Legislature(2021 - 2022)BUTROVICH 205
03/03/2022 01:30 PM Senate HEALTH & SOCIAL SERVICES
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| Audio | Topic |
|---|---|
| Start | |
| SB175 | |
| SB192 | |
| Adjourn |
* first hearing in first committee of referral
+ teleconferenced
= bill was previously heard/scheduled
+ teleconferenced
= bill was previously heard/scheduled
| *+ | SB 192 | TELECONFERENCED | |
| += | SB 175 | TELECONFERENCED | |
| + | TELECONFERENCED |
SB 175-HEALTH CARE SERVICES BY TELEHEALTH
1:32:19 PM
CHAIR WILSON announced the consideration of SENATE BILL NO. 175
"An Act relating to telehealth; relating to the practice of
medicine; relating to medical assistance coverage for services
provided by telehealth; and providing for an effective date."
1:32:38 PM
SENATOR COSTELLO moved to adopt the committee substitute (CS)
for SB 175, work order 32-LS1421\I, as the working document.
1:32:50 PM
CHAIR WILSON objected for purposes of discussion. He explained
that the CS is a good faith compromise with stakeholders that
will make a better bill.
1:33:40 PM
CHAIR WILSON removed his objection; he found no further
objection, and Version I was adopted as the working document.
1:33:49 PM
SENATOR HUGHES and SENATOR BEGICH joined the meeting.
1:34:04 PM
CHAIR WILSON, speaking as sponsor, paraphrased the following
sponsor statement for SB 175:
[Original punctuation provided.]
The COVID pandemic brought many hardships, but also
inspired innovation. The committee has had extensive
conversations on telehealth, through both SB 56
(Disaster Bill) and SB 78 (Senator Costello's
Telehealth Bill). SB 175 capitalizes on these
innovations and conversations. Access to telehealth
services were broadened temporarily during the COVID-
19 pandemic. We want to continue these telehealth
flexibilities and make them permanent in statute. SB
175:
• Improves access to behavioral health and helps to
address opioid use disorder.
• Reduces bureaucracy.
• Makes health care possible when an in-person
visit doesn't make sense, or just isn't an
option.
1:35:04 PM
There is an extensive packet of letters of support to
this legislation. Some of the supporters are:
Southcentral Foundation, ASHNHA, Alaska Association on
Developmental Disabilities, Alaska Behavioral Health
Association, AARP, Alaska Primary Care Association
Alaska Regional Coalition (TCC, Kawerak, Maniilaq,
Chugachmuit, Central Council Tlingit & Haida), Alaska
Native Health Board, Family Centered Services of
Alaska, Set Free Alaska, and U.S. Renal Care.
SB 175:
1) Creates a new section on telehealth for health care
providers licensed with the State of Alaska that
removes the requirement for an in-person visit and
ensures payment parity for telehealth visit.
2) Allows physicians licensed in another state to deliver
telehealth services within their scope of practice if:
a. There is an established physician-patient
relationship,
b. The non-resident physician has given the patient
an in-person physical exam,
c. And the services are related to ongoing treatment
or follow-up care related to past treatment.
3) Ensures telehealth availability for services related
to opioid use disorder and controlled substances for
certain providers.
4) Increases telehealth access for Alaska Medicaid
beneficiaries by ensuring coverage and ensures payment
parity and Medicaid coverage for virtually any
telehealth modality.
SB 175 does not require anyone to deliver or receive
services through telehealth. Both the provider and the
patient may choose to limit or decline a telehealth
encounter.
1:36:40 PM
CHAIR WILSON noted that Representative Spohnholz sponsored a
companion bill.
1:37:02 PM
JASMIN MARTIN, Staff, Senator David Wilson, Juneau, Alaska,
paraphrased the following sectional analysis on behalf of the
sponsor:
[Original punctuation provided.]
Section 1: Adds a new section (.085 Telehealth) to AS
08 (Business and Professions) .01 (Centralized
Licensing).
(a) Allows a healthcare provider (other than
physician licensed in in another state) to
provide health care services via telehealth
without first conducting an in-person visit.
