Legislature(2023 - 2024)GRUENBERG 120
02/13/2024 01:00 PM House MILITARY & VETERANS' AFFAIRS
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| Audio | Topic |
|---|---|
| Start | |
| HB158 | |
| HB228 | |
| Adjourn |
* first hearing in first committee of referral
+ teleconferenced
= bill was previously heard/scheduled
+ teleconferenced
= bill was previously heard/scheduled
| *+ | HB 228 | TELECONFERENCED | |
| += | HB 158 | TELECONFERENCED | |
| + | TELECONFERENCED | ||
HB 228-MENTAL HEALTH/PSYCHEDELIC MED. TASK FORCE
1:12:00 PM
CHAIR WRIGHT announced that the final order of business would be
HOUSE BILL NO. 228, "An Act establishing the Alaska mental
health and psychedelic medicine task force; and providing for an
effective date."
1:12:33 PM
REPRESENTATIVE JENNIE ARMSTRONG, Alaska State Legislature, as
prime sponsor, read the sponsor statement [included in committee
packet], which read as follows [original punctuation provided]:
HB 228 seeks to create a task force to consider
barriers to the implementation of and equitable access
to certain psychedelic medicines ahead of the expected
FDA authorization1 of prescription drugs that would
fall under this category.
The task force will report to the Legislature by
December 31, 2024 what regulations or other changes
are necessary in the state for Alaskans to safely
benefit from these new treatments for mental health
issues such as treatment-resistant depression, post-
traumatic stress disorder, substance use disorder and
other mental health issues common in Alaska.
Alaska has the highest share of veterans per capita2
and one of the highest suicide rates in the nation.3
Coupled with also being a state where 43.3% of women
and 30.2% of men in Alaska experience domestic
violence and related crimes in their lifetimes and
where 84% of American Indian/Alaska Native women
experience violence,4 there is a potential for these
medicines to have a profoundly positive impact on the
mental health crises we see statewide. This task force
is an opportunity to ensure we are prepared for the
potential federal medicalization of these life-saving
and life-changing medicines.
1:13:39 PM
The committee took an at-ease from 1:13 p.m. to 1:15 p.m.
1:15:55 PM
REPRESENTATIVE RAUSCHER moved to adopt the proposed committee
substitute (CS) for HB 228, Version 33-LS0976\Y, Bergerud,
2/9/24, as the working document.
REPRESENTATIVE CARPENTER objected for the purpose of discussion.
1:16:32 PM
CALVIN ZUELOW, Staff, Representative Jennie Armstrong, Alaska
State Legislature, on behalf of Representative Armstrong, prime
sponsor, read the summary changes from version R to Y [included
in committee packet], which read as follows [original
punctuation provided]:
1. In section 1 (a), after "The purpose of the task
force is to," new language is added that reads
"prepare for the potential medicalization of
psychedelic medicines by the United States Food and
Drug Administration; to make policy recommendations to
the Alaska State Legislature concerning insurance and
licensure, given the unique nature of the
administration of psychedelic medicines; and to ensure
the state is prepared if psychedelic medicines become
available for prescription." This change clarifies the
purpose of the task force is only to ensure the state
is prepared if the federal government authorizes
prescriptions of psychedelic medicines, and not to
advocate for or against the medicalization of
psychedelics.
2. In section 1 (a) (4), the existing language which
reads "consider legal and regulatory pathways to the
legalization of psychedelic medicines in the state,
and the potential effects of the medicines on public
health" is replaced with language that reads "consider
legal and regulatory changes that could be necessary
in the state after federal medical approval of
psychedelic medicines." This change is also made to
clarify the purpose and work of the task force.
3. In section 1 (b) (5), the language "one of whom
must be a recognized ethnoherbalist," is deleted. This
change is made to give the Alaska Native Health Board
more latitude to choose their representatives to the
task force.
4. A new subsection is added as 1 (b) (8), and
following subsections are renumbered. The new
subsection 1 (b) (8) reads: "One member representing
licensed therapists or counselors, appointed by the
board of directors of the Alaska Addiction
Professionals Association." This change recognizes
that therapists or counselors would be involved in the
administration of psychedelic medicines and adds a
representative from the field to the task force.
5. In section 1 (e), the language "but are entitled to
per diem and travel expenses authorized for boards and
commissions under AS 39.20.180" is deleted. This
change removes state funding for board travel.
6. Section 1 (f) (2) which instructs the task force to
"ensure members are available for legislative
hearings" is deleted, as the task force will terminate
before the next legislative session.
