Legislature(2023 - 2024)BUTROVICH 205
04/04/2024 03:30 PM Senate HEALTH & SOCIAL SERVICES
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| Audio | Topic |
|---|---|
| Start | |
| Confirmation Hearing(s) | |
| Presentation: Governor's Task Force on Child Care | |
| HB57 | |
| SB240 | |
| Adjourn |
* first hearing in first committee of referral
+ teleconferenced
= bill was previously heard/scheduled
+ teleconferenced
= bill was previously heard/scheduled
| + | TELECONFERENCED | ||
| + | TELECONFERENCED | ||
| += | HB 89 | TELECONFERENCED | |
| += | HB 57 | TELECONFERENCED | |
| += | SB 240 | TELECONFERENCED | |
ALASKA STATE LEGISLATURE
SENATE HEALTH AND SOCIAL SERVICES STANDING COMMITTEE
April 4, 2024
3:45 p.m.
DRAFT
MEMBERS PRESENT
Senator David Wilson, Chair
Senator James Kaufman, Vice Chair
Senator Forrest Dunbar
Senator Cathy Giessel
MEMBERS ABSENT
Senator Löki Tobin
COMMITTEE CALENDAR
CONFIRMATION HEARING(S):
State Medical Board
Eric Nimmo - Chickaloon
- CONFIRMATION ADVANCED
PRESENTATION: GOVERNOR'S TASK FORCE ON CHILD CARE
- HEARD
COMMITTEE SUBSTITUTE FOR HOUSE BILL NO. 89(FIN)
"An Act relating to education tax credits for certain payments
and contributions for child care and child care facilities;
relating to the insurance tax education credit, the income tax
education credit, the oil or gas producer education credit, the
property tax education credit, the mining business education
credit, the fisheries business education credit, and the
fisheries resource landing tax education credit; renaming the
day care assistance program the child care assistance program;
relating to the child care assistance program and the child care
grant program; providing for an effective date by amending the
effective date of secs. 1, 2, and 21, ch. 61, SLA 2014; and
providing for an effective date."
- REMOVED FROM AGENDA
HOUSE BILL NO. 57
"An Act relating to review organizations and permitting an
emergency medical services provider to establish a review
organization; and relating to patient records."
- MOVED SCS HB 57(HSS) OUT OF COMMITTEE
SENATE BILL NO. 240
"An Act relating to medical assistance coverage for
rehabilitative, mandatory, and optional services furnished or
paid for by a school district on behalf of certain children."
- MOVED CSSB 240(HSS) OUT OF COMMITTEE
PREVIOUS COMMITTEE ACTION
BILL: HB 57
SHORT TITLE: EMERGENCY MED. SVCS: REVIEW ORGANIZATIONS
SPONSOR(s): REPRESENTATIVE(s) WRIGHT
02/03/23 (H) READ THE FIRST TIME - REFERRALS
02/03/23 (H) L&C, HSS
02/17/23 (H) L&C AT 3:15 PM BARNES 124
02/17/23 (H) Heard & Held
02/17/23 (H) MINUTE(L&C)
03/03/23 (H) L&C AT 3:15 PM BARNES 124
03/03/23 (H) Moved HB 57 Out of Committee
03/03/23 (H) MINUTE(L&C)
03/06/23 (H) L&C RPT 4DP 1NR
03/06/23 (H) DP: SADDLER, PRAX, RUFFRIDGE, SUMNER
03/06/23 (H) NR: CARRICK
03/21/23 (H) HSS AT 3:00 PM DAVIS 106
03/21/23 (H) Heard & Held
03/21/23 (H) MINUTE(HSS)
03/28/23 (H) HSS AT 3:00 PM DAVIS 106
03/28/23 (H) Moved HB 57 Out of Committee
03/28/23 (H) MINUTE(HSS)
03/29/23 (H) HSS RPT 5DP
03/29/23 (H) DP: RUFFRIDGE, SUMNER, FIELDS, MINA,
PRAX
05/09/23 (H) TRANSMITTED TO (S)
05/09/23 (H) VERSION: HB 57
05/10/23 (S) READ THE FIRST TIME - REFERRALS
05/10/23 (S) L&C, HSS
