Legislature(2019 - 2020)BUTROVICH 205
04/03/2019 01:30 PM Senate HEALTH & SOCIAL SERVICES
Note: the audio ![]()
and video ![]()
recordings are distinct records and are obtained from different sources. As such there may be key differences between the two. The audio recordings are captured by our records offices as the official record of the meeting and will have more accurate timestamps. Use the icons to switch between them.
| Audio | Topic |
|---|---|
| Start | |
| SB93 | |
| Adjourn |
* first hearing in first committee of referral
+ teleconferenced
= bill was previously heard/scheduled
+ teleconferenced
= bill was previously heard/scheduled
| + | TELECONFERENCED | ||
| += | SB 93 | TELECONFERENCED | |
SB 93-MEDICAL PROVIDER INCENTIVES/LOAN REPAYM'T
1:30:57 PM
CHAIR WILSON announced that the only order of business would be
SENATE BILL NO. 93, "An Act relating to a workforce enhancement
program for health care professionals employed in the state; and
providing for an effective date."
CHAIR WILSON recapped that the sponsor presented an overview of
SB 93 during the March 25, 2019, meeting. The committee
discussed some potential amendments. His office worked with the
Department of Health and Social Services (DHSS) and SHARP
[Supporting Health Access Repayment Program] to produce a
committee substitute.
1:31:20 PM
CHAIR WILSON solicited a motion to adopt the proposed committee
substitute (CS).
1:31:24 PM
SENATOR COGHILL moved to adopt the committee substitute (CS) for
SB 93, work order 31-LS0598\U, as the working document.
1:31:37 PM
SENATOR GIESSEL objected for purposes of discussion.
1:31:40 PM
CHAIR WILSON reviewed the explanation of changes for the
committee substitute (CS) SB 93 from Version A to Version U:
Section 18.29.100 Legislative Intent:
Version U clarifies the Legislative Intent is to
increase the availability of health care services
throughout the state, especially to underserved
individuals and health care professional shortage
areas. References to "underserved" were changed to
"underserved individuals" throughout the bill.
Section 18.29.105, Advisory Council:
Version U clarifies department employees can
participate as non-voting members, but may not serve
in a leadership role, and establishes that civil
penalties, not to exceed $1,000, per violation, apply
to both participating employers and health care
professionals.
1:33:08 PM
At-ease.
1:33:36 PM
CHAIR WILSON referred to pages 3-5 to Section 18.29.110:
Section 18.29.110, Employer Payments:
New language sets out the annual maximum payment
amounts for direct incentives per tier:
• Tier I: $35,000 for regular positions and $47,250 for
very hard-to-fill positions
• Tier II: $20,000 for regular positions and $27,000 for
very hard-to-fill positions
• Tier III: $15,000 for regular positions and $20,250
for very hard-to-fill positions
CHAIR WILSON said the $15,000 was selected by the
department after input from the stakeholders.
Section 18.29.125, Student Loan Repayment:
Clarifies eligibility requirements for repayment of
student loans.
CHAIR WILSON referred to the next change on page 6, line
25, which added the department, in case the commission was
dismantled, as the entity who can verify student loan debt.
Section 18.29.130, Eligibility:
Clarifies verification of student loan debt may be
conducted by the Alaska Commission on PostSecondary
Education or the Department of Health and Human
Services.
CHAIR WILSON referred to pages 6-8.
Section 18.29.190, Definitions:
Adds a definition for the term "underserved
individuals."
Additionally, Version U deletes Sections 7, 9, and 10
in the original bill, thereby removing all language
pertaining to a requirement of a doctoral degree for
advance practice registered nurses.
Lastly, the sections throughout the Committee
Substitute were re-numbered accordingly.
CHAIR WILSON said that several testifiers suggested that
the program benefits should be available to underserved
individuals, so a definition was added in AS 18.19.190.
Carryover language from House Bill 78 and language in SB 93
allow the commissioner to add other health care professions
to Tier I and Tier II. It does not change the existing
educational requirements so if the minimum degree
requirements for an advance practice registered nurse were
to change in the future, this bill allows the occupation to
move to the appropriate tier.
1:37:33 PM
SENATOR COGHILL asked for further clarification on the language
in Section 2, which shows [AS 18.29.]035 and [AS 18.29.]099 are
effective in July but also lists the same statues as repealed.
SENATOR WILSON replied that SB 93 would go into effect in July,
thus repealing it at the same time that the new provisions in SB
93 would be enacted.
