirements for travel. He said that
paragraph (9) was used for non-congregate housing for the
homeless, for travelers that tested positive, and for healthcare
workers. He said that paragraph (10) was used to distribute
personal protective equipment (PPE), testing supplies, and
vaccines and therapeutic treatment. He pointed out that the
administration did not use paragraphs (4), (5), (6), (8) or
(11).
4:38:13 PM
COMMISSIONER CRUM summarized that not all these authorities were
used. He noted that of the authorities that were used, they
were not all necessarily utilized at the same time. He then
asked, "How does Alaska proceed to a recovery phase, moving
beyond the disaster and emergency?" He said the state could
take a more limited approach. He argued this will also help the
state's economic metrics.
COMMISSIONER CRUM reiterated that through the evaluative process
the administration went through after the disaster declaration
expired on February 14, 2021, the administration realized it
didn't need all the authorities available under the Alaska
Disaster Act. He explained that the administration hopes to use
a more targeted approach by using uncodified law to establish
the needed authorities. He said the authorities that are
identified as important include allowing the Department of
Health and Social Services (DHSS) to manage vaccine distribution
and the therapeutic response to COVID-19, and to allow DHSS to
cooperate with the Federal Government, with respect to blanket
waivers, the 1135 Waiver, Appendix K authorities, as well as the
application and distribution of Emergency Allotment (EA)
Supplemental Nutrition Assistance Program (SNAP) benefits.
COMMISSIONER CRUM said another part was to allow the Department
of Military & Veterans' Affairs (DMVA) to assist DHSS. He said
the DMVA would receive authority from the governor to allow
activation of the Alaska Guard to respond to the pandemic and
coordinate with the Federal Emergency Management Agency (FEMA).
He said there was also the authority for the use of telehealth
and telemedicine for healthcare providers currently licensed in
another state, as well as immunity for employers, governmental
agencies, or persons engaged in the state response.
COMMISSIONER CRUM summarized his presentation. He stated that
the administration understood Alaska's need to progress to a
recovery phase, but also to have the tools to respond as things
change. He said it is possible to continue a safe response plan
without providing the broad authority of a public health
emergency disaster declaration. He noted that standalone bills
had been introduced in the other body to address changes for
shareholder meetings, licensing issues, and telemedicine.
4:42:35 PM
CO-CHAIR SNYDER asked Commissioner Crum if he had a presentation
to go with his testimony.
COMMISSIONER CRUM said [there was no presentation].
CO-CHAIR SNYDER asked if Commissioner Crum's testimony meant the
administration was backing away from the need for HB 76.
COMMISSIONER CRUM replied yes. He said that when the
declaration expired, the administration had to determine how it
would maintain the response. From that, the administration
identified what was needed to have legal coverage going forward
and to make sure it could continue distributing the vaccines and
therapeutics. He said that from public response there was
concern about using the Disaster Declaration Act any further.
He said the administration had been trying to work with federal
partners to make sure that any specific language necessary gave
the administration the cover needed to continue the response.
4:44:51 PM
REPRESENTATIVE MCCARTY clarified that the state felt it was no
longer in an emergency status with COVID-19 and asked if that
was the reasoning for changing the decision.
COMMISSIONER CRUM answered that it has to do with the definition
of the word "disaster." He said the words carry "a certain
connotation." He acknowledged that there was a current public
health emergency, but said it was "with a little 'e' and not a
capital." He stated that the administration has identified ways
it can still access the necessary authorities.
REPRESENTATIVE MCCARTY asked if the state's new status of not
having an emergency in place had any bearings on federal COVID-
19 funds.
COMMISSIONER CRUM responded that the two items tied to state
action were the non-congregate sheltering order, which was being
worked on with FEMA, and the EA SNAP benefits. He said this
could be tied into a law that would be used for future
approvals.
REPRESENTATIVE MCCARTY asked if this has any bearing on data
collection to assess if COVID-19 is becoming better or worse.
COMMISSIONER CRUM responded that data collection is still
possible through standing authority.
4:47:47 PM
REPRESENTATIVE SPOHNHOLZ asked how this changed the ability to
require testing for non-residents who come into the state. She
noted that much of Alaska has limited healthcare, and this had
been an important measure to prevent the spread of COVID-19.