(b) Allows an out-of-state physician to provide
health care services via telehealth if:
(1) The physician and patient have pre-
established relationship.
(2) There has been an in-person
examination.
(3) The telehealth visits are a follow-up to
previously provided health care
services.
(c) Creates limits for a telehealth appointment.
If a telehealth appointment falls outside a
provider's authorized scope of practice, they
may refer the patient to an appropriate
clinician. Prohibits a healthcare provider
from charging for any portion of the visit
that was beyond their scope of practice.
(d) Requires fees charged for telehealth to be no
more than fees charged for in person visits.
(e) Allows a physician, podiatrist, osteopath, or
physician assistant licensed with the State of
Alaska to prescribe controlled substances via
telehealth if they comply with Alaska Statute
regarding prescribing controlled substances
without a physical examination.
(f) Allows an advanced practice registered nurse
licensed with the State of Alaska to
prescribe controlled substances via
telehealth.
(g) Prohibits a provider from prescribing
controlled substances via telehealth other
than as provided in (e) and (f).
1:39:00 PM
(h) Removes the burden to document barriers to an
in-person visit and clarifies that the board
or department cannot require health care
services to be provided from a certain
location.
(i) Clarifies that nothing in this section re-
quires a provider to provide telehealth
services or a patient to use telehealth
services.
(j) Defines: "health care provider," "licensed,"
and "telehealth."
Section 2: Amends AS 08 (Business and Professions) .64
(Medicine) .364 (Prescription of drugs without a
physical examination).
Removes the in-person requirement in AS 08.64.364(b)
for an appropriate health care provider to assist a
patient during a telehealth appointment with a
physician or physician assistant regarding controlled
substances.
1:39:45 PM
Section 3: Adds a new section (.100 Telehealth) to AS
18 (Health, Safety, Housing, Human Rights, and Public
Defenders) .08 (Emergency Medical Services).
(a) Allows an individual certified or licensed to
provide emergency services to provide
emergency services through telehealth.
(b) Requires a certified or licensed individual to
stay within their scope of practice during a
telehealth visit. Prohibits them from charging
for any portion of the visit that was beyond
their scope of practice.
(c) Requires fees charged for telehealth to be no
more than fees charged for in person visits.
(d) Removes the burden to document attempts at an
in person visit and clarifies that the council
or department cannot require health care
services to be provided from a certain
location.
(e) Clarifies that nothing in this section requires
a provider to provide telehealth services or a
patient to use telehealth services.
(f) Defines "telehealth" as defined in section 1.
1:40:46 PM
Section 4: Adds a new section (.069. Payment for
Telehealth) to AS 47 (Welfare, Social Services, and
Institutions) .07 (Medical Assistance for Needy
Persons).
(a) Requires Medicaid to pay for services by
telehealth at the same rate they would if the
services were provided in person.
(b) Requires the department to adopt regulations
for services provided through telehealth.
Requires these regulations to treat services
provided through telehealth in the same
manners as services provided in person. Allows
the department to limit modes, coverage, and
reimbursement of telehealth only if:
(1) The department specifically excludes or
limits services from telehealth coverage
through regulation.
(2) Determines, through substantial medical
evidence, that a service cannot be safely
provided via telehealth.
(3) Providing a service through telehealth
would violate federal law or render a
service ineligible for reimbursement
under federal law.
(c) Requires all telehealth services comply with
HIPAA.
(d) Defines "federally qualified health center,"
"rural health clinic," "state plan," and
"telehealth."
1:41:23 PM
Section 5: Adds a new section (.585 Telehealth) to AS
47 (Welfare, Social Services, and Institutions) .30
(Mental Health).
Identical to section 3 but applies to entities which
are approved to receive grant funding by the
Department of Health and Social Services to deliver
community health services.
Section 6: Adds a new section (.145 Telehealth) to AS
47 (Welfare, Social Services, and Institutions) .37
(Uniform Alcoholism and Intoxication Act).
