04/25/2019 09:00 AM House FINANCE

CS FOR SENATE BILL NO. 93(HSS)                                                                                                
                                                                                                                                
     "An Act relating to a workforce enhancement program                                                                        
     for health care professionals employed in the state;                                                                       
     and providing for an effective date."                                                                                      
                                                                                                                                
9:00:51 AM                                                                                                                    
                                                                                                                                
Vice-Chair Johnston MOVED to  ADOPT proposed House Committee                                                                    
Substitute for CSSB 93 (FIN),  Work Draft 31-LS0589\S (Marx,                                                                    
04/24/19)(copy on file).                                                                                                        
                                                                                                                                
There being NO OBJECTION, it was so ordered.                                                                                    
                                                                                                                                
9:01:26 AM                                                                                                                    
                                                                                                                                
BARBARA   BARNES,  STAFF,   REPRESENTATIVE  TAMMIE   WILSON,                                                                    
reviewed  the  changes  of  the  committee  substitute.  She                                                                    
pointed to  page 1, line 9.  Rural was added to  the list of                                                                    
areas to  be covered by the  bill. On page 5,  lines 12-16 a                                                                    
new  subsection  was  added   to  allow  for  inflation  and                                                                    
utilization of  the Consumer Price Index  5-year average for                                                                    
calculations  and allowing  for the  option of  changing the                                                                    
annual  amounts   without  having   to  come  back   to  the                                                                    
legislature.                                                                                                                    
                                                                                                                                
Ms.  Barnes  continued to  page  7,  lines 19-21  rural  was                                                                    
defined as a community with  a population of 5,500 people or                                                                    
less that was not connected by  road or rail to Anchorage or                                                                    
Fairbanks or  with a population  of 1,500 or  less connected                                                                    
by road or  rail to Anchorage or Fairbanks. On  page 7, line                                                                    
25 doctor  of nursing  practice, clinical  psychologist, and                                                                    
counseling  psychologist were  added  to the  Tier 1  health                                                                    
care professionals category. She  concluded with the changes                                                                    
to the committee substitute.                                                                                                    
                                                                                                                                
Co-Chair Wilson asked for a review of the fiscal notes.                                                                         
                                                                                                                                
9:02:54 AM                                                                                                                    
AT EASE                                                                                                                         
                                                                                                                                
9:03:17 AM                                                                                                                    
RECONVENED                                                                                                                      
                                                                                                                                
SARA   CHAMBERS,   DIRECTOR,   DIVISION   OF   CORPORATIONS,                                                                    
BUSINESS,   AND   PROFESSIONAL  LICENSING,   DEPARTMENT   OF                                                                    
COMMERCE,  JUNEAU  (via   teleconference),  reviewed  Fiscal                                                                    
Note 1. She  explained that  the original  version of  SB 93                                                                    
included  some responsibilities  for  the  Board of  Nursing                                                                    
within  the division.  Therefore, she  had submitted  a zero                                                                    
fiscal note.  However, the  responsibilities were  taken out                                                                    
in the committee substitute. The  division had withdrawn its                                                                    
fiscal note and currently did  not have any affiliation with                                                                    
the bill.                                                                                                                       
                                                                                                                                
Co-Chair Wilson  reviewed Fiscal Note 2  from the Department                                                                    
of  Health and  Social Services  (DHSS). She  explained that                                                                    
the only change  to the fiscal note was the  amount of money                                                                    
to start  the program. She  reminded members that it  had to                                                                    
be a  state program  in order to  receive the  benefits from                                                                    
the  federal  government.  She reported  there  would  be  a                                                                    
change  in  revenue  in  a   forthcoming  fiscal  note.  She                                                                    
highlighted that  as the fiscal note  was currently written,                                                                    
it  was a  general  funds  source but  would  be changed  to                                                                    
statutory  receipt authority  and  would match  page 2.  The                                                                    
wrong fund  source was originally  inserted but  the amounts                                                                    
would not change.                                                                                                               
                                                                                                                                
