Legislature(2023 - 2024)SENATE FINANCE 532
02/14/2024 09:30 AM Senate FINANCE
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| Audio | Topic |
|---|---|
| Start | |
| SB91 | |
| Adjourn |
* first hearing in first committee of referral
+ teleconferenced
= bill was previously heard/scheduled
+ teleconferenced
= bill was previously heard/scheduled
| + | SB 91 | TELECONFERENCED | |
| *+ | HB 193 | TELECONFERENCED | |
| + | TELECONFERENCED |
SENATE BILL NO. 91
"An Act relating to telehealth; relating to
multidisciplinary care teams; and relating to the
practice of medicine."
9:36:30 AM
SENATOR MATT CLAMAN, SPONSOR, introduced the legislation.
He read from the Sponsor Statement (copy on file):
Senate Bill 91 expands telehealth providers and
services available to Alaskans. Last year, the
legislature passed House Bill 265, which created a
framework in statute for telehealth and ensured
Alaskans' access to critical health care.
In the summer of 2022, Senator Claman was contacted by
a constituent who was recently diagnosed with
Amyotrophic Lateral Sclerosis (ALS). Upon receiving
her diagnosis, Sheila Swanson flew to Seattle to
receive specialty treatment. Sheila was told that she
could continue to receive care from the physician via
telehealth, but would need to fly to Seattle to
receive in person care from other seven members of her
multidisciplinary ALS care team, including a
respiratory therapist, speech language pathologist,
physical therapist and occupational therapist.
Senate Bill 91 would allow out-of-state
multidisciplinary care team members to provide
telehealth services. The bill applies to two different
situations. The first situation is on-going treatment
or follow-up care from an out-of-state physician or
member of their disciplinary care team related to
health care services previously provided by the
physician to the patient. Senate Bill 91 requires that
the physician and patient have an established
physician-patient relationship and the physician has
had a previous in-person visit with the patient.
The second situation addressed in the bill is when a
patient receives care for a suspected or diagnosed
life-threatening condition. To receive treatment from
a non-physician member of the multidisciplinary care
team, Senate Bill 91 requires a documented referral to
the member of the multidisciplinary care team by
either a physician licensed in Alaska or through a
physician licensed out-of-state with whom the patient
has a previously established relationship.
Senate Bill 91 amends the statute passed by House Bill
265 by adding "multidisciplinary care teams" as an
option for telehealth. The legislation was amended in
Senate Health and Social Services to include a
definition for which health care providers are
eligible to provide services as part of a
multidisciplinary care team. Included in this
amendment are provisions that require the
multidisciplinary care team members to submit
information about the team's lead physician, the area
of health care in which they practice, and proof of
licensure.
The bill was further amended to include a fee regime
for providers to join the State of Alaska's telehealth
registry, including a $100 registration fee, $100
renewal fee every two years, and $50 fee to report
changes in the business's registration information.
Alaskans deserve to receive the appropriate care in
their local support network when possible, and Senate
Bill 91 will expand these options.
Co-Chair Olson applauded the bill sponsor for bringing the
issue forward.
9:39:49 AM
CLAIRE LUBKE, STAFF, SENATOR MATT CLAMAN, highlighted the
Sectional Analysis (copy on file):
Section 1
AS 08.02.130. Telehealth
Amends subsection (b) to expand who may provide health
care services through telehealth. An out of state
member of the physician's multidisciplinary care team
may provide telehealth services under the following
conditions: (1) for on-going treatment or follow-up
care by the member of the physician's
multidisciplinary care team if the physician and
patient have an established physician-patient
relationship and the physician has previously
conducted an in person visit; or (2) for a visit
regarding a suspected or diagnosed life-threatening
condition for which the patient has been referred to
the physician licensed in another state or a member of
the physician's multidisciplinary care team and the
visit involves communication with the patient
regarding diagnostic or treatment plan options or
analysis of test results for the life-threatening
condition.
Section 2
AS 08.02.130. Telehealth
Amends the definition of "health care provider" in
(j)(1) in this section to include a member of a
multidisciplinary care team.
Section 3
AS 08.02.130. Telehealth
Creates a definition for "member of a
multidisciplinary care team" in (5) of this section to
mean "an audiologist, speech-language pathologist,
behavior analyst, professional counselor, dietitian,
nutritionist, naturopath, marital and family
therapist, podiatrist, osteopath, physician assistant,
nurse, pharmacist, physical therapist, occupational
therapist, psychologist or psychological associate, or
a social worker who is a member of a team that
includes a physician licensed in another state who
meets the requirements of (b)(1) of this section."
Section 4
AS 08.02.130. Telehealth
Creates new subsections relating to the registration
of multidisciplinary care team members with the
department telehealth registry. Subsection (k) states
that a member of a multidisciplinary care team shall
register with the department before providing services
to a patient located in Alaska. This registration
includes submitting: (1) the name of the physician
leading the multidisciplinary care team; (2) the area
of health care in which the member of the
multidisciplinary care team will be practicing and
proof of licensure in a state or territory of the
United States in that area; and (3) any applicable
fees.
Section 5
AS 08.02. Miscellaneous Provisions
9:43:48 AM
Senator Kiehl asked what was meant by "services not
reasonably available in the state."