Identical to section 3 but applies to public or
private treatment facilities approved by the
Department of Health and Social Services in AS
47.37.140 to deliver services designated under AS
47.37.40 AS 47.37.270 addressing substance use
disorders.
Section 7-10
Amends the uncodified law to instruct the Department
of Health and Social Services to submit an amendment
to the state plan and seek approval from the U.S.
Department of Health and Human Services if needed and
provides immediate effective dates for other areas of
this bill.
1:42:25 PM
MS. MARTIN presented the changes from version A to version
I of SB 175:
[Original punctuation provided.]
Section 1
Replaces any reference to "examination" with "visit,"
and updates corresponding language throughout the
bill, except for providers licensed in another state.
Removes language in subsection (a) of version A
related to the telehealth authority of providers
licensed in another state. This language is replaced
with subsection (b), which creates an exemption for
physicians licensed in another state to deliver health
care services within their scope of practice if there
is an established physician-patient relationship, the
non-resident physician has given the patient an in-
person physical exam, and the services are related to
ongoing treatment or follow-up care related to past
treatment.
Cleans up the provisions regarding medication assisted
treatment by removing subsection (d) in version A,
which pertained to services addressing opioid use
disorder. This language was deemed unnecessary to
ensure the telehealth delivery of medication assisted
treatment to treat opioid use disorder (i.e.,
medication, counseling, and behavioral health
therapies).
Revises the prescribing authority provision by
separating physicians, podiatrists, osteopaths, and
physician assistants in subsection (e) from advanced
practice registered nurses (APRNs) in subsection (f).
Amends the APRN language in subsection (f) to remove
the in-person requirement of prescribing controlled
substances (including buprenorphine) via telehealth.
This does not change the prescribing scope for these
providers.
Creates subsection (h) to remove requirements to
document all attempts for an in-person visit and
prevents the department or board from limiting the
physical setting of a health care provider delivering
telehealth.
Clarifying language is inserted under subsection
(j)(2) defining all providers in this section as
licensed in good standing.
1:43:36 PM
Section 3 Creates subsection (h) under Title 18 to
remove requirements to document all attempts for an
in-person visit. This section replicates the same
provisions on documentation and physical setting for
emergency medical services as Section 1.
Section 4
Amends telehealth services included in Alaska Medicaid
by explicitly including home and community-based
waiver services in subsection (a)(2) and adding
services provided under a state plan option (e.g.,
1915(k) services) in subsection (a)(3). Adds language
in subsection (b), line 13 to ensure the department
must revise regulatory language to include telehealth
in the definition of a "visit."
Section 5-6
These are new sections adding telehealth provisions to
entities in Title 47. These entities represent
grantees which deliver community mental health
services, or facilities approved by the department to
deliver substance use disorder treatment. Their
authority to deliver telehealth was previously
unaddressed in version W because they are not
applicable to the provisions in Title 8 or the Alaska
Medicaid provisions in Title 47. Both sections
replicate the same telehealth provisions on cost,
scope of services, patient protections, documentation,
and physical setting as Section 1.
1:44:23 PM
Section 5 creates AS 47.30.585 to include entities
designated under AS 47.30.520 AS 47.30.620, which
are approved to receive grant funding by the
Department of Health and Social Services to deliver
community mental health services.
Section 6 creates AS 47.37.145 to include public or
private treatment facilities approved by the
Department of Health and Social Services in AS
47.37.140 to deliver services designated under AS
47.37.40 AS 47.37.270 addressing substance use
disorders.
1:45:07 PM
SENATOR REINBOLD stated that when the telehealth bill was
introduced by former Representative Vasquez, Alaska physicians
were adamant about the requirement for an in-person visit before
online visits could occur. She asked for an explanation of what
SB 175 does in that regard that wasn't in that House bill.
MS. MARTIN responded that the bill removes the burden of
documenting an attempted in-person visit. It would also
establish payment parity for telehealth and in-person visits.
1:46:03 PM
SENATOR REINBOLD asked if SB 175 would address prescribing
related to telehealth.
1:46:21 PM
At ease
1:48:52 PM
CHAIR WILSON reconvened the meeting.