Representative Tilton referred to  page 3, lines 27-29 which                                                                    
talked about how  an employer's payment could  come from any                                                                    
available  source  including  a  philanthropic  institution,                                                                    
health    foundation,     government    agency,    community                                                                    
organization,  or private  individuals. She  wondered if  it                                                                    
was possible  for an  employer to  be receiving  grants from                                                                    
the State of Alaska and using them for the program.                                                                             
                                                                                                                                
Co-Chair  Wilson invited  the sponsors  of the  bill to  the                                                                    
table.                                                                                                                          
                                                                                                                                
9:05:50 AM                                                                                                                    
                                                                                                                                
REPRESENTATIVE  IVY   SPOHNHOLZ,  COMPANION   BILL  SPONSOR,                                                                    
responded  that it  would  have to  be  consistent with  the                                                                    
grant  award received  by an  employer and  would depend  on                                                                    
whether the  grant award  allowed for the  funds to  be used                                                                    
for  the  compensation of  employees.  She  did not  believe                                                                    
there would be  a conflict, but it depended on  the grant in                                                                    
question rather than the eligibility for SHARP.                                                                                 
                                                                                                                                
Representative Tilton asked whether, as  long as a grant was                                                                    
consistent with a grant award,  the monies could be used for                                                                    
repayment. She was asking because  it sounded like that much                                                                    
of  the program  came through  non-profits. Many  non-profit                                                                    
organizations  received grant  funding  through the  federal                                                                    
government.                                                                                                                     
                                                                                                                                
Representative   Spohnholz  responded   that  most   of  the                                                                    
organizations  eligible   for  the  SHARP  3   Program  were                                                                    
primarily non-profits  for Medicaid  billing. It  could also                                                                    
include  some grant  funding. The  state did  some substance                                                                    
abuse treatment  that was grant  funding. She  surmised that                                                                    
as long  as it was  consistent with  the terms of  the grant                                                                    
application, she thought it would be okay.                                                                                      
                                                                                                                                
Representative  Carpenter noted  the  comment regarding  not                                                                    
having  to  come  back to  the  legislature  for  additional                                                                    
authority. He asked Representative Spohnholz to comment.                                                                        
                                                                                                                                
Representative Spohnholz explained that  the rational was to                                                                    
allow for  the program  to keep  up with  the cost  of doing                                                                    
business  over   time  without  having  to   come  back  for                                                                    
permission  from the  legislature. She  felt if  the private                                                                    
sector  was going  to essentially  fund the  program support                                                                    
increases, and  was willing to pay  for it, it would  not be                                                                    
necessary to  come back to the  legislature, especially with                                                                    
appropriate sideboards in place.  She noted that health care                                                                    
inflation was more aggressive that  the Consumer Price Index                                                                    
(CPI). Health are  in the State of Alaska in  the prior year                                                                    
was about  7 percent, whereas  CPI was under 2  percent. The                                                                    
increases were not aggressive.                                                                                                  
                                                                                                                                
Co-Chair  Wilson commented  on  the use  of  the word  "may"                                                                    
instead of "shall."                                                                                                             
                                                                                                                                
Representative Carpenter  added that the increases  were not                                                                    
decided by the federal government.  They would be decided by                                                                    
the employer.                                                                                                                   
                                                                                                                                
Co-Chair  Wilson responded  that  he was  correct that  they                                                                    
would have that opportunity.                                                                                                    
                                                                                                                                
Representative  Spohnholz  followed  up that  the  decisions                                                                    
would  be made  by the  SHARP Council  in consultation  with                                                                    
members of the employer community.  It was not being done to                                                                    
employers but by them.                                                                                                          
                                                                                                                                
Vice-Chair Johnston  MOVED to report HCSCSSB  93(fin) out of                                                                    
Committee   with   individual    recommendations   and   the                                                                    
accompanying fiscal note.                                                                                                       
                                                                                                                                
There being NO OBJECTION, it was so ordered.                                                                                    
                                                                                                                                
HCS CSSB  93(FIN) was REPORTED  out of committee with  a "do                                                                    
pass" recommendation and with one  new fiscal impact note by                                                                    
the Department of Health and Social Services.                                                                                   
                                                                                                                                
9:09:51 AM                                                                                                                    
AT EASE                                                                                                                         
                                                                                                                                
9:10:57 AM                                                                                                                    
RECONVENED