Senator Claman replied that the goal of the bill was
intended for multidisciplinary care teams.
9:45:39 AM
Senator Kiehl noted that there was a different approach to
registering out of state providers. He queried the reason
for delta.
Senator Claman replied that there were changes already
outlined in statute.
9:49:32 AM
AT EASE
9:49:43 AM
RECONVENED
9:50:23 AM
SYLVAN ROBB, DIRECTOR OF DIVISION OF CORPORATIONS,
BUSINESS, AND PROFESSIONAL LICENSING, DEPARTMENT OF
COMMERCE, COMMUNITY AND ECONOMIC DEVELOPMENT, explained the
fiscal note.
Co-Chair Olson wondered whether there was a need for more
than one investigator on the issue in other states.
Ms. Robb replied that there was not current research on
that subject, but agreed to follow up.
Senator Kiehl requested a status of the current telehealth
issues.
Ms. Robb replied that there were no complaints related to
physicians, who were currently the only professionals who
were allowed to operate in Alaska without an Alaska
license. She stated that the bill allowed for seventeen
additional professions to the individuals who could operate
without an Alaska license.
Senator Kiehl wondered how many out of state businesses
were in the registry.
Ms. Robb replied that the telemedicine business registry
had 1810 businesses, although it was a perpetual registry.
Senator Bishop asked the mechanism for adjusting for
inflation.
Ms. Robb replied that there were no fees that were
currently adjusted for inflation, so this was a new
provision for the division. She felt that there would be
use of widely available metrics of inflation.
9:55:07 AM
Senator Wilson queried the current registration fee.
Ms. Robb replied that it was $50.
Ms. Lubke presented a prerecorded invited testimony video
from Tim Jennings and Gail Braten. Mr. Braten has been
diagnosed with ALS, and spoke in support of the bill.
10:00:13 AM
Ms. Lubke presented a prerecorded invited testimony from
Dr. Ileana Howard, who was an associate professor of
rehabilitation from the University of Washington.
10:04:58 AM
BROOKE LAVENDER, ALS CARE SERVICES MANAGER, ALS
ASSOCIATION, GIRDWOOD (via teleconference), spoke in
support of the legislation.
10:08:28 AM
EMILY NENON, AMERICAN CANCER SOCIETY, CANCER ACTION
NETWORK, ANCHORAGE (via teleconference), testified in
support of the bill.
Co-Chair Olson wondered whether Ms. Nenon wanted an
amendment to the bill.
Ms. Nenon replied that the patient protections were well
intended, but hoped to better define the "care team."
10:14:12 AM
KELLY MARRE, SELF, SOLDOTNA (via teleconference), spoke in
support of the bill.
10:15:59 AM
Co-Chair Olson OPENED public testimony.
10:16:06 AM
SETH GREINER, NATIONAL MULTIPLE, SEATTLE (via
teleconference), testified in support of the legislation.
10:18:41 AM
BEVERLY WOOLEY, SELF, BIG LAKE (via teleconference), spoke
in support of the bill.
10:23:48 AM
MICHELE FOLEY, SELF, FAIRBANKS (via teleconference),
testified in support of the legislation.
Co-Chair Olson CLOSED public testimony
Senator Wilson wondered whether the fiscal note was UGF or
DGF.
Ms. Robb replied that it was receipt supported services.
Senator Wilson looked at Section 4, and wondered whether
there should be a keeping of licensure.
Ms. Robb deferred to the bill sponsor.
10:29:06 AM
Senator Wilson stated that licensed providers should be
required to see patients in Alaska.
Senator Claman stated that he wanted to examine that
section, and stated that he hoped that it would be
approached in the same manner of other telehealth
provisions.
10:30:21 AM
Senator Wilson agreed to work with the bill sponsor.
Senator Claman thanked the committee for hearing the bill.
SB 91 was HEARD and HELD in committee for further
consideration.
| Document Name | Date/Time | Subjects |
|---|---|---|
| SB 91 Testimony Packet 021224.pdf |
SFIN 2/14/2024 9:30:00 AM |
SB 91 |
| SB 91 Research Murkowski multidisciplinary care PR 11.02.2023.pdf |
SFIN 2/14/2024 9:30:00 AM |
SB 91 |
| SB 91 Research Murkowski sponsor ALS multidisciplinary care.pdf |
SFIN 2/14/2024 9:30:00 AM |
SB 91 |
| SB 91 Testimony - Received as of 1.22.24.pdf |
SFIN 2/14/2024 9:30:00 AM |
SB 91 |
| SB 91 Research ALS Association Multidisciplinary Care Team.pdf |
SFIN 2/14/2024 9:30:00 AM |
SB 91 |
| SB 91 Sectional Analysis Version B.pdf |
SFIN 2/14/2024 9:30:00 AM |
SB 91 |
| SB 91 Sponsor Statement version B.pdf |
SFIN 2/14/2024 9:30:00 AM |
SB 91 |
| SB 91 MS Society AK SB 91 Multidisciplinary care teams telehealth SUPPORT SFC committee.pdf |
SFIN 2/14/2024 9:30:00 AM |
SB 91 |
| SB 91 DCCED CBPL 020924.pdf |
SFIN 2/14/2024 9:30:00 AM |
SB 91 |