1:48:57 PM
SENATOR REINBOLD asked whether HB 275 and SB 175 were identical
because the fiscal notes talk about two different bills.
1:49:12 PM
CHAIR WILSON replied that the bills were the same. He deferred
to the Division of Healthcare Services, Department of Health and
Social Services (DHSS) to address the fiscal notes and the
reason an additional person is needed to provide services the
division is already providing to the public.
1:49:57 PM
RENEE GAYHART, Director, Division of Health Care Services,
Department of Health and Social Services (DHSS), Juneau, Alaska,
related that the department would retain some flexibilities for
public health emergency care. It would require regulatory
changes and quality assurance reviews of payments, which would
require additional staff time. The additional staff was to
ensure quality assurance. She noted that the Division of
Behavioral Health and Senior and Disability Services staff were
online.
1:51:34 PM
CHAIR WILSON asked if the department should wait to determine if
there are additional costs to the administration. The fiscal
note does not say how many more patients would use telehealth as
a modality versus in-patient care. According to the fiscal note,
it appears the department adds this as a cost into perpetuity
and not just as a one-time charge. He asked why the department
would not just request temporary funds in the supplemental
budget.
MS. GAYHART responded that the department has been working with
Representative Spohnholz and others on what could be added
through SB 175 and the companion bill. Due to the pandemic, the
flexibilities put in place added many recipients to telehealth.
She indicated that if the changes in the bill are permanent,
they require additional regulations, system edits, and post-
payment claims review. She stated that the Centers for Medicare
and Medicaid Services (CMS) temporarily waived the requirements
because of the pandemic, noting that CMS reimburses the
department for services it provides to recipients through
providers. However, making those changes permanent would require
additional staff.
1:53:40 PM
CHAIR WILSON expressed concern about the ongoing costs in SB
175. He offered his view that the regulation changes would not
happen until FY 2027 and FY 2028.
1:54:05 PM
GENNIFER MOREAU-JOHNSON, Director, Division of Behavioral
Health, Department of Health and Social Services (DHSS),
Anchorage, Alaska, stated that the Division of Behavioral Health
was very interested in supporting access to care. She
highlighted that part of their mission is to ensure effective
care and assurance of quality outcomes. The full-time position
in the division's fiscal note would provide review and
monitoring to assure the clinical appropriateness of the
services and for ongoing review to ensure national best
practices related to telehealth. She envisioned that telehealth
would be a method of delivery that would continue to develop
over time. Thus, the division believes the position should be a
full-time permanent position to stay abreast of national best
practices and ensure quality.
1:55:19 PM
CHAIR WILSON wondered whether the division was currently doing
so.
MS. MOREAU-JOHNSON answered yes. However, this bill proposes
language that would require regulatory changes for the
administration of telehealth, which would require additional
staff support.
1:55:46 PM
SENATOR BEGICH asked what additional work the bill required. He
related that the division would need to develop new regulations
for one year, but she indicated the department currently reviews
and monitors telehealth activities. Thus, he was unsure of the
additional work that SB 175 would require.
MS. MOREAU-JOHNSON answered that language in SB 175 relates to
substantial medical evidence, and because telehealth is an
emerging platform, the division wants to ensure patients receive
quality telehealth care. She said the bill focuses on providing
behavioral services through telehealth, and the division
supports that access but wants to ensure adequate services are
provided. She highlighted that the division is small and has
taken on substantial work to implement the [Medicaid Section]
1115 waiver.
1:57:02 PM
SENATOR BEGICH stated he could understand up to a five-year
follow-up; however, SB 175 should reduce documentation once
enacted, so he was not comfortable with the fiscal note. He
offered his view that the fiscal note is inflated by half a
million dollars. He surmised that it would likely take a year or
18 months at most. He said he did not see the need for an
ongoing full-time position over time and suggested that the
division clearly assess the time required to determine quality
telehealth delivery.