02/12/24 (S) L&C AT 1:30 PM BELTZ 105 (TSBldg)
02/12/24 (S) Heard & Held
02/12/24 (S) MINUTE(L&C)
02/21/24 (S) L&C AT 1:30 PM BELTZ 105 (TSBldg)
02/21/24 (S) Moved HB 57 Out of Committee
02/21/24 (S) MINUTE(L&C)
02/23/24 (S) L&C RPT 4DP
02/23/24 (S) DP: BJORKMAN, DUNBAR, GRAY-JACKSON,
MERRICK
03/14/24 (S) HSS AT 3:30 PM BUTROVICH 205
03/14/24 (S) Heard & Held
03/14/24 (S) MINUTE(HSS)
04/02/24 (S) HSS AT 3:30 PM BUTROVICH 205
04/02/24 (S) Scheduled but Not Heard
04/04/24 (S) HSS AT 3:30 PM BUTROVICH 205
BILL: SB 240
SHORT TITLE: SCHOOL DISTRICT MEDICAL ASSISTANCE
SPONSOR(s): RULES BY REQUEST OF THE GOVERNOR
02/19/24 (S) READ THE FIRST TIME - REFERRALS
02/19/24 (S) HSS
02/27/24 (S) HSS AT 3:30 PM BUTROVICH 205
02/27/24 (S) Heard & Held
02/27/24 (S) MINUTE(HSS)
03/12/24 (S) HSS AT 3:30 PM BUTROVICH 205
03/12/24 (S) Heard & Held
03/12/24 (S) MINUTE(HSS)
04/04/24 (S) HSS AT 3:30 PM BUTROVICH 205
WITNESS REGISTER
ERIC NIMMO, Appointee
State Medical Board
Chickaloon, Alaska
POSITION STATEMENT: Testified as the governor's appointee to the
State Medical Board.
HEIDI HEDBERG, Commissioner
Department of Health
Juneau, Alaska
POSITION STATEMENT: Co-presented a presentation on the
Governor's Task Force on Child Care.
LEAH VAN KIRK, Deputy Commissioner
Department of Health
Juneau, Alaska
POSITION STATEMENT: Co-presented a presentation on the
Governor's Task Force on Child Care.
REPRESENTATIVE STANLEY WRIGHT, District 22
Alaska State Legislature
Juneau, Alaska
POSITION STATEMENT: Sponsor of HB 57.
JARED KOSIN, President
Alaska Hospital and Healthcare Association
Anchorage, Alaska
POSITION STATEMENT: Commented on HB 57.
LEAH VAN KIRK, Deputy Commissioner
Department of Health
Juneau, Alaska
POSITION STATEMENT: Provided a brief overview of SB 240.
ACTION NARRATIVE
3:45:29 PM
CHAIR DAVID WILSON called the Senate Health and Social Services
Standing Committee meeting to order at 3:45 p.m. Present at the
call to order were Senators Dunbar, Giessel, and Chair Wilson.
Senator Kaufman arrived thereafter.
^CONFIRMATION HEARING(S)
CONFIRMATION HEARING(S)
STATE MEDICAL BOARD
3:46:30 PM
CHAIR WILSON announced the consideration of the governor's
appointee Eric Nimmo to the State Medical Board.
CHAIR WILSON asked Dr. Nimmo to tell the committee about himself
and his interest in serving on the State Medical Board.
3:46:51 PM
ERIC NIMMO, M.D., Appointee, State Medical Board, Chickaloon,
Alaska, shared his personal and work history, including his
career as a doctor and subsequent role with the Department of
Corrections, from which he retired in 2022. He stated that he
still has valuable experience to offer to Alaska and its
citizens. When approached by a colleague about serving on the
medical board, he decided to pursue the opportunity. He
expressed his belief that healthcare should be provided with
excellence, grounded in evidence-based research and experience,
and remain free from excessive regulation, undue influence from
third-party payers, or popular opinion, which aligns with
sentiments he has heard from current board members.
3:49:46 PM
SENATOR GIESSEL asked whether Dr. Nimmo had attended any State
Medical Board meetings yet.
DR. NIMMO replied he attended the last one by zoom conference,
which was in February.