SENATOR COGHILL asked if SHARP 2 was primarily being repealed.
CHAIR WILSON answered yes.
SENATOR COGHILL asked if the bill was being repealed and
replaced.
CHAIR WILSON answered yes.
1:38:51 PM
SENATOR BEGICH asked whether the little typos in the fiscal
notes had been corrected.
CHAIR WILSON answered yes.
1:39:11 PM
SENATOR STEVENS said that Version M removed the requirement for
a doctoral degree for advance practice registered nurses. He
asked whether doctoral degrees were required for some positions.
1:39:36 PM
SENATOR GIESSEL said that an advance practice registered nurse
in the state is not required to have a doctoral degree. The
profession is moving in that direction and it may become the
level of entry in the future, but at this time the requirement
for the position is a master's degree.
SENATOR STEVENS clarified that there is no requirement for a
doctorate for any advance practice registered nurse.
SENATOR GIESSEL replied that is correct. She reiterated that the
practice requirement for an advance practice registered nurse in
Alaska is a master's degree.
CHAIR WILSON reiterated that the bill included language that if
that requirement or any requirement for a professional degree
changes, the department can move them to the appropriate tier
level.
1:40:50 PM
SENATOR GIESSEL removed her objection.
1:41:01 PM
CHAIR WILSON found no further objection. Therefore, CSSB 93,
work order 31-LS0589\U, was adopted.
1:41:41 PM
JILL LEWIS, Deputy Director, Department of Health and Social
Services (DHSS), Juneau, reviewed the CSSB 93 fiscal notes. She
said the Department of Commerce, Community and Economic
Development (DCCED) submitted a zero fiscal note for Version A
because it referenced an action concerning the Board of Nursing.
However, those sections have been deleted in Version U.
The fiscal note for Department of Health and Social Services
(DHSS), Public Health, Emergency Programs, is a large fiscal
note. It increases from $814,300 in FY 2020 to $5.043 million in
FY 2025. This provides the authority to collect and spend the
designated program receipts for the employers' contribution to
the DHSS and does not have any UGF [unrestricted general funds].
She said the funding has a small amount for personal services
derived from the administrative fee that employers include with
their payments. The remainder of the operating expenditures is
in services, which is for the actual contracts with
practitioners. As previously mentioned, the revenue listed for
$814,300 in FY 2020 to $5.043.0 million shows that it is new
revenue for the program. The net amount is zero.
MS. LEWIS indicated that in the third year, a new position is
listed, which anticipates the volume growing to the extent that
it cannot be handled by existing staff. It also provides a small
amount to pay for a contractor in year five if the program
continues to grow to provide additional staff support.
1:44:08 PM
SENATOR BEGICH asked for clarification that personal services
increased from 153.3 in FY 2023 to 238.9 in FY 2024, but the
program remains at one position.
MS. LEWIS replied that as the program grows, the department will
collect additional receipts in the administrative fee because
the fees are a percent of the loan values that the department
collects. As the program grows, so will the administrative fees.
Those fees will initially support the existing staff person who
currently administers the program. Eventually the program will
receive enough fees to fully fund the staff person with fees
from [Supporting Health Access Repayment Program] SHARP 3. The
division will also impose a fee for SHARP 1, so other resources
will be available.
1:45:18 PM
CHAIR WILSON solicited a motion.
1:45:26 PM
SENATOR COGHILL moved to report the CS for SB 93, Version U,
from committee with individual recommendations and accompanying
fiscal notes. There being no further objection, the CSSB 93(HSS)
was reported from the Senate Health and Social Services Standing
Committee.
CHAIR WILSON said that Legislative Legal Services is authorized
to make any necessary technical or conforming adjustments.
1:45:48 PM
At ease.
1:47:06 PM
CHAIR WILSON reconvened the meeting. He remarked that Senator
Stevens was present for the discussion but was absent for the
vote to move CSSB 93(HSS) from committee.
| Document Name | Date/Time | Subjects |
|---|---|---|
| SB 93 Work Draft version U.pdf |
SHSS 4/3/2019 1:30:00 PM |
SB 93 |
| SB 93 LoS 4.2.19.pdf |
SHSS 4/3/2019 1:30:00 PM |
SB 93 |
| SB 93 Explanation of Changes A to U.pdf |
SHSS 4/3/2019 1:30:00 PM |
SB 93 |