Legislature(2021 - 2022)DAVIS 106
05/04/2021 03:00 PM House HEALTH & SOCIAL SERVICES
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| Audio | Topic |
|---|---|
| Start | |
| SB65 | |
| SB89 | |
| HB105|| HB116 | |
| Adjourn |
* first hearing in first committee of referral
+ teleconferenced
= bill was previously heard/scheduled
+ teleconferenced
= bill was previously heard/scheduled
| += | HB 153 | TELECONFERENCED | |
| += | HB 106 | TELECONFERENCED | |
| += | HB 105 | TELECONFERENCED | |
| += | HB 116 | TELECONFERENCED | |
| + | TELECONFERENCED | ||
| += | SB 65 | TELECONFERENCED | |
| + | SB 89 | TELECONFERENCED | |
ALASKA STATE LEGISLATURE
HOUSE HEALTH AND SOCIAL SERVICES STANDING COMMITTEE
May 4, 2021
3:08 p.m.
MEMBERS PRESENT
Representative Liz Snyder, Co-Chair
Representative Tiffany Zulkosky, Co-Chair
Representative Ivy Spohnholz
Representative Ken McCarty
Representative Mike Prax
Representative Christopher Kurka
MEMBERS ABSENT
Representative Zack Fields
COMMITTEE CALENDAR
CS FOR SENATE BILL NO. 65(JUD)
"An Act relating to immunity for consulting physicians,
podiatrists, osteopaths, advanced practice registered nurses,
physician assistants, chiropractors, dentists, optometrists, and
pharmacists."
- MOVED HCS CSSB 65(HSS) OUT OF COMMITTEE
CS FOR SENATE BILL NO. 89(FIN)
"An Act relating to house rules for assisted living homes."
- HEARD & HELD
HOUSE BILL NO. 105
"An Act relating to the duties of the commissioner of
corrections; relating to the detention of minors; relating to
minors subject to adult courts; relating to the placement of
minors in adult correctional facilities; and providing for an
effective date."
- HEARD & HELD
HOUSE BILL NO. 116
"An Act relating to care of juveniles and to juvenile justice;
relating to employment of juvenile probation officers by the
Department of Health and Social Services; relating to terms used
in juvenile justice; relating to mandatory reporters of child
abuse or neglect; relating to sexual assault in the third
degree; relating to sexual assault in the fourth degree;
repealing a requirement for administrative revocation of a
minor's driver's license, permit, privilege to drive, or
privilege to obtain a license for consumption or possession of
alcohol or drugs; and providing for an effective date."
- HEARD & HELD
HOUSE BILL NO. 153
"An Act relating to the identification, location, and
notification of specified family members of a child who is in
state custody."
- BILL HEARING CANCELED
HOUSE BILL NO. 106
"An Act relating to missing persons under 21 years of age."
- BILL HEARING CANCELED
PREVIOUS COMMITTEE ACTION
BILL: SB 65
SHORT TITLE: LIABILITY CONSULTING HEALTH CARE PROVIDER
SPONSOR(s): SENATOR(s) KIEHL
02/03/21 (S) READ THE FIRST TIME - REFERRALS
02/03/21 (S) HSS, JUD
02/16/21 (S) HSS AT 1:30 PM BUTROVICH 205
02/16/21 (S) Heard & Held
02/16/21 (S) MINUTE(HSS)
02/18/21 (S) HSS AT 1:30 PM BUTROVICH 205
02/18/21 (S) Moved CSSB 65(HSS) Out of Committee
02/18/21 (S) MINUTE(HSS)
02/19/21 (S) HSS RPT CS 3DP 1NR NEW TITLE
02/19/21 (S) DP: WILSON, BEGICH, HUGHES
02/19/21 (S) NR: REINBOLD
03/05/21 (S) JUD AT 1:30 PM BUTROVICH 205
03/05/21 (S) -- MEETING CANCELED --
03/08/21 (S) JUD AT 1:30 PM BUTROVICH 205
03/08/21 (S) Heard & Held
03/08/21 (S) MINUTE(JUD)
03/12/21 (S) JUD AT 1:30 PM BUTROVICH 205
03/12/21 (S) Heard & Held
03/12/21 (S) MINUTE(JUD)
03/31/21 (S) JUD AT 1:30 PM BUTROVICH 205
03/31/21 (S) Moved CSSB 65(JUD) Out of Committee
03/31/21 (S) MINUTE(JUD)
04/03/21 (S) JUD RPT CS 3DP 2NR NEW TITLE
04/03/21 (S) DP: KIEHL, HUGHES, MYERS
04/03/21 (S) NR: REINBOLD, SHOWER
04/12/21 (S) TRANSMITTED TO (H)
04/12/21 (S) VERSION: CSSB 65(JUD)
04/14/21 (H) READ THE FIRST TIME - REFERRALS
04/14/21 (H) HSS, JUD
04/27/21 (H) HSS AT 3:00 PM DAVIS 106
04/27/21 (H) Heard & Held
04/27/21 (H) MINUTE(HSS)
04/29/21 (H) HSS AT 3:00 PM DAVIS 106
04/29/21 (H) -- MEETING CANCELED --
05/04/21 (H) HSS AT 3:00 PM DAVIS 106