3:50:15 PM
SENATOR GIESSEL asked Dr. Nimmo to identify the top issues
currently being addressed by the State Medical Board.
DR. NIMMO stated that the primary issue at the time appeared to
be the new physician assistant (PA) regulations, which were
subsequently tabled pending related legislation. He added that
he has extensive experience working with PAs and nurse
practitioners in various settings, particularly during his
tenure with the Department of Corrections.
SENATOR GIESSEL acknowledged the importance of working with
nurse practitioners, disclosing that she is one herself. She
then asked Dr. Nimmo for his thoughts on the State Medical
Board's role in addressing opioid issues, particularly regarding
rescue medications, and inquired about the level of attention he
would give this issue if on the board.
3:51:27 PM
DR. NIMMO stated he is currently unaware of the State Medical
Board's stance on opioid issues but has extensive experience
observing the crisis. He recalled the pressure placed on
providers to prescribe increasing amounts of opioids and, later,
witnessing the effects of opioid withdrawal among individuals in
the Department of Corrections. He noted the challenge of
managing this issue, including the implementation of approved
treatments, and described it as a complex problem.
3:52:29 PM
CHAIR WILSON asked where Dr. Nimmo envisions the State Medical
Board focusing its efforts in the near future, including the
next three to five years.
3:52:43 PM
DR. NIMMO stated that he is not yet familiar enough with the
State Medical Board to engage in strategic planning, as he has
just begun working on applicant approvals and disciplinary
actions. He stated his belief that a key issue is preserving
Alaskan healthcare providers' ability to operate in ways suited
to Alaska, without excessive influence from national trends. He
supports allowing providers to make decisions based on their
medical experience and evidence.
3:54:03 PM
CHAIR WILSON solicited a motion.
3:54:07 PM
SENATOR DUNBAR moved Eric Nimmo, appointee to the State Medical
Board, be forwarded to a Joint Session for consideration.
He reminded members that signing the report(s) 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.
3:54:24 PM
CHAIR WILSON stated that in accordance with AS 39.05.080, the
Senate Health and Social Services Standing Committee reviewed
the following and recommends the appointment be forwarded to a
Joint Session for consideration:
State Medical Board
Eric Nimmo - Chickaloon
3:54:42 PM
At ease
^PRESENTATION: GOVERNOR'S TASK FORCE ON CHILD CARE
PRESENTATION: GOVERNOR'S TASK FORCE ON CHILD CARE
3:55:57 PM
CHAIR WILSON reconvened the meeting and announced the
consideration of a presentation on the Governor's Task Force on
Child Care.
3:56:19 PM
HEIDI HEDBERG, Commissioner, Department of Health, Juneau,
Alaska moved to slide 2 and explained that the governor issued
Administrative Order 346, establishing a task force to assess
child care services statewide. The presentation would provide a
high level summary of the work to date that the task force has
taken:
[Original punctuation provided.]
Presentation Outline
1. Task Force Purpose
2. Summary of efforts
3. Report Recommendations
4. Moving Forward
3:56:51 PM
COMMISSONER HEDBERG moved to slide 3 and said the task force
aimed to gather diverse representation from child care providers
and included legislators, such as Senator Tobin and
Representative Coulombe, to develop recommendations for
improving access to quality child care. She highlighted the
critical role of a strong child care system in enhancing
children's health, supporting parents in the workforce, driving
economic growth, and preparing children for school. The task
force focused on children aged zero to six and divided its work
into six topic areas. She said the presentation would only cover
background checks, workforce, and licensing, which were the
three areas that the task force focused on from May 2023 to
December 2023:
[Original punctuation provided.]
Governor's Task Force on Child Care
Administrative Order 346
Purpose
• Develop a plan to improve availability and
affordability of quality child care
• Consult existing resources
• Develop policy recommendations
Focus Areas
• Background Checks
• Workforce
• Licensing
• Access
• Quality
• Subsidy
Structure
• Eleven voting members
• Representatives from across the state
3:58:10 PM
COMMISONER HEDBERG continued on slide 3 and said the
presentation would only cover background checks, workforce, and
licensing, which were the three areas that the task force
focused on from May 2023 to December 2023. She stated she would
provide a high level overview of what the department has done
towards implementing 33 recommendations.