7. Section 1 (g) is reworded to clarify the
termination date of the task force is when the Thirty-
Fourth Alaska Legislature convenes in January 2025,
not when the Thirty-Fifth Alaska Legislature convenes
in January 2027. This change aligns with the existing
task force report due date of December 31, 2024.
1:19:20 PM
REPRESENTATIVE CARPENTER removed his objection. There being no
further objection, Version Y was before the committee.
1:19:55 PM
REPRESENTATIVE ARMSTRONG began the PowerPoint presentation on HB
228 [hardcopy included in committee packet] on slide 2, which
read as follows [original punctuation provided]:
This task force will not consider or take a position
on the medicalization, decriminalization or
legalization of psychedelic medicines.
REPRESENTATIVE ARMSTONG moved to slide 3, which read as follows
[original punctuation provided]:
The purpose of the task force
This task force will craft a set of policy
recommendations for the 34th legislature to consider
in advance of the potential medicalization of certain
psychedelic medicines by the FDA so that we can be
prepared if and when that happens.
Assess the potential use of psychedelic medicine in
addressing the state's ongoing mental health crisis
Consider barriers to implementation and equitable
access
Consider and recommend licensing and insurance
requirements for practitioners in the state
Consider legal and regulatory changes that could be
necessary in the state 7 after federal medical
approval of psychedelic medicines.
REPRESENTATIVE ARMSTONG added that several states have already
established such task forces, and some have already released
reports, including Utah, Hawaii, Washington, Oregon,
Connecticut, and Nevada. In 2021, Texas became the first state
to enact a psychedelic research bill; the state itself is
funding a trial that would administer psilocybin to veterans
with post-traumatic stress disorder (PTSD).
1:24:05 PM
REPRESENTATIVE ARMSTRONG transitioned to slide 4, which read as
follows [original punctuation provided]:
Why is this important?
The FDA approves about 43 novel drugs each year, but
not all of them have the potential to make as big of
an impact as psychedelic medicines.
"Popular media is inundated with overwhelmingly
positive references to these drugs... The high degree
of enthusiasm and anticipation is beyond anything
we've ever seen with any unapproved psychiatric drug."
Dr. Javier Muniz, a senior official at the F.D.A.
division that evaluates new drugs
1:24:48 PM
REPRESENTATIVE ARMSTRONG switched to slide 5, which read as
follows [original punctuation provided]:
Alaska is suffering from an acute mental health and
addiction crisis
MENTAL HEALTH
• 3rd highest suicide rate in the country
ADDICTION
• 35.6 drug overdose deaths per 100,000
VIOLENCE
• Highest rate of women killed by men for the 7th year
in a row
• 58 out of every 100 women have experienced intimate
partner violence, sexual violence or both
REPRESENTATIVE ARMSTRONG switched to slide 6, which read as
follows [original punctuation provided]:
"If I hadn't gone through it, my son would have a
folded flag, and instead, he has a father. I think we
need more mothers and fathers and less folded flags."
-Jonathan Lubecky, Army Veteran who underwent
psychedelic treatment
• Alaska has the largest share of Veterans per capita in
the U.S.
• Veterans have a 57% higher suicide rate than
nonveterans
• ~2 of 10 Veterans with PTSD also have substrance (sic)
use disorder
• In the wars in Iraq and Afghanistan, about 1 in 10
returning Veterans seen by the VA have a problem with
alcohol or other drugs.
• In November 2023, the VA said it was committed to
studying psychedelics for PTSD treatment
o "There are several studies at VA facilities
researching psychedelic-assisted therapy for mental
health, and the department is closely monitoring
outside research."
1:26:22 PM
REPRESENTATIVE ARMSTRONG moved to slide 7, which read as follows
[original punctuation provided]:
We can make sure Alaska is ready
By bringing together a diverse group of folks who will
offer policy recommendations to the Legislature, we
can make sure that Alaska is able to safely maximize
the benefits these new medicines can provide to our
state.
CLINICAL TRIALS MAP:
https://psychedelics.berkeley.edu/
clinical-trials-map/
KEY DATES
• 2017: FDA designated MDMA-assisted therapy for PTSD a
Breakthrough Therapy.
• 2021: MAPS PBC conducted two Phase 3 clinical trials
for its MDMA therapy
o Both showed that patients had "clinically significant
improvements" in PTSD symptoms after receiving the
treatment.
o The results of the second Phase 3 trial, published in
2023 in Nature Medicine, showed that 71.2% of
participant receiving the MDMA therapy no longer met
diagnostic criteria for PTSD at the end of the study.