BILL: SB 89
SHORT TITLE: ASSISTED LIVING HOMES: HOUSE RULES
SPONSOR(s): RULES BY REQUEST OF THE GOVERNOR
02/22/21 (S) READ THE FIRST TIME - REFERRALS
02/22/21 (S) HSS, FIN
03/18/21 (S) HSS AT 1:30 PM BUTROVICH 205
03/18/21 (S) Heard & Held
03/18/21 (S) MINUTE(HSS)
03/30/21 (S) HSS AT 1:30 PM BUTROVICH 205
03/30/21 (S) Moved SB 89 Out of Committee
03/30/21 (S) MINUTE(HSS)
03/31/21 (S) HSS RPT 4DP 1NR
03/31/21 (S) DP: WILSON, BEGICH, COSTELLO, HUGHES
03/31/21 (S) NR: REINBOLD
04/07/21 (S) FIN AT 9:00 AM SENATE FINANCE 532
04/07/21 (S) Heard & Held
04/07/21 (S) MINUTE(FIN)
04/12/21 (S) FIN AT 9:00 AM SENATE FINANCE 532
04/12/21 (S) <Bill Hearing Rescheduled to 4/14/21>
04/14/21 (S) FIN RPT CS 6DP 1NR SAME TITLE
04/14/21 (S) DP: STEDMAN, BISHOP, HOFFMAN, WILSON,
WIELECHOWSKI, VON IMHOF
04/14/21 (S) NR: OLSON
04/14/21 (S) FIN AT 9:00 AM SENATE FINANCE 532
04/14/21 (S) Moved CSSB 89(FIN) Out of Committee
04/14/21 (S) MINUTE(FIN)
04/26/21 (S) TRANSMITTED TO (H)
04/26/21 (S) VERSION: CSSB 89(FIN)
04/28/21 (H) READ THE FIRST TIME - REFERRALS
04/28/21 (H) HSS
04/29/21 (H) HSS AT 3:00 PM DAVIS 106
04/29/21 (H) -- MEETING CANCELED --
05/04/21 (H) HSS AT 3:00 PM DAVIS 106
BILL: HB 105
SHORT TITLE: DETENTION OF MINORS
SPONSOR(s): RULES BY REQUEST OF THE GOVERNOR
02/19/21 (H) READ THE FIRST TIME - REFERRALS
02/19/21 (H) JUD, HSS
03/05/21 (H) JUD AT 1:30 PM GRUENBERG 120
03/05/21 (H) Heard & Held
03/05/21 (H) MINUTE(JUD)
03/08/21 (H) JUD AT 1:30 PM GRUENBERG 120
03/08/21 (H) <Bill Hearing Canceled>
03/10/21 (H) JUD AT 1:30 PM GRUENBERG 120
03/10/21 (H) Moved CSHB 105(JUD) Out of Committee
03/10/21 (H) MINUTE(JUD)
03/12/21 (H) JUD RPT CS(JUD) 4DP 3NR
03/12/21 (H) DP: DRUMMOND, SNYDER, KREISS-TOMKINS,
CLAMAN
03/12/21 (H) NR: EASTMAN, VANCE, KURKA
04/15/21 (H) HSS AT 3:00 PM DAVIS 106
04/15/21 (H) Heard & Held
04/15/21 (H) MINUTE(HSS)
04/27/21 (H) HSS AT 3:00 PM DAVIS 106
04/27/21 (H) Heard & Held
04/27/21 (H) MINUTE(HSS)
04/29/21 (H) HSS AT 3:00 PM DAVIS 106
04/29/21 (H) -- MEETING CANCELED --
05/04/21 (H) HSS AT 3:00 PM DAVIS 106
BILL: HB 116
SHORT TITLE: JUVENILES: JUSTICE,FACILITES,TREATMENT
SPONSOR(s): SPOHNHOLZ
02/24/21 (H) READ THE FIRST TIME - REFERRALS
02/24/21 (H) HSS, JUD
04/09/21 (H) HSS REFERRAL MOVED TO AFTER JUD
04/09/21 (H) BILL REPRINTED
04/12/21 (H) JUD AT 1:00 PM GRUENBERG 120
04/12/21 (H) Heard & Held
04/12/21 (H) MINUTE(JUD)
04/14/21 (H) JUD AT 1:00 PM GRUENBERG 120
04/14/21 (H) Heard & Held
04/14/21 (H) MINUTE(JUD)
04/16/21 (H) JUD AT 1:00 PM GRUENBERG 120
04/16/21 (H) Moved HB 116 Out of Committee
04/16/21 (H) MINUTE(JUD)
04/19/21 (H) JUD RPT 3DP 3AM
04/19/21 (H) DP: DRUMMOND, SNYDER, CLAMAN
04/19/21 (H) AM: EASTMAN, VANCE, KURKA
04/27/21 (H) HSS AT 3:00 PM DAVIS 106
04/27/21 (H) Heard & Held
04/27/21 (H) MINUTE(HSS)
04/29/21 (H) HSS AT 3:00 PM DAVIS 106
04/29/21 (H) -- MEETING CANCELED --
05/04/21 (H) HSS AT 3:00 PM DAVIS 106
WITNESS REGISTER
SENATOR JESSE KIEHL
Alaska State Legislature
Juneau, Alaska
POSITION STATEMENT: As prime sponsor, testified and answered
questions during the hearing on SB 65.
JOHN LEE, Director
Anchorage Office
Division of Senior and Disabilities Services
Department of Health and Social Services (DHSS)
Anchorage, Alaska
POSITION STATEMENT: Presented CSSB 89(FIN) on behalf of the
House Rules Committee by request of the governor.
CRAIG BAXTER, Assisted Living Home Manager
Residential Licensing/Background Check Program
Division of Health Services
Department of Health and Social Services (DHSS)
Anchorage, Alaska
POSITION STATEMENT: Answered questions during the hearing on SB
89, on behalf of the House Rules Committee by request of the
governor.
MATT DAVIDSON, Social Services Program Officer
Division of Juvenile Justice (DJJ)
Department of Health and Social Services (DHSS)
Juneau, Alaska
POSITION STATEMENT: Explained the changes under the proposed
committee substitute, Version I, for HB 105.