3:58:44 PM
COMMISSIONER HEDBERG moved to slide 4 reported that in the first
six months, the task force conducted 14 meetings from May to
December. During this time, two public comment periods allowed
for input, with 26 individuals calling in and 76 submitting
written comments, totaling around 500 comments on the 33
recommendations. She noted that the last two areas of public
comment topics collaboration with municipal governments and
zoning challenges are particularly relevant to local
authorities, while other areas reflect recommendations for
state-level action:
[Original punctuation provided.]
Public Comment Topics
Support of the Recommendations
Workforce Support
Wage Increases
Recognition/Professionalization
Child Care Access and Affordability
Licensing and Requirements
Education and Training
Background Checks
Funding and Sustainability
Collaboration and Municipal Involvement
Zoning Challenges
3:59:40 PM
COMMISSIONER HEDBERG moved to slide 5 and provided an overview
of the task force's five recommendations on background checks,
aimed at increasing access and reducing barriers. She explained
that after a cyberattack years ago, the Department of Health and
Social Services implemented a "whitelisting" process that
required child care providers to purchase secure URLs to submit
background checks, which proved time-consuming and costly. In
response, the department engaged a contractor to create a secure
portal for direct submission of background checks, eliminating
the whitelisting requirement. Additionally, in partnership with
the Department of Public Safety, four Live Scan electronic
fingerprinting units are being deployed to rural communities in
state office buildings, allowing providers to electronically
submit fingerprints and reduce processing time. She noted that
once established, the service may expand to other sectors. In
collaboration with the Office for Children's Services, mobile
fingerprinting devices are also being deployed to enable
background checks for those in remote communities, providing
broader access to child care sector employment.
[Original punctuation provided.]
Report Recommendations
• Task Force Initial Report submitted on December
31, 2023
• 33 recommendations across five areas of focus:
Background Checks
Licensing
Workforce
Employers
Tribal Authority
4:03:10 PM
CHAIR WILSON noted a similar issue exists for behavioral health
providers, who also require a dedicated URL to be on the
whitelist. He asked whether the secure portal was designed
solely for child care recommendations or if it could be
implemented across the Department of Health for other providers,
such as behavioral health facilities.
COMMISSIONER HEDBERG replied it applies to all sectors.
4:03:44 PM
LEAH VAN KIRK, Deputy Commissioner, Department of Health,
Juneau, Alaska, outlined the task force's recommendations on
licensing, emphasizing its role in ensuring safe, high-quality
environments for children in Alaska. She said feedback from
providers and public comments highlighted the need for a
stronger licensing system, focusing on technical support and
removing barriers. She noted that since the task force's start,
a new technology system for the Child Care Program Office has
been procured and is set to launch in October 2024. This system
includes portals for providers, families, and staff, enabling
web-based licensing applications, status checks, and alerts to
improve efficiency. She also addressed the challenges of the
licensing process, which can be time-intensive and subject to
various municipal requirements, making coaching and navigation
support vital. Additionally, she cited the successful efforts in
the south Kenai Peninsula, where the Division of Public Health's
Healthy and Equitable Communities Program increased child care
spots by 45 in under a year. Finally, she emphasized the
importance of creating and distributing materials to support
those interested in starting child care businesses.
4:05:30 PM
SENATOR KAUFMAN joined the meeting.
4:06:52 PM
MS. VAN KIRK addressed the workforce challenges within Alaska's
early childhood education sector, noting the task force's goal
to create a well-supported, professionally compensated workforce
with access to benefits, professional development, and
advancement pathways. She highlighted the University of Alaska
Anchorage's (UAA) success in increasing degree and endorsement
programs in early childhood education, leading to a significant
rise in enrollment and demonstrating Alaskans' interest in this
field. The department conducted a workforce study revealing 93
percent of current early childhood educators plan to stay in the
profession. She explained that multiple studies, including one
by Johns Hopkins University in 2019, the First Children's
Finance report, and Alaska's Early Childhood Strategic Plan,
informed task force recommendations. These include raising
wages, expanding benefits, improving work conditions,
strengthening career pathways, and offering more support for in-
home providers, who experience higher turnover than staff in
licensed centers. She also expressed enthusiasm for upcoming
technology improvements to enhance communication between
providers and Child Care Program Office staff, launching in
October.