• December 13, 2023: MAPS PBC formally submitted a New
Drug Application (NDA) to the FDA
o If approved, would be the first new FDA-approved PTSD
treatment in more than 20 years.
• February 9, 2024: FDA accepted the application and
granted it Priority Review
• August 2024: FDA expected to announce its
determination
1:30:10 PM
REPRESENTATIVE RAUSCHER asked about the 71.2 percent that
received the trial MDMA therapy and what the total population
was.
REPRESENTATIVE ARMSTRONG offered her understanding that MAPS has
had about 1,700 people undergo trials, but said she can follow
up with the exact figure.
1:30:37 PM
REPRESENTATIVE GRAY asked why a task force is needed for this
psychiatric medication but not others.
REPRESENTATIVE ARMSTRONG explained that MDMA therapy is done in
a prescribed setting; the person takes the MDMA three times over
three different eight-hour therapy sessions with a therapist, as
well as 12 drug-free therapy sessions. She said a task force is
needed because licensing this medication, and ensuring it is
affordable through insurance, is important.
REPRESENTATIVE GRAY offered that there are other treatments,
like electro-convulsive therapy for depression, that didn't
require a task force. He questioned the choice of assigning a
task force instead of the medical facility itself making
decisions around the drug.
REPRESENTATIVE ARMSTRONG pointed out that medical facilities
cannot make licensing determinations. She said that a new
licensing structure needs to be created in Alaska to determine
who can be licensed and what qualifies them.
REPRESENTATIVE GRAY commented that veterans get care through the
Department of Veterans Affairs and hospitals, which are federal
institutions that follow federal guidelines. He said he is
unsure that a state task force would have any authority over a
federal facility and what it does with its patients.
REPRESENTATIVE ARMSTRONG answered that there are several
insurance groups in the state, including Veterans Affairs,
Medicaid, and Medicare. She said the task force would examine
the groups and determine what they are allowed to do.
1:35:30 PM
REPRESENTATIVE SADDLER said he is not sure if the House Special
Committee on Military and Veterans' Affairs is the right place
to argue the benefits of this medication. He stressed that the
bill is totally contingent on the U.S. Food and Drug
Administration (FDA) approving psychedelic drugs for treatment.
He suggested that the state wait until the FDA approves the
drug, before making the preparations.
REPRESENTATIVE ARMSTRONG responded that the FDA has given every
indication that it would approve the drug in August. She said
if the state were to wait until after FDA approval, it is
unknown when the drug would go into production and distribution;
if the drug were made immediately available and people in Alaska
wanted it, they could not get it because no one in the state
would be licensed to access it yet. She said the task force
would meet this year and provide a report with policy
recommendations at the end of the year.
REPRESENTATIVE SADDLER asked whether psychedelic drugs would be
beneficial.
REPRESENTATIVE ARMSTRONG answered that she cannot speak to that
but pointed to clinical trials with positive results. She said
the state could benefit from this treatment due to its high
rates of mental health issues.
REPRESENTATIVE SADDLER reiterated that it would be prudent to
wait for the FDA to approve the drug.
1:39:40 PM
CHAIR WRIGHT asked why there is not a seat on the task force for
pharmacy.
REPRESENTATIVE ARMSTRONG acknowledged that a pharmacist was not
added to the task force; however, she noted that when the drug
is scheduled, the prior pharmaceutical process would transfer
over. She said she is open to changes.
1:40:26 PM
REPRESENTATIVE CARPENTER asked what agency reviews new drugs.
1:41:12 PM
MICAELA FOWLER, Deputy Commissioner, Office of the Commissioner,
Department of Commerce, Community, and Economic Development,
answered that the Board of Pharmacy reviews new drugs but does
not approve drugs for distribution.
REPRESENTATIVE CARPENTER inquired whether board review is normal
following FDA action.
MS. FOWLER responded that she anticipates, should the FDA
approve the drugs, there would be communications to many boards.
1:42:50 PM
REPRESENTATIVE GROH asked the sponsor to elaborate about the
benefits of the medication for veterans.
REPRESENTATIVE ARMSTRONG answered that the benefit is that the
veteran goes into PTSD remission, thereby surviving. She
reiterated the MDMA therapy process.