ACTION NARRATIVE
3:08:10 PM
CO-CHAIR LIZ SNYDER called the House Health and Social Services
Standing Committee meeting to order at 3:08 p.m.
Representatives Spohnholz, McCarty, Prax, Zulkosky, and Snyder
were present at the call to order. Representative Kurka arrived
as the meeting was in progress.
SB 65-LIABILITY CONSULTING HEALTH CARE PROVIDER
3:09:40 PM
CO-CHAIR SNYDER announced that the first order of business would
be CS FOR SENATE BILL NO. 65(JUD), "An Act relating to immunity
for consulting physicians, podiatrists, osteopaths, advanced
practice registered nurses, physician assistants, chiropractors,
dentists, optometrists, and pharmacists."
3:10:34 PM
REPRESENTATIVE SPOHNHOLZ moved to adopt Amendment 1 to CSSB
65(JUD), labeled 32-LS0002\G.1, Fisher, 4/30/21, which read:
Page 1, line 3:
Delete "and pharmacists"
Insert "pharmacists, physical therapists, and
occupational therapists"
Page 3, line 3:
Delete "or"
Following "AS 08.80":
Insert ", or a physical therapist or occupational
therapist licensed under AS 08.84"
REPRESENTATIVE PRAX objected.
REPRESENTATIVE SPOHNHOLZ explained that to be consistent in who
is included and who is excluded, Amendment 1 would add physical
therapists and occupational therapists to the list of providers
covered in the bill, which includes chiropractors, dentists,
optometrists, and pharmacists.
3:11:25 PM
SENATOR JESSE KIEHL, Alaska State Legislature, as prime sponsor
of SB 65, offered his appreciation for the conversations that he
and Representative Spohnholz have had about Amendment 1. He
maintained that [CSSB 65(JUD)], as offered to the committee, is
consistent in that all the included medical
professions/disciplines have certain similarities in their scope
of practice, although they cover a broad range of health care
providers. The health care providers on the list have the power
of diagnosis, as well as their treatment powers within their
specific area of training and expertise. While physical
therapists and occupational therapists are extremely valuable
health care providers, with a civil liability bill it is
important to consider the relative risk when the legislature is
going to grant total immunity in civil law. For the other
providers on the list, the scopes of practice involve much
higher relative risks of physical harm within their scope of
practice.
SENATOR KIEHL continued his response. He flagged the potential
for a difference in the scope of practice between the treating
provider and the professional who is consulted. He pointed out
that the treating provider has a more limited scope of practice
and the medical provider who is consulted has a much more
extensive scope of practice and training. Under the bill the
treating provider retains full liability, so it is important for
this bill to make sure that the treating provider has the scope
of practice and scope of training to fully evaluate the advice
he or she is given in that unpaid consult. He said he
appreciates the intention of the amendment's sponsor, but that
he is more comfortable with the bill as presented.
3:13:57 PM
REPRESENTATIVE KURKA asked whether he is correct understanding
that Senator Kiehl's concern is if a physical or occupational
therapist gets medical advice from a doctor and then works off
that advice to treat a patient, the doctor should be held liable
because the license of a physical or occupational therapist is
not on the same playing field as a doctor.
SENATOR KIEHL replied that the bill does not create a duty of
care for consultations outside the grant of civil immunity here,
but specifically to the grant of civil immunity, that difference
described by Representative Kurka is a concern.
3:15:05 PM
REPRESENTATIVE SPOHNHOLZ, in relation to the sponsor's statement
about diagnosis and treatment, pointed out that in Alaska a
physical therapist and an occupational therapist do not need a
referral from another provider. For example, a person having
trouble with his or her shoulder can choose to see a physical
therapist without a doctor's prescription. Therefore, she
maintained, physical therapists and occupational therapists are
equivalent. They have their own board, she continued, and given
the comparative other professions included in the bill, all of
which have very different scopes of practices, it seems there is
a lot of parody here.
CO-CHAIR SNYDER commented that the committee is talking about
adding physical therapists and occupational therapists to the
group of individuals that could be called and are protected, as
opposed to the provider doing the calling. She said she
therefore questions why adding them wouldn't be wanted.
SENATOR KIEHL answered that Amendment 1 runs both directions
because it defines a health care provider for purposes both of
making the phone call and receiving the call, not that it would
have to be by phone.
CO-CHAIR SNYDER asked whether it is correct that the liability
protection is to the one receiving the call.
SENATOR KIEHL [nodded in the affirmative].
3:17:01 PM
REPRESENTATIVE MCCARTY asked whether he is correct that the bill
sponsor is saying that the group included in SB 65 is at greater
risk in court-type situations than, say, a mental health
provider, or physical therapist, or occupational therapist.
SENATOR KIEHL confirmed that Representative McCarty's statement
is correct.
3:18:24 PM
REPRESENTATIVE PRAX, to provide context, asked how often a
physical therapist or an occupational therapist would call a
specialist as compared to a general practitioner for example who
would call specialists more often.
REPRESENTATIVE SPOHNHOLZ replied that that is possibly true, but
she is unaware of evidence to show that it is true or not true.
She said calls could be going either way with how the bill is
currently crafted. With the way the bill is drafted, and the
way Amendment 1 is considered, she added, a physical therapist
or occupational therapist could call a general practitioner or
orthopod for consultation. Since Alaska has direct entry to
physical therapy and occupational therapy it makes sense to
include physical therapists and occupational therapists to
ensure that that two-way communication is happening effectively.