4:09:30 PM
MS. VAN KIRK discussed the importance of employer-based child
care, emphasizing how employers across Alaska are increasingly
recognizing their role in supporting a strong statewide
workforce beyond early childhood education. She explained that
the task force is exploring public-private partnerships and
assessing available spaces in school district, state, and public
buildings for potential child care facilities. Recommendations
include supporting businesses in creating on-site or nearby
child care options, with reports from various businesses,
including hospitals, indicating improved employee retention and
a more stable workforce as a result. She also highlighted SB
237, the Alaska Affordability Act, which proposes tax credits
for employers investing in child care or providing child care
stipends, a step that has encouraged broader private sector
engagement across the state.
4:11:22 PM
SENATOR DUNBAR asked whether there were concerns about the
potential of large companies outcompeting small businesses in
offering child care benefits, given Alaska's low-tax environment
with few high-tax organizations. He referenced hospitals and oil
companies that face intense competition for employees,
questioning if such benefits would disproportionately favor
large companies. He inquired if there were options for small
businesses to pool resources or alternative ways for smaller
employers, like a fishing boat operation, to utilize these tax
credits.
COMMISSIONER HEDBERG indicated that questions regarding the
Governor's bill, SB 237, and its tax credits should be directed
to the Department of Revenue, as the credits target specific
business sectors. She acknowledged his points about small
businesses and noted that the task force recommended appointing
a liaison to work with businesses of all sizes on pooling
resources to meet child care needs for employees. She added that
$14 million in remaining American Rescue Plan Act (ARPA) funds
was given out through community grants. One of the pilot
projects was a cooperative in Anchorage, where four
organizations came together to work on the staffing model to
support child care for employees. She emphasized that while tax
credits are one approach, other strategies are being considered
to support on-site or near-site child care for the employees of
businesses.
4:13:47 PM
SENATOR DUNBAR referenced similar union-level efforts using
CARES Act funds to directly subsidize child care providers and
questioned why the state would choose a tax credit model, which
reduces revenue, rather than directly establishing support
programs. He suggested a model where the state collects revenue
and sets up programs that any business could pay into, allowing
smaller businesses to participate alongside large corporations
and have a stake in supporting child care.
CHAIR WILSON said another way to frame the question is could the
state do a Supporting Health Access Repayment Program (SHARP)
for child care providers.
4:14:35 PM
COMMISSIONER HEDBERG stated SHARP was evaluated and the short
answer is no. However, to answer Senator Dunbar she stated all
options are on the table and the department is looking at
everything it can do to support the child care sector.
4:14:59 PM
SENATOR DUNBAR inquired about how other states have approached
funding child care, noting Alaska's unique lack of a broad-based
tax and comparatively low corporate taxes. He mentioned the
District of Columbia's universal pre-K program, which, though
different from child care, shares similar goals and is directly
funded rather than using tax credits. He asked why Alaska
wouldn't adopt a direct funding model and questioned the
outcomes in states that directly fund child care versus those
using tax credit systems.
4:15:43 PM
MS. VAN KIRK explained that the task force is actively
evaluating access and affordability models, with discussions
underway. She highlighted the "tri-share" model, used in states
like Michigan and Kentucky, where employers, parents, and the
state each cover one-third of child care costs. She said the
state was examining other models because barriers in the child
care sector need to be approached incrementally and from
different viewpoints. She emphasized this is especially true
when considering subsidies. She noted that in looking at payer
mix only 20 to 30 percent of children in child care currently
receive subsidies, leaving 70 to 80 percent of families paying
out-of-pocket. The task force is considering options that can
serve both subsidy-eligible families and those who are not,
ensuring support for a range of employersfrom large
corporations to small operations like fishing boats.
