03/19/2024 03:00 PM House HEALTH & SOCIAL SERVICES

        HCR 9-MENTAL HEALTH/SUBSTANCE ASSISTANCE PARITY                                                                     
                                                                                                                                
3:58:34 PM                                                                                                                    
                                                                                                                                
CHAIR PRAX  announced that  the next order  of business  would be                                                               
HOUSE  CONCURRENT RESOLUTION  NO.  9, "Recognizing  the need  for                                                               
parity  in  the provision  of  mental  health and  substance  use                                                               
disorder  medical assistance  benefits in  the state;  and urging                                                               
the Department of Health to  adopt regulations that ensure parity                                                               
in  the provision  of mental  health and  substance use  disorder                                                               
medical assistance benefits in the state."                                                                                      
                                                                                                                                
3:59:24 PM                                                                                                                    
                                                                                                                                
RILEY  NYE,   Staff,  Representative  Mike  Prax,   Alaska  State                                                               
Legislature,  on behalf  of Representative  Prax, prime  sponsor,                                                               
presented  HCR 9.   He  began  by reading  the sponsor  statement                                                               
[included in  committee packet], which read  as follows [original                                                               
punctuation provided]:                                                                                                          
                                                                                                                                
     House  Concurrent  Resolution  9  urges  the  State  of                                                                    
     Alaska  to  pass  parity  standard  regulations,  which                                                                    
     would ensure  that Alaskans have  easy and  fast access                                                                    
     to behavioral health care.                                                                                                 
                                                                                                                                
     Under  parity  standard regulations,  private  insurers                                                                    
     would have to cover  behavioral health services so that                                                                    
     insurers, including  Medicaid, can't make it  harder to                                                                    
     get behavioral  health care than physical  health care.                                                                    
     Implementation  of  parity standard  regulations  would                                                                    
     remove barriers  that are  slowing down  the behavioral                                                                    
     health treatment  process such as  extensive paperwork,                                                                    
     health  care stigmas,  outdated insurance  regulations,                                                                    
     and  restrictions  to  the   amount  of  care  patients                                                                    
     receive.  This   will  ensure  patients  are   able  to                                                                    
     transition  between  physical   and  behavioral  health                                                                    
     services smoothly and more time  will be spent treating                                                                    
     patients rather than completing administrative tasks.                                                                      
                                                                                                                                
     The outcomes  of parity legislation would  be efficient                                                                    
     and cost-effective care,  reduced reliance on emergency                                                                    
     rooms  and   correctional  facilities,   more  Medicaid                                                                    
     providers in the  system, streamlined care coordination                                                                    
     between   health  services,   and  programs   based  on                                                                    
     outcomes  and  evidence.  This  would  ensure  Alaskans                                                                    
     receive behavioral  health care that is  subject to the                                                                    
     same  terms  and  conditions as  medical  and  surgical                                                                    
     care. I urge you to support HCR 9.                                                                                         
                                                                                                                                
4:01:11 PM                                                                                                                    
                                                                                                                                
JOHN SOLOMON,  CEO, Alaska Behavioral Health  Association, gave a                                                               
PowerPoint presentation during the hearing on HCR 9.                                                                            
                                                                                                                                
4:01:58 PM                                                                                                                    
                                                                                                                                
The committee  took an  at-ease from  4:01 p.m.  to 4:02  p.m. to                                                               
address a technical issue.                                                                                                      
                                                                                                                                
4:02:24 PM                                                                                                                    
                                                                                                                                
MR. SOLOMON began the  PowerPoint presentation [hardcopy included                                                               
in the committee  packet] on slide 1, which gave  a background to                                                               
what the Alaska Behavioral Health  Association (ABHA) is and what                                                               
its goals  are as an  organization.  He  moved to slide  2, which                                                               
explained  what  the  concept  of  "parity"  is  with  regard  to                                                               
medicine and mental  health treatment.  He continued  to slide 3,                                                               
which  explained  what  barriers  currently  exist  to  obtaining                                                               
adequate mental  health treatment and  how to overcome them.   He                                                               
moved  through slides  4 and  5,  both of  which highlighted  how                                                               
community health  centers function and how  an individual's first                                                               
appointment at one might transpire.                                                                                             
                                                                                                                                
MR.  SOLOMON  continued  the  presentation   to  slide  6,  which                                                               
overviewed  a   behind-the-scenes  look  at  the   process  of  a                                                               
community behavioral  health center's  operations and staff.   He                                                               
moved  to  slide 7,  which  displayed  a three-color  graph  that                                                               
outlined the  differences between qualitative  treatment limiters                                                               
at healthcare facilities.   He continued through slides  8 and 9,                                                               
both of which  displayed a continuation of  the three-color graph                                                               
as displayed on  slide 7.  He moved to  slide 10, which described                                                               
the  effort   to  ensure  the  accessibility   of  mental  health                                                               
treatment and the reasons that HCR  9 is being brought before the                                                               
legislature this late  in the fight for parity.   He continued to                                                               
slide  11, which  highlighted  certain  real-world outcomes  that                                                               
could  be   expected  from  ensuring  parity   in  mental  health                                                               
treatment.  He continued to  slide 12, which highlighted specific                                                               
factors  attaining   to  a  legislative  parity   resolution  and                                                               
concluded the presentation on slide 13.                                                                                         
                                                                                                                                