3:21:04 PM
REPRESENTATIVE MCCARTY expressed his understanding that the
concern is that an orthopod could call a physical therapist and
then the physical therapist would be the consulting person, and
SB 65 is to protect the consulting individual.
REPRESENTATIVE SPOHNHOLZ responded that, given the way the bill
is drafted, it could go either way.
CO-CHAIR SNYDER pointed out that the liability protection is for
the person being called.
REPRESENTATIVE MCCARTY said that is his understanding as well.
So, he continued, that gets into the question of how frequently
physical or occupational therapists are consulted, and whether
that puts them in greater civil liability type things that exist
in the industry of health care. He stated that what he is
hearing from the bill sponsor is that this category of people is
at a higher risk than others.
CO-CHAIR SNYDER replied that that is what is being assumed.
3:22:41 PM
REPRESENTATIVE SPOHNHOLZ asked the bill sponsor whether the
aforementioned is the case. Given the bill is drafted to
include chiropractors, she stated, the assumption is that they
are at higher risk of potential liability for consulting than a
physical therapist, osteopath, or physician's assistant, yet she
is unsure whether evidence of that has been seen.
SENATOR KIEHL answered that chiropractors were added in the
[Senate Health and Social Services Standing Committee], and one
of the meaningful distinctions among those professions is
diagnostic power. He said it is good law that in Alaska someone
can go directly to see a physical therapist or occupational
therapist, and because their scope of practice does not extend
to diagnosis, their exposure when looking at statute is limited;
whereas the other medical professions included in the bill do
have the power of diagnosis in their statutes. Almost all have
the power of prescription, and to a greater or lesser extent
optometrists can prescribe a limited quantity of opioids; the
exception there would be the pharmacists themselves. The scope
of practice of pharmacists is quite limited. The number of
topics on which a pharmacist might provide a consultation to one
of the other providers on the list is limited to pharmacology,
so there aren't broader concerns about their ability to, for
example, evaluate advice they are given or to be asked advice on
a topic. He expressed his hope that this covers Representative
Spohnholz' thoughts about the consistency of the list.
3:25:23 PM
REPRESENTATIVE PRAX maintained his objection. He offered his
appreciation for what Representative Spohnholz is saying to try
to make this applicable equally from the point of the law. But,
he continued, what is being done on the other side is to give a
privilege to certain groups. He said he is hesitant to make
that broader at this time but might reconsider at another time.
REPRESENTATIVE KURKA stated he is split both ways on who should
receive the liability protection under certain circumstances,
but he also sees that physicians should take responsibility for
their advice in other situations. He can see situations where
individuals are consulted in their respective professions,
whether or not they are physical therapists, and maybe the
liability protection for their profession versus the situation
where they are getting advice from a different licensure, and
there is the possibility that these are separate things.
3:28:18 PM
CO-CHAIR ZULKOSKY offered her appreciation for the explanation
of looking at the provider types included in the bill and what
aligning all of them means with respect to the power of
diagnosis and the level of risk that is associated among them in
terms of prescribing power or rendering diagnoses. Physical
therapists and occupational therapists may not necessarily have
the power of diagnosis, and they also do not have the level of
risk in terms of the treatment that they provide. While there
is parody in the type of treatment that might be provided, a
physical therapist, for example, is not doing high manipulation
like a chiropractor would be doing. She asked how there is not
parody if there is a lower level of risk that might be
experienced in consulting a physical therapist or occupational
therapist or vice versa.
SENATOR KIEHL responded that the relative level of risk gets to
the need to grant statutory immunity. Where that level of risk
is lower, he said, the need to grant a total immunity from suit
is also significantly lower. Excluding someone from this list
of total immunity from lawsuit doesn't create some duty of care
where it didn't exist before, it isn't exposing them to brand
new lawsuits that others are being exempted from. That
comparative risk of harm is a significant factor in looking at
who needs to be covered under the bill.
3:31:49 PM
REPRESENTATIVE SPOHNHOLZ suggested that SB 65 tries to create
comfort on the part of a consulting provider to provide candid,
effective consultation to another provider, a positive intent of
this bill that she supports. This is an issue of parody, she
opined, because physical therapists diagnose and do spinal
manipulation just as chiropractors do. Physical therapists have
a very broad range of practice and given the expanding scope of
their practice over time and that they do provide consultation,
it's an issue of parody if chiropractors are going to be
included. Physical therapists do many of the same things plus
other invasive procedures that they didn't do 50 years ago but
are doing now. There are specialties in physical therapy just
like there are specialties in nursing, physician assistants, or
medical doctors. This is a matter of parody, and if they are
not going to be included then perhaps chiropractors, dentists,
and optometrists should be taken out. But, if all of those are
going to be included, then not including physical therapists and
occupational therapists would be an oversight.
3:34:14 PM
A roll call vote was taken. Representatives Kurka, Spohnholz,
McCarty, Prax, Zulkosky, and Snyder voted in favor of Amendment
1. Therefore, Amendment 1 was adopted by a vote of 6-0.
REPRESENTATIVE MCCARTY commented that this is a marvelous bill
that frees up the ability for professionals to consult with one
another to improve health care professions without the threat of
lawsuits.
REPRESENTATIVE PRAX thanked the bill sponsor for agreeing to
personally call one of his constituents who had questions about
the bill.
3:36:07 PM
CO-CHAIR ZULKOSKY moved to report CSSB 65(JUD), as amended, out
of committee with individual recommendations and the
accompanying [zero] fiscal note.
REPRESENTATIVE KURKA stated that he is not going to oppose the
bill at this time and probably will support it on the floor as
written, but he is concerned about adding a lot of new language
in statute. The sponsor has been clear that the intent is not
to create a duty of care that wasn't there already, but he
questions why a new list is being created that is not somewhere
else. He is concerned about the unintended implications of
creating this immunity, but the intent of the bill is important.