4:17:32 PM
MS. VAN KIRK highlighted the role of tribal authority in child
care oversight, noting that the federal Administration for
Children and Families (ACF) provides oversight to both states
and tribes, enforcing the same health and safety standards. The
governor's task force recommended allowing ACF to serve as the
primary oversight agency for tribal child care facilities,
exempting them from additional state oversight and reducing
duplicative requirements. She explained that this approach
mirrors the exemption for military child care facilities, which
are regulated by the Department of Defense rather than by state
licensing.
4:18:37 PM
MS. VAN KIRK moved to slide 6 to discuss subsidy, access and
affordability, and quality. She said the department's final
report would include:
[Original punctuation provided.]
• Models used in other states to share the cost of
care
• Innovations to incentivize new early childhood
education and child care centers
• Increasing access for children with special needs
• Supporting children's behavioral health
She also noted that the department is looking at subsidies and
there are three levers that impact federal funding and how they
are used:
[Original punctuation provided.]
Family Co-Pay
State Rate
Eligibility
MS. VAN KIRK explained that both the cost of care survey and
market price survey should inform the state rate for child care.
Currently, Alaska uses the market price survey, which examines
provider charges and sets the state rate at the 75th percentile.
The cost of care survey, however, assesses actual provider costs
and geographical differences, and is expected to be completed in
July. She added that the state is concluding its market price
survey and looks forward to integrating these findings to guide
future efforts.
4:21:38 PM
SENATOR DUNBAR asked whether increasing access to Head Start is
one of the task force's recommendations.
MS. VAN KIRK clarified that the recommendation did not
specifically target Head Start, which is overseen by the
Department of Education. However, since Head Start programs
often provide child care, the task force aims to align early
childhood education systems to ensure quality across all
settings. This alignment would support consistent, high-quality
early education across programs where children may be enrolled.
4:22:35 PM
SENATOR DUNBAR acknowledged the department's focus on alignment
and quality but noted that, for many people, the priority is
finding child care that provides both care and education, such
as Head Start, which is widely used in his district. Given
discussions on access and affordability, he asked if expanding
Head Start classrooms would benefit the overall early childhood
system.
MS. VAN KIRK stated that the goal is to provide high-quality,
affordable programming for parents, regardless of its name or
oversight agency. She affirmed that collaboration across the
sector is essential.
4:24:01 PM
At ease
HB 57-EMERGENCY MED. SVCS: REVIEW ORGANIZATIONS
4:24:56 PM
CHAIR WILSON reconvened the meeting and announced the
consideration of HOUSE BILL NO. 57 "An Act relating to review
organizations and permitting an emergency medical services
provider to establish a review organization; and relating to
patient records."
4:25:23 PM
REPRESENTATIVE STANLEY WRIGHT, District 22, Alaska State
Legislature, Juneau, Alaska, sponsor of HB 57 provided the
following recap:
House Bill 57 introduces legal protections for
confidential EMS peer reviews and quality assurance
discussions, fostering an environment of continuous
learning and safety. It shields EMS providers and
medical directors from legal repercussions, ensuring
that they focus on improving patient care without
fear.
4:26:16 PM
CHAIR WILSON moved to adopt Amendment 1, work order 33-
LS0334\A.3, to HB 57.
33-LS0335\A.3
Bergerud
4/3/24
AMENDMENT 1
OFFERED IN THE SENATE BY SENATOR WILSON
TO HB 57
Page 1, line 2:
Delete "and"
Following "records":
Insert "; and relating to disclosure and
reporting of health care services, prices, and fee
information"
Page 3, following line 22:
Insert a new bill section to read:
"* Sec. 4. AS 18.23.400(n)(3) is amended to read:
(3) "health care facility municipal, or
state hospital, psychiatric hospital, emergency
department, independent diagnostic testing facility,
residential psychiatric treatment center as defined in
AS 47.32.900, kidney disease treatment center
(including freestanding hemodialysis units), office of
a private physician or dentist whether in individual
or group practice, ambulatory surgical center as
defined in AS 47.32.900, freestanding birth center as
defined in AS 47.32.900, and rural health clinic as
defined in AS 47.32.900; "health care facility" does
not include " means a private,
(A) the Alaska Pioneers' Home and the
Alaska Veterans' Home administered by the
department under AS 47.55;
(B) an assisted living home as defined in
AS 47.33.990;
(C) a nursing facility licensed by the
department to provide long-term care;
(D) a facility operated by an Alaska tribal
health organization;
[AND]
(E) a hospital operated by the United
States Department of Veterans Affairs or the
United States Department of Defense, or any other
federally operated hospital or institution; or
(F) a hospital subject to 45 C.F.R. 180 as
that section read on the effective date of this
Act or any other federal price transparency
requirements that are reasonably similar to or
exceed the requirements in this section;"
4:26:23 PM
SENATOR KAUFMAN objected for purposes of discussion.