COMMISSIONER CRUM responded that the authorities the state
requested do not include the authority to require pre-travel
testing.
REPRESENTATIVE SPOHNHOLZ asked for clarification if Commissioner
Crum didn't think it's necessary for non-residents to get tested
if and when they come into Alaska.
COMMISSIONER CRUM said it is important to identify who is coming
into the state and shared that now the administration is working
directly with the tourism industry. He said the barriers [for
testing] had been removed by keeping the infrastructure in place
and removing the testing fee.
REPRESENTATIVE SPOHNHOLZ commented that the commissioner is
trying to adapt, and she appreciated that. She expressed that
she thought it in an important public health measure to require
testing for people coming into Alaska. She pointed out that
Alaska has a high number of non-resident workers and tourists.
COMMISSIONER CRUM agreed that it has been an important tool.
4:50:52 PM
CO-CHAIR SNYDER brought up that on January 14, 2021, when the
last disaster declaration passed, Alaska had 193 [new cases of
COVID-19], food insecurity at about 12 percent, and unemployment
claims remained elevated. She also pointed out that that day
Alaska had 124 new cases with increasing food insecurity. She
opined that the current statistics were similar [to when the
last disaster declaration was issued], but the administration
was pursuing authority in a more piecemeal fashion and asked for
explanation on Commissioner Crum's strategy.
COMMISSIONER CRUM responded that DHSS is trying to operate in a
timely manner, and that is why there is a trimmed down response.
He said they had to adjust [without the approval for a new
declaration] on February 14, 2021. He pointed out that the
distribution of the vaccine has been a priority and has helped
reduce hospitalizations from COVID-19.
4:53:26 PM
REPRESENTATIVE KURKA asked how many positive cases of COVID-19
were found by testing travelers, thus resulting, in preventing
those cases from entering Alaska. He then said that he
understood that contact tracing was possible in the beginning,
but his perception was that it fell apart because there were so
many cases. He asked what the point of screening was if the
state could no longer contact trace.
COMMISSIONER CRUM turned to Heidi Hedberg to address the
question.
4:54:53 PM
HEIDI HEDBERG, Director, Division of Public Health, Department
of Health and Social Services, answered questions about HB 76.
She said airport testing began on June 6, 2020, and it has
screened almost 500,000 travelers and identified almost 3000
positives. She opined that it had been a successful endeavor.
In terms of contact tracing, she said DHSS engaged in contact
tracing once it found someone was positive and asked the
individual to notify everyone that he/she came into contact with
for more than 15 minutes within six feet. She stated that that
had really helped to lower the number of positive cases.
REPRESENTATIVE KURKA asked what percentage of cases are
successfully tracked through contact tracing.
DIRECTOR HEDBERG said DHSS would have to follow up with that,
but they do use a database. She said they could compare
percentages of where individuals were exposed, although that
varied through communities across the state.
REPRESENTATIVE KURKA commented that it was clear from DHSS's
online information dashboard how many ICU beds are being used
for COVID-19 patients. He asked what the number of active cases
was, rather than new cases.
4:58:52 PM
COMMISSIONER CRUM shared that underneath the dashboard one can
download raw summary data to look at patients on the COVID-19
aspect.
4:59:26 PM
DIRECTOR HEDBERG responded that when it comes to active cases,
the Center for Disease Control (CDC) said individuals need to
quarantine for 10 days, but some individuals can be symptomatic
for much longer. She said during the summer DSS removed the
"recovered" cases from the dashboard because it is person
specific.
5:00:28 PM
CO-CHAIR ZULKOSKY shared that they have run out of time and
asked if the commissioner could be available during the next
meeting for additional questions.
COMMISSIONER CRUM said he would be there.
5:01:14 PM
REPRESENTATIVE SPOHNHOLZ clarified a misunderstanding that 64
percent of Alaska Native children are not in foster care, rather
64 percent of children in foster care are Alaska Native. She
shared that there are 190,000 children in Alaska, and about
38,000 of them are Native. Alaska only has 2,800 children in
foster care, she explained.
CO-CHAIR ZULKOSKY announced that HB 76 would be held over.