There being no objection, HCS CSSB 65(HSS) was reported out of
the House Health and Social Services Standing Committee.
3:39:20 PM
The committee took an at-ease from 3:39 p.m. to 3:40 p.m.
SB 89-ASSISTED LIVING HOMES: HOUSE RULES
3:40:07 PM
CO-CHAIR SNYDER announced that the next order of business would
be CS FOR SENATE BILL NO. 89(FIN), "An Act relating to house
rules for assisted living homes." She noted that CSSB 89(FIN)
is the companion bill to HB 103, which the committee heard on
4/13/21.
3:40:54 PM
JOHN LEE, Director, Anchorage Office, Division of Senior and
Disabilities Services, Department of Health and Social Services
(DHSS), presented CSSB 89(FIN) on behalf of the House Rules
Committee by request of the governor. He spoke from a document
titled, "SB 89 Assisted Living Homes; House Rules ONE PAGE
SUMMARY." He stated that the bill is needed because Alaska's
statutes are not in compliance with federal regulations that
require home and community-based service providers to give
people who are on waivers the same access to the community as
people who are not on waivers. For example, state law allows
that an assisted living home may establish house rules that
address a resident's rights to have visitors.
MR. LEE pointed out that while state statute says the rules may
not be unusually restrictive, the federal regulation is more
explicit, stating that individuals on waivers and in such
settings "are able to have visitors of their choosing at any
time." Although Alaska received initial approval from the
federal government for its plan to bring its settings into
compliance, he advised, the approval was contingent on the state
revising its statute to reflect this federal statute. Ongoing
financial participation in the state's waiver programs by the
federal government is reliant on services being provided in
compliant settings. Without this amendment to the state statute
the federal government match is in jeopardy.
MR. LEE explained that the bill proposes a simple insertion of
language into the Assisted Living Homes Statutes [AS 47.33] that
will bring the state into compliance with the Centers for
Medicare and Medicaid Services (CMS) home and community-based
settings requirements, thereby protecting Alaska's federal share
of [Medicaid] payments for home and community-based [waiver]
services. The bill ensures that [recipients] of residential
[waiver] services will be able to live under conditions that are
as much like a person's home as possible.
MR. LEE addressed who would be impacted by the bill. He related
that Alaska's approximately 700 assisted living homes would be
required to abide by the conditions defined in the bill. The
new statutory language would afford all residents living in
assisted living homes the same rights, regardless of whether the
home accepts Medicaid as payment. Over 650 homes are already in
compliance with these conditions because they are certified to
operate home and community-based waiver services under these
conditions.
MR. LEE reviewed the timeline [for compliance]. He stated that
CMS requires states to have these settings in place by March
2023. He further noted that the fiscal impact is zero.
3:43:43 PM
MR. LEE provided a sectional analysis of CSSB 89(FIN). He
explained that Section 1 amends AS 47.33.060, House Rules for
Assisted Living Homes that Explicitly Require Consistency with
Federal Law When House Rules are Established. Section 2 adds a
new [subsection] for assisted living homes to make explicit that
assisted living homes that provide waiver services may not adopt
house rules inconsistent with federal law. Section 3 carries
the statutory amendments proposed in Section 1 and Section 2
regarding the resident's right to have visitors.
3:44:29 PM
CO-CHAIR ZULKOSKY asked whether there are any significant
changes between [CSSB 89(FIN)], the Senate version before the
committee, and HB 103, which the committee heard previously.
MR. LEE replied that one of the bills has language that
addresses the Executive Order (EO) to split the department into
two compartments, and the other does not. In further response
to Co-Chair Zulkosky, he confirmed that that is the only
significant change.
3:45:26 PM
REPRESENTATIVE KURKA asked which committee is the bill's next
referral.
CO-CHAIR SNYDER responded that there is no other committee of
referral, so the bill will next go to the House Rules Committee.
3:46:19 PM
REPRESENTATIVE MCCARTY moved to adopt Amendment 1 to CSSB
89(FIN), labeled 32-GH1675\A.2, Dunmire, 4/15/21, which read:
Page 1, lines 7 - 12:
Delete all material and insert:
"* Sec. 2. AS 47.33.060 is amended by adding new
subsections to read:
(e) An assisted living home shall permit an
individual immediate access to a resident without
requiring an appointment if the individual visits the
resident during the visiting hours established by the
home, subject to the resident's consent to receive a
visit from the individual.
(f) An assisted living home may adopt an appointment
system to facilitate visits outside of visiting
hours."
REPRESENTATIVE SPOHNHOLZ objected for purposes of discussion.
REPRESENTATIVE MCCARTY withdrew Amendment 1 so as to not cause
conflict with federal rules.
3:47:16 PM
REPRESENTATIVE SPOHNHOLZ moved to adopt Amendment 2 to CSSB
89(FIN), labeled 32-GH1675\A.4, Dunmire, 4/28/21, which read:
Page 2, line 1, following "environment":
Insert "free from abuse and discrimination"
Page 2, line 16:
Delete "and"
Insert "[AND]"
Page 2, line 18, following "AS 47.33.060":
Insert "; and
(D) reasonable access to the Internet, to
the extent available to the home;"
Page 3, line 5, following "with":
Insert "cultural preferences and"
Page 3, line 11, following "home":
Insert "without fear of reprisal or retaliation"
Page 3, line 18:
Delete "and"
Insert "[AND]"
Page 3, line 20, following "home":
Insert ";
(20) receive information in a language the
resident understands; and
(21) receive quality care"
CO-CHAIR ZULKOSKY objected for purposes of discussion.