1:45:19 PM
REPRESENTATIVE GRAY asked for assurance that there would be a
special license required for this medication that wouldn't be
required for others.
REPRESENTATIVE ARMSTRONG responded that this medicine requires
specialized care and training [for those administering it]. She
stressed that there must be a task force so that the treatment
process can be fine-tuned. She said there would be greater harm
in allowing insurance companies to charge what they want, as
well as allowing anyone to practice using this treatment.
REPRESENTATIVE GRAY asked if the task force would serve as a
barrier from the drugs being rolled out immediately.
REPRESENTATIVE ARMSTRONG answered that the purpose of the task
force is to answer questions such as whether the drug is easy to
get or who should qualify. She said the task force would not be
a barrier; it would speed the process up.
REPRESENTATIVE GRAY said that if special licenses aren't
required and it does become a new prescription medication, then
any one with a medical license who can prescribe medication
would prescribe it. He asked about the finding that not having
a task force would slow down access when there are other drugs
that are just approved.
REPRESENTATIVE ARMSTRONG explained that there are many anti-
depressants that are not blanket prescribed and require
referrals. She said the qualifying process for patients needs
to be thoroughly vetted.
1:49:48 PM
REPRESENTATIVE CARPENTER asked if the appropriate boards could
come together and jointly meet.
MS. FOWLER answered yes, the boards could come together to have
cross-professional discussions.
REPRESENTATIVE CARPENTER inquired as to whether, if the intent
is to apply subject matter experts to manage this drug, the task
force requires FDA guidelines.
1:51:55 PM
REPRESENTATIVE ARMSTRONG answered that the FDA has provided non-
binding guidelines, as well as 20 years of clinical data.
Regarding whether the boards can meet jointly to discuss this,
she said that the task force's membership includes
representatives from the Alaska Native Health Board and a
licensed therapist; there are different stakeholder groups that
need to be represented. She noted that culturally informed care
is an important aspect of care that the task force would need to
discuss. She added that the fiscal note is from the original
version of the bill, and that there will be an updated note once
the department has reviewed the committee substitute.
REPRESENTATIVE CARPENTER questioned if there has been anyone
that has shown interest in starting a business around this
medicine.
REPRESENTATIVE ARMSTRONG responded that some of the companies
are looking at the creation of new medicine. She said there are
municipalities that have de-criminalized the medicine. She
pointed to Oregon as the only state that legalized such
medicines. She shared that she is already getting
advertisements for Ketamine therapy in Anchorage, so as time
goes on, there may be more places offering the treatment.
1:55:30 PM
BETH LAW shared that she is a retired colonel living in Wasilla,
who spent 34 years in military service, 14 of which were spent
as active duty in Alaska, and she was deployed during Operation
Iraqi Freedom. She further shared that she survived alcoholic
parents, sexual assaults, and rape. She said that in 2009, she
was diagnosed with stage IV lung cancer and given two years to
live. She was her sister's caregiver, who passed away in 2012;
she was her father's until he passed in 2014; in 2015 she was a
caregiver for a close friend, who also passed. She said she
experienced years of being on anti-depressants and mood
stabilizers for her combat experience as well as for her anxiety
and depression.
MS. LAW stated that she has first-hand experience in psilocybin
treatment through a retreat in Jamaica called Myco Meditations.
There is an initial session with group therapy, followed by
three different doses; the set and setting are important. She
explained that the facility does not admit bi-polar individuals,
nor narcissists, as the treatment has much to do with the
person's subconscious and conscious mind. She said that during
her one-week treatment, she did three different doses of
psilocybin mushrooms, and a therapist was always present with
her; each dosing lasts about six hours. Following each dose,
she underwent an integration period which had her relay what she
had experienced and make sense of it. She stressed that the
treatment is not a vacation, it is structured with a doctor that
administers the medicine. She shared that her fear of dying
went away after her treatment in Jamaica, and though she knows
she has cancer, it is not something she constantly thinks about.
She said she cannot say enough good things about the treatment
and how much it helped her. She added that she knows people who
had experience with MDMA, Ketamine, and psilocybin, and said
that MDMA and Ketamine far outweigh psilocybin in terms of
therapeutic purposes.
2:02:44 PM
MICHAEL DEMOLINA, PhD, LPCS, CDCS, MAC, President, Wisdom
Traditions Counseling, shared that he went to Fort Richardson
from 1988 to 1992, and at the fort, he treated active-duty
Vietnam soldiers as part of the drug and alcohol program. He
commented that he is and has been the president and founder of
an out-patient clinic in Anchorage for 35 years. He shared that
he is a national trainer in trauma informed care using movement
desensitization, brain spotting, and emotional freedom technique
(EFT) tapping; the success rate in treating veterans increased
from 42 percent to 72 percent. He said he is open to questions
as he has been taking notes.