4:20:27 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE SADDLER asked whether HCR  9 would call for parity                                                               
under Alaska's Medicaid program.                                                                                                
                                                                                                                                
MR. SOLOMON  answered that Alaska  is exempt from  federal parity                                                               
standards and said that Alaska is not beholden to Medicaid.                                                                     
                                                                                                                                
4:22:58 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE FIELDS asked whether  the legislature could pass a                                                               
bill to achieve parity in mental health treatment.                                                                              
                                                                                                                                
MR. SOLOMON  replied that there is  a bill already in  line to be                                                               
passed after HCR 9 would be passed.                                                                                             
                                                                                                                                
4:24:08 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE   RUFFRIDGE    asked   whether    current   Alaska                                                               
regulations are  to blame for a  lack of access to  mental health                                                               
treatment, not necessarily parity.                                                                                              
                                                                                                                                
4:25:45 PM                                                                                                                    
                                                                                                                                
TRACY  DOMPELING,   Director,  Division  of   Behavioral  Health,                                                               
Department  of Health,  answered  committee questions  on HCR  9.                                                               
She  said  that HCR  9  would  give  guidance on  Alaska's  state                                                               
healthcare plans and 1115 services.                                                                                             
                                                                                                                                
REPRESENTATIVE  RUFFRIDGE asked  whether a  lack of  parity is  a                                                               
result  of  a  failure  of  the state  when  the  original  state                                                               
healthcare plan was created.                                                                                                    
                                                                                                                                
MS. DOMPELING  replied that HCR 9  is possible and said  that the                                                               
Division of  Behavioral Health, within  the Department  of Health                                                               
(DOH) has  been working with healthcare  providers and facilities                                                               
to ensure parity may be achieved.                                                                                               
                                                                                                                                
4:28:02 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE  SADDLER asked  whether DOH  would seek  to revise                                                               
existing regulations.                                                                                                           
                                                                                                                                
MS.  DOMPELING explained  that  DOH has  been  meaning to  revise                                                               
regulations surrounding  parity for a  while and said that  HCR 9                                                               
would give DOH further guidance on the matter.                                                                                  
                                                                                                                                
4:29:27 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE MINA referenced Alaska  Statute (AS) 21.54.151 and                                                               
asked  whether  behavioral  health   parity  already  exists  for                                                               
private insurance.                                                                                                              
                                                                                                                                
MS. DOMPELING deferred to Renee Gayhart of DOH.                                                                                 
                                                                                                                                
4:29:51 PM                                                                                                                    
                                                                                                                                
RENEE  GAYHART,  Director,  Division  of  Health  Care  Services,                                                               
Department of Health, responded that  she would follow up with an                                                               
answer following the committee meeting.                                                                                         
                                                                                                                                
4:31:27 PM                                                                                                                    
                                                                                                                                
CHAIR PRAX asked  whether HCR 9 is necessary to  show the federal                                                               
government Alaska's intentions with regard to parity.                                                                           
                                                                                                                                
MS. GAYHART indicated that's correct.                                                                                           
                                                                                                                                
4:32:06 PM                                                                                                                    
                                                                                                                                
The committee took an at-ease from 4:32 p.m. to 4:33 p.m.                                                                       
                                                                                                                                
4:33:45 PM                                                                                                                    
                                                                                                                                
CHAIR PRAX opened public testimony on HCR 9.                                                                                    
                                                                                                                                
4:34:32 PM                                                                                                                    
                                                                                                                                
JARED KOSIN, Alaska Hospital  & Healthcare Association, testified                                                               
in support  of HCR  9.   He said  that HCR  9 would  align Alaska                                                               
statutes,  policies,  and  regulations  with  the  Mental  Health                                                               
parity and  the Addiction  Equity Act of  2008 and  explained how                                                               
this would be beneficial to healthcare throughout Alaska.                                                                       
                                                                                                                                
4:36:06 PM                                                                                                                    
                                                                                                                                
LANCE  JOHNSON,   COO,  Alaska  Behavioral   Health  Association,                                                               
testified in  support of HCR  9.  He said  that HCR 9  would well                                                               
prepare Alaska's  behavioral healthcare  industry for  the future                                                               
and said that HCR  9 represents a lot of good  work that has been                                                               
done.                                                                                                                           
                                                                                                                                
4:37:31 PM                                                                                                                    
                                                                                                                                
CHAIR PRAX,  after ascertaining  that there was  no one  else who                                                               
wished to testify, closed public testimony on HCR 9.                                                                            
                                                                                                                                
4:37:54 PM                                                                                                                    
                                                                                                                                
The committee took a brief at-ease at 4:37 p.m.                                                                                 
                                                                                                                                
4:38:00 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE RUFFRIDGE moved  to report HCR 9  out of committee                                                               
with  individual  recommendations  and  the  accompanying  fiscal                                                               
notes.  There  being no objection, HCR 9 was  reported out of the                                                               
House Health and Social Services Standing Committee.