REPRESENTATIVE SPOHNHOLZ explained Amendment 2 would incorporate
the following recommendations from Alaska's Office of Long Term
Care Ombudsman: that residents be free from abuse and
discrimination, that reasonable internet access be ensured to
the extent available, that strengthen the rights of residents to
submit grievances, that residents can receive cultural
preferences with regard to meal preparation along with religious
and other health related restrictions, that residents who aren't
English proficient receive information in a language they can
understand, and that residents can live in the home and file
complaints without fear of reprisal and retaliation. She said
these recommendations reflect grievances addressed by the
ombudsman related to assisted living homes. She drew attention
to a letter provided to committee members that the Long Term
Care Ombudsman submitted to the committee chair.
3:49:13 PM
REPRESENTATIVE PRAX expressed concern that these recommendations
are somewhat nebulous and subject to interpretation. It is up
to the ombudsman to determine these things, he opined, and it
goes without saying that it should be without fear of reprisal
or retaliation but saying it can open the door. People in this
situation can be obstreperous and the facility must be able to
exercise some control; if the facility goes too far then the
resident's remedy is to go to the ombudsman. It should be
worked out on a case-by-case basis rather than trying to spell
it out in statute.
REPRESENTATIVE SPOHNHOLZ offered her belief that these would not
be too nebulous or ambiguous. She said the average number of
residents in an assisted living home in Alaska is three, and
they are homes in communities, not large facilities. Although
people may need assisted living support, they should still be
able to continue having culturally appropriate foods, access to
the internet, and to feel safe in the home for which they are
paying for a service. The ombudsman can help the department in
the regulation drafting process for complying with the statute,
and that process would include an opportunity for public comment
and for operators of these homes to provide feedback.
3:53:26 PM
CO-CHAIR ZULKOSKY stated she would like to hear from the
department as to whether the preference is for broad language or
prescriptive language to capture the recommendations from the
Office of Long Term Care Ombudsman.
MR. LEE replied that [the Division of Senior and Disabilities
Services] has looked at Amendment 2 and does not believe it
would put the division at risk of violating the settings rules.
He deferred to Mr. Craig Baxter to answer the question from the
perspective of the Division of Health Care Services.
CO-CHAIR ZULKOSKY related that she has talked to some
constituent groups that run assisted living homes and they
welcomed the language in this amendment. She requested
confirmation that there would be regulation setting processes
that would provide assisted living facilities with the
opportunity to respond to this new statute.
MR. LEE deferred to Mr. Baxter to answer the question.
3:55:16 PM
CRAIG BAXTER, Assisted Living Home Manager, Residential
Licensing/Background Check Program, Division of Health Services,
Department of Health and Social Services (DHSS), on behalf of
the House Rules Committee by request of the governor, answered
that it depends on which one of the house rules the amendment
addresses. Some of them are fine and the division would be able
to enforce with the way the amendment is written; others are too
broad, and he would recommend the statute clarify some things
more clearly. His concern, he continued, is writing and
implementing a regulation package versus addressing it here
within the statute within the amendment, which would give a lot
more guidance on how to enforce. While he knows how the appeals
process goes and what the intent is, he can see [the department]
struggling to hold facilities accountable with some of the
items. The ombudsman's recommended amendments are great, but
some are broad enough that it might be difficult for [the
department] with the statute alone to provide quality
enforcement without there being a regulation package to clarify
and flush those out.
REPRESENTATIVE SPOHNHOLZ asked whether she is correct in
understanding Mr. Baxter to have said that a regulations package
would be needed to define more specifically the details for how
to implement Amendment 2.
MR. BAXTER replied yes. For example, he said, the "receive
quality care" amendment could be taken in many ways, so a
definition or flushing out within the amendment would give [the
department] some guidelines as to what the intent would be for
quality care. The food amendment is fine because the department
already has regulations that address food. Regarding the
"without fear of reprisal or retaliation" amendment, there are
already statutes that address retaliation, but more guidance is
needed on the word "fear." This is because someone could
interpret the actions of a facility in a way that they would be
afraid of reprisal when reprisal or retaliation weren't
intended. Must [the department] show that the facility intended
to take a reprisal or a retaliatory action against the
individual? [The department] would have to come up with a way
to define some of those items to be on solid footing for
enforcement. The proposed changes are positive and needed, but
more clarification would go a long way as far as providing
meaningful enforcement.
CO-CHAIR SNYDER remarked that she is hearing struggle back and
forth between desire to have statute that is prescriptive or
statute that is wide enough to give some latitude for
appropriate interpretation.
3:59:43 PM
REPRESENTATIVE KURKA commented that it looks like clarification
is being added on the list of what the rights are of the
residents of a home, but others are quite broad, and some seem
over the top. He questioned whether "reasonable access to the
Internet" is a right and whether it is a cost that should be
incurred by the home. He said he is concerned with adding more
and more things that are luxuries rather than basic needs.
REPRESENTATIVE SPOHNHOLZ related that "quality care" is included
in Amendment 2 because 374 complaints were received in 2020,
making it the second most frequent complaint for assisted living
homes that year. In 2019, 583 complaints were received, making
it a serious volume. She agreed the language in the amendment
is broad but said she prefers not to be too specific in statute
because the definition of "quality care" may change a bit over
time. The quality of care is a right that also aligns with the
home and community-based services final rule that focuses on
quality individual experiences. The long term care ombudsman
says that the quality of care should focus on a person-centered
approach to care, which is well defined because the report goes
into this in detail. She said she has been repeatedly assured
that the long term care ombudsman and [the Residential Licensing
Section] have a very robust working relationship. It is made
clear in the long term care ombudsman's report that residents
have the right to make choices and to control decisions in their
lives even in an assisted living home. Residents have the right
to provide input into their care plan and their care planning
team. She suggested the department work with the long term care
ombudsman to go into more granular detail regarding the
definition of quality care. Representative Spohnholz disagreed
that internet access is not a right. She argued that it is a
right because in 2021 a person who doesn't have access to the
internet lacks access to basic information and this is not less
important for people with disabilities or elders who need
physical support. Amendment 2 doesn't say how it would be paid
for, she added, but internet access should be a right in 2021.