2:05:14 PM
REPRESENTATIVE CARPENTER asked what the medication does.
DR. DEMOLINA answered that the American Psychiatrical
Association provides a trauma informed care rubric for exposure
therapy, which rewires the brain. He explained that in
comparison to the normal treatment process, psychedelic-assisted
therapy shortens treatment times from two years to three months,
as well as has a 10 percent higher level of success. He
explained the part of the brain called the "default mode
network," which is the narrative part of the brain; the dosage
session neutralizes the network temporarily enough so that the
person can come back to their own embodied experience of trauma
and tell a different story. He said that much of the discussion
thus far has highlighted the importance of the therapeutic
aspect of the treatment, and that education will need to happen
across the nation about the treatment. He explained that, in
psychedelic-assisted therapy, the therapist must be involved in
a preparation session with the patient to let them know what to
expect, followed by an integration session. The last 20 years
of research has been about determining what the right amount of
dosage is and what the right pattern of therapy is. He said
that the conditions that are excluded from this treatment,
narcissism and bi-polar disorder, are the reason he is
advocating for the bill; this is a different kind of medicine
that needs medical clearance and has therapy sessions.
2:09:20 PM
CHAIR WRIGHT opened public testimony on HB 228.
2:09:47 PM
SARA KOZUP-EVON, RN, President-Elect, Advanced Practice
Registered Nurses Alliance (APRN), said that APRN works on
policy and regulation matters around advanced practice
registered nurses, and works with the Board of Nursing. She
explained that she is a psychiatric nurse practitioner and owner
of a small group practice in Anchorage, where she has treated
patients with tri-care and Veterans' Affairs insurance, but
mainly works with adults that have mood and anxiety disorders.
She shared that she completed a year-long psychedelic-assisted
therapy training program.
MS. KOZUP-EVON said that she is calling for passage of HB 228,
as current mental health tools she has are inadequate, like
individual therapy and Prozac; however, bringing in psychedelic
framework has been a game changer for her patients. She
explained that she works with Ketamine, which is the only
federally legal psychedelic-adjacent medicine currently
available in clinical practice, which she uses as an off-label
treatment for PTSD and treatment-resistant depression. She said
that veterans in Alaska have many unmet mental health needs, and
the ongoing research on psychedelic medicines shows promise in
meeting the need. The medicines make the patients very
vulnerable, which is why thought must be put towards who can
prescribe the medicines, as well as "holding space" for the
patient. She explained that advanced practice nurses will play
a role in both prescribing and administering the therapy for
this medicine, and that collaboration among the task force
members is the best chance for creating an accessible and
ethical system of care for psychedelics.
2:13:06 PM
REPRESENTATIVE GRAY asked if a year-long drug course should be
required in order to be licensed to use this medication.
DR. KOZUP-EVON answered that the training can be done in less
than a year. She added that additional training is needed, as
the psychedelic framework is so specific to address the
increased vulnerability of patients. The medicine also requires
ongoing ethical consultations in the community.
2:14:53 PM
BAILEY STUART, Owner, Stuart Consulting, said she is in support
of HB 228, and said it is in the best interest of the state and
veterans that conversations are about what takes place following
FDA approval of psychedelics as medicine. She relayed that, in
January, the Federal Department of Veterans' Affairs issued a
request for proposals to study the use of certain psychedelic
compounds in treating PTSD and depression. She stressed that
there should be a regulatory framework in place before FDA
approval. She said that the future of medicine, particularly
for mental health, is going in the direction of assisted-
psychedelic therapy.
2:17:45 PM
KATHLEEN WEDEMEYER, Deputy Director, Citizens Commission on
Human Rights, said that while version Y of the bill clarifies
that the state shall not make legal or deliver psychedelic drugs
without full FDA approval, the Citizens Commission on Human
Rights' position is "other." She cautioned members on setting
up a system of mental health treatment that trades one brain
resetting drug for another. She read the following quote from
former United Nations Special Rapporteur on the Right to Health,
Dainius Puras:
"There is now unequivocal evidence of the failures of
a system that relies too heavily on the biomedical
model of mental health services, including the front-
line and excessive use of psychotropic medicines, and
yet these models persist."
