Legislature(2017 - 2018)BELTZ 105 (TSBldg)
03/08/2018 01:30 PM Senate LABOR & COMMERCE
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| Audio | Topic |
|---|---|
| Start | |
| HB86 | |
| SB205 | |
| SB62 | |
| SB112 | |
| Adjourn |
* first hearing in first committee of referral
+ teleconferenced
= bill was previously heard/scheduled
+ teleconferenced
= bill was previously heard/scheduled
| += | HB 157 | TELECONFERENCED | |
| + | TELECONFERENCED | ||
| += | SB 205 | TELECONFERENCED | |
| += | SB 62 | TELECONFERENCED | |
| += | HB 86 | TELECONFERENCED | |
| += | SB 112 | TELECONFERENCED | |
SB 62-REPEAL CERTIFICATE OF NEED PROGRAM
2:04:33 PM
CHAIR COSTELLO reconvened the meeting, announced the
consideration of SB 62, and noted the proposed committee
substitute (CS).
2:05:02 PM
SENATOR MEYER moved to adopt the work draft CS for SB 62,
labeled 30-LS0502\D, as the working document.
CHAIR COSTELLO objected for discussion purposes.
2:05:19 PM
NATASHA MCCLANAHAN, Staff, Senator Mia Costello, Alaska State
Legislature, Juneau, Alaska, explained the following changes
from version A to version D of SB 62:
SB 62 version A would have repealed the certificate of
need program for healthcare facilities. After three
committee hearings in Senate Labor and Commerce
changes were made to the legislation based on
conversations with stakeholders and public testimony.
SB 62 version D allows for an exemption from the
certificate of need program if the new construction of
a healthcare facility, alteration of bed capacity, or
addition of a category of health services is in a
location that is over 100 miles from another
healthcare facility. This removes a barrier for remote
communities that are currently struggling to attract
and retain healthcare services in an effort to provide
equal access to care for all Alaskans.
2:06:22 PM
CHAIR COSTELLO removed her objection and version D was adopted.
She noted an attorney from legislative legal was available to
answer questions. She asked Mr. Zepp to comment on how the
committee substitute changes the scope of the bill. It is a
tailored response to the testimony the committee heard from
Interior Alaskans about their inability to access health care in
the community. She noted that the next committee of referral is
Finance.
GARY ZEPP, Staff, Senator David Wilson, Alaska State
Legislature, Juneau, Alaska, said the evolution of the bill is
in the right direction for the people of Delta. The original
intent was for communities to decide and remove the government
barriers that are currently in place for the certificate of need
program. While the bill isn't as broad in scope, he believes the
sponsor would be pleased that it is still helping Alaskans
provide health care services and facilities in their
communities.
CHAIR COSTELLO said the committee also heard that going through
the process of certificate of need was valuable. Communities can
still go through that process. She noted that they reached out
to the Department of Health and Social Services (DHSS) for
information about applications received and what communities are
paying. There was a recognition that the regulations regarding
certificate of need have not been updated in some time. Her hope
is that as this version of the bill moves forward, it sends a
message to the department that updating the regulations would be
helpful. She looks forward to discussion in the Senate Finance
because it surrounds the cost of health care. Whether this is
the answer remains to be seen.
2:10:17 PM
SENATOR GARDNER asked if the committee could expect to hear from
the Department of Health and Social Services on the committee
substitute and see updated fiscal notes.
CHAIR COSTELLO said it was her understanding that DHSS won't
state a position on the bill until it looks like it will pass.
MS. MCCLANAHAN agreed; a letter to that effect from [the DHSS
deputy commissioner] is in the backup documents.
2:11:08 PM
SENATOR STEVENS commented that it's backward to think that the
department won't get involved until it looks like the bill will
pass.
CHAIR COSTELLO said unless it's a governor's bill, that's been
the common approach. She said her office could reach out to the
department and see if they have a position on the committee
substitute.
2:11:52 PM
SENATOR MICCICHE said the change to AS 18.07.031(a) adds the
words "in a location within 100 miles of another healthcare
facility." The applicability seems to require two parts -
located more than 100 miles from another health care facility
and that it has an existing certificate of need issued by DHSS.
He asked when a certificate of need exists, does it remain in
effect after the construction and during the operation of the
health care facility or at some point, could it be closed down
after the project is complete and would the applicability affect
the outcome of Section 1.
2:12:59 PM
JEAN MISCHEL, Legislative Counsel, Legislative Legal Services,
Legislative Affairs Agency, Alaska State Legislature, Juneau,
Alaska, said the applicability provision is essentially a hold
harmless provision. The courts have found that certificates of
need have some value and are construed as a property interest.
They exist during the operation of the health care facility;
they don't go away after construction. They're attached, they
get renewed, and modified over time.
SENATOR MICCICHE commented that exactly 100 miles is not
covered. Section 1 has more than 100 miles in applicability and
within 100 miles, which is somewhat less than 100 miles. He
asked if that is a potential problem. Although the chance that
it is exactly between 100 and 101 miles is rare, he asked if
that is a gap the committee should clarify.
MS. MISCHEL said she didn't see the gap. Legislative legal
interprets "within 100 miles" to include 100 miles and "more
than 100 miles" would be anything over 100 miles.
2:15:04 PM
CHAIR COSTELLO stated she would hold SB 62 until the Department
of Health and Social Services provided an updated opinion on the
topic.
MS. MCCLANAHAN clarified that the letter was from the deputy
commissioner of DHSS, not the commissioner.