CO-CHAIR ZULKOSKY removed her objection to Amendment 2.
REPRESENTATIVE KURKA objected to Amendment 2. He said he would
be more comfortable if the resident had the ability to incur the
extra cost of the internet and again questioned whether it is a
right to have access to the internet. He maintained that access
to food being selected on cultural preferences could be
extraordinarily broad and beyond convictions. He questioned
whether cultural preference should be considered a right and
said the menu should be looked at when a person is considering
which home to go into.
A roll call vote was taken. Representatives Spohnholz,
Zulkosky, and Snyder voted in favor of Amendment 2.
Representatives Prax and Kurka voted against it. Therefore,
Amendment 2 was adopted by a vote of 3-2.
4:07:23 PM
The committee took a brief at-ease at 4:07 p.m.
4:07:47 PM
CO-CHAIR SNYDER announced that CSSB 89(FIN) was held over.
REPRESENTATIVE KURKA noted that it was past the deadline for
submitting amendments to the bill.
4:08:47 PM
The committee took an at-ease from 4:08 p.m. to 4:15 p.m.
HB 105-DETENTION OF MINORS
HB 116-JUVENILES: JUSTICE,FACILITES,TREATMENT
4:15:26 PM
CO-CHAIR SNYDER announced that the final order of business would
be HOUSE BILL NO. 105, "An Act relating to the duties of the
commissioner of corrections; relating to the detention of
minors; relating to minors subject to adult courts; relating to
the placement of minors in adult correctional facilities; and
providing for an effective date." and HOUSE BILL NO. 116, "An
Act relating to care of juveniles and to juvenile justice;
relating to employment of juvenile probation officers by the
Department of Health and Social Services; relating to terms used
in juvenile justice; relating to mandatory reporters of child
abuse or neglect; relating to sexual assault in the third
degree; relating to sexual assault in the fourth degree;
repealing a requirement for administrative revocation of a
minor's driver's license, permit, privilege to drive, or
privilege to obtain a license for consumption or possession of
alcohol or drugs; and providing for an effective date."
CO-CHAIR SNYDER recounted that during the committee's last
meeting the overlap between HB 105 and HB 116 was discussed.
She stated that HB 116 is rolled into the committee substitute
that will be proposed today.
4:16:24 PM
CO-CHAIR ZULKOSKY moved to adopt the proposed committee
substitute (CS) for HB 105, Version 32-GH1576\I, Radford,
5/1/21, as the working document. There being no objection,
Version I was before the committee.
4:17:00 PM
MATT DAVIDSON, Social Services Program Officer, Division of
Juvenile Justice (DJJ), Department of Health and Social Services
(DHSS), explained the changes made under the proposed committee
substitute, Version I, for HB 105. He stated that both the
division and the department are excited to be at this point with
these two important pieces of legislation, especially combining
them into one bill. He said HB 105, Detention of Minors, and HB
116, Juveniles: Justice, Facilities, Treatment, meld together
nicely given they deal with a similar subject and have several
overlapping sections. Mr. Davidson related that Version I is
comprised of 10 sections directly from HB 105 [Version 32-
GH1576\B], 38 sections without changes directly from HB 116
[Version 32-LS0537\A], and 10 sections that are a meld between
the two bills. He further related that Version I contains
updates to sections of HB 105 to reflect language adopted by the
Senate when that body considered [SB 91, Version 32-GS1576\I],
the companion to HB 105. He noted that for the sectional
analysis he will only highlight the changes that were made that
were not included in HB 105 or HB 116.
MR. DAVIDSON explained that Version I, Section 6, page 3, [lines
9-10], contains an amendment suggested by Representative Kurka
regarding the definition of a position of authority for the
purposes of sexual abuse of a minor. The suggested amendment
moved the phrase "substantially similar" to a different position
in the statute that would be more inclusive of the entire list
of officials that could have a position of authority.
MR. DAVIDSON specified that Version I, Section 13, reflects a
minor legislative drafting change that was made in [SB 91]. He
said Section 14 combines the new federal rules about detention
of non-delinquent minors that are in HB 105 with language in HB
116 describing facilities. He stated that Section 16 is HB 105
with the updated terms found in HB 116. He conveyed that
Section 19 is a drafting style change that was made in the other
body but with no change in the meaning of the bill. He related
that Section 21 contains a minor drafting style revision.
4:23:45 PM
MR. DAVIDSON explained that Version I, Section 25, which is
Section 25 of HB 105 and Section 8 of [SB 91], is an amendment
that provides for minors who have been waived into the adult
correctional system to be held in DJJ facilities. He pointed
out that this is the core of HB 105 and that the other body made
changes to that section to help clarify the expectations for the
new rules that are being operated under. The exceptions to the
rule are specified for during transport to the DJJ facility to
attend court hearings or under the court appeal processes of
Section 25, [subsections] (c) and (d). Also, a specific right
for counsel is to be given to a minor who is going to be moved
into an adult system under [subsections] (c) and (d). The most
important change in Section 25 is the addition and definition of
the term "waived minor." Because adding these minors who have
been waived into the adult correctional system into delinquency
statute was causing confusion, a very specific definition was
provided in [subsection] (g) of Section 25.