4:26:30 PM
At ease
4:26:45 PM
CHAIR WILSON reconvened the meeting and explained that Amendment
1 addresses price transparency and disclosure of healthcare cost
information for providers. Alaska updated its laws in 2018, but
since that time, federal laws have been updated twicefirst with
the Affordable Care Act (ACA) and then with the No Surprises Act
(NSA), which are more rigorous than our state laws. Amendment 1
provides statutory clarity upon those laws and, if passed, would
require hospitals to comply with federal requirements under 45
CFR 180, in addition to state standards found in AS 18.23.400,
if 45 CFR 180 or similar federal hospital transparency
regulations are repealed. This ensures hospitals remain subject
to state reporting requirements, maintaining price transparency
without duplicative reporting obligations. Federal requirements
are currently more stringent than state requirements. Members
have been provided with four relevant items from the Alaska
Hospital and Healthcare Association, Alaska Regional Hospital,
and Fairbanks Memorial Hospital. He stated representatives from
these organizations were available to answer questions.
4:29:08 PM
SENATOR GIESSEL acknowledged the efficacy of the amendment but
expressed difficulty understanding its connection to Emergency
Medical Services (EMS) reviews, noting that it feels like an
entirely new topic, perhaps suited for a separate bill. She
requested clarification.
CHAIR WILSON clarified that it is not a separate bill but rather
an amendment to similar sections of law and statutes addressed
by the current bill.
SENATOR GIESSEL replied she understood and noted it.
CHAIR WILSON responded that the premise is to do a legislative
fix to statute. He noted that a title change resolution was also
prepared.
4:30:01 PM
SENATOR GIESSEL stated that she would be interested in hearing
the sponsor's response to this significant amendment.
4:30:11 PM
REPRESENTATIVE WRIGHT stated that he had reviewed the amendment
and is open to taking more if it creates positive changes in
similar legislation.
4:30:39 PM
SENATOR DUNBAR noted for the record, and with appreciation to
the Chair, that Amendment 1 as he reads it provides a
"backstop." He stated the purpose of the amendment is to ensure
hospitals adhere to the higher federal standard under 45 CFR
180, or any similar federal price transparency requirement, in
case of future changes. He explained that if federal law were
fully repealed, the amendment would default to the state
standard, serving as a fallback. He emphasized that this is his
interpretation of the amendment and expressed hope that future
readers understand it similarly, commending the Chair's work in
crafting the language.
4:32:27 PM
CHAIR WILSON asked Mr. Kosin to provide comment and background
on the impetus for Amendment 1, as well as some of the
challenges Alaskan hospitals encounter with dueling federal and
state statutes.
4:32:54 PM
JARED KOSIN, President, Alaska Hospital and Healthcare
Association, Anchorage, Alaska, pointed out that Alaska's
requirements require manual data entry into a PDF, while federal
standards are automated and on a much broader scale. Aligning
with federal standards would save both hospitals and the state
considerable time and resources, as it would eliminate redundant
data entry. He expressed appreciation for the amendment,
emphasizing that if federal standards ever fall below Alaska's
current requirements, hospitals will automatically revert to the
state standards. He also highlighted the federal focus on
shoppable services and episodes of care, which provide
practical, consumer-friendly information that state requirements
currently lack.
4:36:51 PM
CHAIR WILSON asked if objection was maintained.
4:36:59 PM
SENATOR KAUFMAN removed his objection.
4:37:00 PM
CHAIR WILSON found no further objection and solicited a motion.
4:37:29 PM
SENATOR KAUFMAN moved to report HB 57, work order 33-LS0335\A,
as amended, from committee with individual recommendations and
attached fiscal note(s).