MS. WEDEMEYER said psychedelics are unpredictable by nature,
behave differently for each person, and can have long-term,
harmful side effects. She read a quote from forensic
psychiatrist Brian Holoyda:
"There remains insufficient evidence regarding the
safety of psilocybin, however. In addition, clinical
trials have been extremely exclusionary in selecting
participants, so there is little data on the effects
of psilocybin in real-world populations of patients
with psychiatric disorders."
MS. WEDEMEYER urged members to examine other avenues, like ones
detailed in the World Health Organization's guidance on
community health services.
2:19:56 PM
REPRESENTATIVE CARPENTER stated that there is a problem with
prescription drug abuse in the country, and that drugs used in
psychedelic treatment are significantly different drugs. He
asked whether there is evidence that show whether the drugs are
not addictive, and how to prevent the drugs from being abused.
REPRESENTATIVE ARMSTRONG said she could follow up with a chart
to show the addictiveness level of various drugs. She explained
that in the psychedelic medicine trials, there has been nothing
to show that the drugs are addictive. She explained that people
would not be prescribed the medicine and then be able to take it
home; the medicine is ingested on-site with someone supervising.
She said that psychedelic-assisted therapy is not something that
people would want to do repeatedly and suggested that the task
force investigate and prevent "doctor shopping."
2:22:38 PM
MS. WEDEMEYER added that in the diagnostic manual, there is now
a hallucinogen persisting perception disorder listed as a
condition that occurs as a result of using hallucinogenic drugs.
REPRESENTATIVE CARPENTER said that, since the legalization of
marijuana, there are numerous ways in which to ingest the drug.
He offered his concern about that the drug, which can put a
person in physical care for 8 hours, could be abused by the
public.
2:24:03 PM
REPRESENTATIVE ARMSTRONG responded that this is why it is
important to have a task force on this matter as it could answer
questions around the use of the drug. She said that medical
professionals in the state are preparing for authorization and
legalization of these prescription drugs.
2:25:13 PM
DR. DEMOLINA commented that he underwent mental and physical
(MAP) training for about a year and had done the training
because of the inevitability of "whatever our attitudes are to
it." He shared that he already gets calls about people that are
flying outside of the country to receive psychedelic-assisted
therapy; clinics are having to respond to people who have gone
but the practice did not have "wrap-around" service or quality
control. He offered his full support in having standards on how
the therapy is rolled out.
2:26:39 PM
REPRESENTATIVE GRAY asked Ms. Wedemeyer about the Citizens
Commission on Human Rights' connection with the Church of
Scientology.
MS. WEDEMEYER answered that they are sponsored by the Church of
Scientology; in 1969, the church and Dr. Thomas Szasz founded
the commission.
REPRESENTATIVE GRAY inquired as to what the commission's stance
is on other traditional anti-depressants, like selective
serotonin reuptake inhibitors (SSRIs).
MS. WEDEMEYER responded that they are not fans of the use of
chemical drugs. She said that if people are prescribed an anti-
depressant, they should also be given a physical examination to
rule out physical causes of their depression.
2:28:57 PM
CHAIR WRIGHT, after ascertaining that no one else wished to
testify, closed public testimony on HB 228.
2:29:07 PM
CHAIR WRIGHT announced that HB 228, Version Y, was held over.
| Document Name | Date/Time | Subjects |
|---|---|---|
| HB228 Sponsor Statement 02012024.pdf |
HMLV 2/13/2024 1:00:00 PM HSTA 4/2/2024 3:00:00 PM |
HB 228 |
| HB228 Sectional Analysis 02012024.pdf |
HMLV 2/13/2024 1:00:00 PM HSTA 4/2/2024 3:00:00 PM |
HB 228 |
| HB228 Version R 02022024.pdf |
HMLV 2/13/2024 1:00:00 PM HSTA 4/2/2024 3:00:00 PM |
HB 228 |
| HB228 Version Y 02022024.pdf |
HMLV 2/13/2024 1:00:00 PM |
HB 228 |
| HB228 Explanation of Changes Version R to Y 02092024.pdf |
HMLV 2/13/2024 1:00:00 PM |
HB 228 |
| HB228 Fiscal Note DCCED-COMM-02-09-24.pdf |
HMLV 2/13/2024 1:00:00 PM |
HB 228 |
| HB228 Presentation in HMLV 2.13.24.pdf |
HMLV 2/13/2024 1:00:00 PM |
HB 228 |