MR. DAVIDSON stated that Section 28 contains a minor drafting
style change that was made in the other body. He conveyed that
Sections 30-34 are a combination of HB 116 with the drafting
style changes made in the other body. The same provisions that
are in HB 105 are combined with HB 116, the new definition of
DJJ facilities. He explained that Sections 36-37 take the other
body's version which added a new subsection (f) clarifying the
expectation that waived minors will be transported directly to
DJJ facilities rather than going to adult facilities, and the
combination of HB 116 terminology. He said Section 55 combines
the applicability sections of both bills. He related that the
final section, Section 58, is from [HB 105, Section 20, which
establishes an effective date of July 1, 2021, except as noted
in Section 57.]
4:26:20 PM
REPRESENTATIVE SPOHNHOLZ thanked Tracy Dompeling, Matt Davidson,
and Suzanne Cunningham with the administration for collaborating
with her staff person Megan Holland on bringing together HB 105
and HB 116.
REPRESENTATIVE KURKA noted he hasn't yet reviewed Version I but
likes "the fix" done on Section 6 that in HB 116 would possibly
have allowed for someone to not be prosecuted for sexual
assault.
REPRESENTATIVE SPOHNHOLZ thanked Representative Kurka for his
work on that definition.
CO-CHAIR SNYDER concurred it was a good catch by Representative
Kurka and an elegant fix to that section.
[HB 105 and HB 116 were held over.]
4:29:03 PM
ADJOURNMENT
There being no further business before the committee, the House
Health and Social Services Standing Committee meeting was
adjourned at 4:29 p.m.
| Document Name | Date/Time | Subjects |
|---|---|---|
| SB 89 Amendments.pdf |
HHSS 5/4/2021 3:00:00 PM HHSS 5/13/2021 3:00:00 PM |
SB 89 |
| SB 65 Amendment 1_Spohnholz.pdf |
HHSS 5/4/2021 3:00:00 PM |
SB 65 |
| SB 65 v. B.pdf |
HHSS 4/27/2021 3:00:00 PM HHSS 4/29/2021 3:00:00 PM HHSS 5/4/2021 3:00:00 PM |
SB 65 |
| SB 65 Sponsor Statement 2.4.2021.pdf |
HHSS 4/27/2021 3:00:00 PM HHSS 4/29/2021 3:00:00 PM HHSS 5/4/2021 3:00:00 PM HJUD 5/5/2021 1:00:00 PM HJUD 5/17/2021 1:00:00 PM SHSS 2/16/2021 1:30:00 PM |
SB 65 |
| SB 65 Sectional Analysis v. B 2.4.2021.pdf |
HHSS 4/27/2021 3:00:00 PM HHSS 4/29/2021 3:00:00 PM HHSS 5/4/2021 3:00:00 PM SHSS 2/16/2021 1:30:00 PM |
SB 65 |
| CSSB65 Ver. I.PDF |
HHSS 4/27/2021 3:00:00 PM HHSS 4/29/2021 3:00:00 PM HHSS 5/4/2021 3:00:00 PM SJUD 3/31/2021 1:30:00 PM |
SB 65 |
| SB 89 Version A.PDF |
HHSS 5/4/2021 3:00:00 PM SHSS 3/18/2021 1:30:00 PM |
SB 89 |
| SB 89 FAQ on Final Rule prepared by Coalition for Community Choice.pdf |
HHSS 4/29/2021 3:00:00 PM HHSS 5/4/2021 3:00:00 PM HHSS 5/13/2021 3:00:00 PM SFIN 4/7/2021 9:00:00 AM SHSS 3/18/2021 1:30:00 PM |
SB 89 |
| SB 89 Fiscal Note 1 DHSS.PDF |
HHSS 4/29/2021 3:00:00 PM HHSS 5/4/2021 3:00:00 PM HHSS 5/13/2021 3:00:00 PM SHSS 3/18/2021 1:30:00 PM |
SB 89 |
| SB 89 One Page Summary.pdf |
HHSS 4/29/2021 3:00:00 PM HHSS 5/4/2021 3:00:00 PM HHSS 5/13/2021 3:00:00 PM SFIN 4/7/2021 9:00:00 AM SHSS 3/18/2021 1:30:00 PM |
SB 89 |
| SB 89 All Ways Caring Letter of Support.pdf |
HHSS 4/29/2021 3:00:00 PM HHSS 5/4/2021 3:00:00 PM HHSS 5/13/2021 3:00:00 PM SHSS 3/18/2021 1:30:00 PM |
SB 89 |
| SB 89 FAQ on Final Rule prepared by Coalition for Community Choice.pdf |
HHSS 4/29/2021 3:00:00 PM HHSS 5/4/2021 3:00:00 PM |
SB 89 |
| SB 89 Commission on Aging Letter of Support.pdf |
HHSS 4/29/2021 3:00:00 PM HHSS 5/4/2021 3:00:00 PM HHSS 5/13/2021 3:00:00 PM SHSS 4/1/2021 1:30:00 PM |
SB 89 |
| SB 89 Work Draft ver. B 4.13.2021.pdf |
HHSS 4/29/2021 3:00:00 PM HHSS 5/4/2021 3:00:00 PM SFIN 4/14/2021 9:00:00 AM |
SB 89 |
| CS for HB 105.pdf |
HHSS 5/4/2021 3:00:00 PM |
HB 105 |
| HB 105 Detention of Minors Sectional Analysis Version 32 GH1576 I.pdf |
HHSS 5/4/2021 3:00:00 PM |
HB 105 |
| HB 103, AKLTCO Annual Report.pdf |
HHSS 5/4/2021 3:00:00 PM |
HB 103 |