4:37:42 PM
CHAIR WILSON asked if there was objection.
4:37:48 PM
SENATOR DUNBAR objected for purposes of discussion.
SENATOR DUNBAR stated there was mention of a title change.
CHAIR WILSON explained that Legislative Legal Services would
provide a title change resolution that will be read across the
floor and then go to the Senate Secretaries office until HB 57
is taken up.
4:38:09 PM
SENATOR DUNBAR removed his objection.
4:38:12 PM
CHAIR WILSON found no further objection and SCS HB 57 (HSS) was
reported from the Senate Health and Social Services Standing
Committee.
4:38:27 PM
At ease
SB 240-SCHOOL DISTRICT MEDICAL ASSISTANCE
4:40:01 PM
CHAIR WILSON reconvened the meeting and announced the
consideration of SENATE BILL NO. 240 "An Act relating to medical
assistance coverage for rehabilitative, mandatory, and optional
services furnished or paid for by a school district on behalf of
certain children."
CHAIR WILSON stated an initial hearing on SB 240 was held
February 27, 2024. At a second hearing on March 12, 2024, the
committee adopted an amendment to SB 240 that lowered the age of
consent for Medicaid services. He said the Department of Health
answered questions and copies were distributed to members.
4:41:27 PM
LEAH VAN KIRK, Deputy Commission, Department of Health, Juneau,
Alaska, provided a brief overview of SB 240 stating that it
removes the requirement for a child to have a disability or an
Individualized Education Plan (IEP), for school districts to
submit claims for Medicaid reimbursement. SB 240 focuses on
providing services to children in schools regardless of their
status related to special education or any type of diagnosis.
4:42:12 PM
CHAIR WILSON spoke to previous concerns and the response from
the department. He stated his concern was the need for parental
consent for billing purposes. The department replied parental
consent would be needed.
4:42:48 PM
MS. VAN KIRK thanked the committee for hearing SB 240.
4:42:54 PM
CHAIR WILSON solicited the will of the committee.
4:42:59 PM
SENATOR KAUFMAN moved to report SB 240, work order 33-GS-2369\A,
as amended, from committee with individual recommendations and
attached fiscal note(s).
4:43:13 PM
CHAIR WILSON objected for purposes of discussion.
CHAIR WILSON stated he forgot to mention a document from
Georgetown University was posted to BASIS that discusses
Medicaid utilization in school districts. He opined that it is
useful information for SB 240 and other pieces of legislation.
4:43:42 PM
CHAIR WILSON removed his objection.
4:43:45 PM
CHAIR WILSON found no further objection and CSSB 240 (HSS) was
reported from the Senate Health and Social Services Standing
Committee.
4:44:17 PM
There being no further business to come before the committee,
Chair Wilson adjourned the Senate Health and Social Services
Standing Committee meeting at 4:44 p.m.
| Document Name | Date/Time | Subjects |
|---|---|---|
| Eric Nimmo Med Board App_Redacted.pdf |
SHSS 4/4/2024 3:30:00 PM |
SHSS 4.4.24 Consideration of Governor's Appointees - Eric Nimmo, State Medical Board |
| Eric Nimmo Medical Board Resume_Redacted.pdf |
SHSS 4/4/2024 3:30:00 PM |
SHSS 4.4.24 - Consideration of Governor's Appointees - Eric Nimmo, State Medical Board |
| SHSS GTFCC Presentation 4.4.24.pdf |
SHSS 4/4/2024 3:30:00 PM |
SHSS 4.4.24 DOH Governor's Task Force on Child Care Presentation |
| SB 240 DOH on Age of Consent Amdnmt.pdf |
SHSS 4/4/2024 3:30:00 PM |
SB 240 |
| HB 57 Amdmt Wilson A.3.pdf |
SHSS 4/4/2024 3:30:00 PM |
HB 57 |
| SHSS 4.4.24 December 2023 Governor's Task Force on Child Care Report.pdf |
SHSS 4/4/2024 3:30:00 PM |
SHSS 4.4.24 DOH Presentation on Governor's Task Force on Child Care |
| SB 240 Amdmt 1 - Adopted.pdf |
SHSS 4/4/2024 3:30:00 PM |
SB 240 |