1:58:08 PM
SENATOR HUGHES expressed concern about the cost of SB 175 for
Alaskans because it allows fees for a telehealth visit at the
same rate as an in-person visit. She recalled stipulating years
ago that telehealth would reduce health care costs in the state,
especially for villages. She stated that the costs associated
with telehealth are less than for a clinic. For example, no
medical assistant takes the patient's blood pressure and
performs other duties, resulting in lower overhead. She
highlighted that Alaska has a problem with high health care
costs, so she questioned why the medical fees for telehealth and
in-person visits would be the same.
CHAIR WILSON commented that his office worked with other
telehealth providers during a Medicaid Policy conference and
found that there were two reasons for including payment parity
in SB 175. One reason was that it helps incentivize the use of
telehealth since most doctors prefer in-patient visits for the
profitability of their practice. He offered to distribute
information from the National Conference of Legislatures (NCSL)
on this. NCSL researched the issue and found it also related to
the initial cost for some of the rural community health
providers in the nation to provide telehealth. Thus, payment
parity allows providers to recoup the initial costs of setting
up private and secure telehealth communications equipment. This
is particularly important for small practices in underserved
communities because they may not have the financial means to
offer telehealth if the reimbursement rates are substantially
lower. He noted that he was working with stakeholders and the
sponsor of the companion bill to consider an amendment for a
sunset date for payment parity.
2:01:52 PM
SENATOR HUGHES opined that telehealth costs affect individuals
and will also be reflected in savings to the Medicaid budget.
She referred to page 6, line 9 of Version I, that says the
Department of Health and Social Services (DHSS) has the
responsibility to decide what will be covered, excluded,
limited, or reimbursed for services provided by telehealth. She
offered her belief that the medical board decides what doctors
can do, and the nursing board decides what nurse practitioners
can do. She wondered how DHSS would determine what is
appropriate for telehealth. She suggested that the medical board
would want to determine what is suitable for telehealth.
CHAIR WILSON replied that this section was addressing
reimbursable services. It allows the department to determine
which provided services will be reimbursed. For example, certain
case management providers may not be covered through Medicaid
for in-patient visits, but the visit may be covered through
another private insurance. This provision would allow them to
say which service modalities will be reimbursed. It would allow
the state to set the regulations accordingly for current
procedural terminology (CPT) codes and determine which ones
would be set for reimbursable services in Alaska.
2:04:29 PM
MS. MOREAU-JOHNSON agreed that the language in SB 175 provides
the department the authority to establish regulations for
reimbursement and to maintain like reimbursement for like
services to the extent possible.
2:04:51 PM
SENATOR HUGHES referred to Section 1, which states that in-state
providers may use telehealth without conducting a patient's
physical exam. In contrast, out-of-state providers must have an
in-person medical exam before providing service. She questioned
the constitutionality of having different telehealth
requirements for using non-Alaskan licensed physicians.
CHAIR WILSON replied that he did not believe it caused any
constitutional issues. He explained that Section 1 relates to
licensing requirements for doctors, creating parity for Alaska
and out-of-state physicians.
2:05:55 PM
SARAH CHAMBERS, Director, Division of Corporations, Business,
and Professional Licensing, Department of Commerce, Community
and Economic Development (DCCED), Juneau, Alaska, related her
understanding that Section 1 eliminates licensure for out-of-
state providers. Out-of-state providers must be licensed in
Alaska to provide care in the state. SB 175 would allow out-of-
state physicians licensed in another jurisdiction to practice in
Alaska via telehealth, but they must follow Alaska's laws. She
related that during the pandemic, some Alaskans had a Seattle
doctor for specialty care but had health restrictions and could
not travel to Seattle. Their provider had limited access to in-
patient services, or it was cost prohibitive.
2:07:32 PM
SENATOR HUGHES stated the explanation makes sense. She wondered
if this was opening the door to allow out-of-state physicians to
live in the state and provide telehealth services indefinitely
without obtaining an Alaska license.
CHAIR WILSON opined that the requirements would make that
difficult and deferred to Ms. Chambers.
MS. CHAMBERS replied that the intent is to have a bifurcated
system where a physician practicing in Alaska must have an
Alaska license. She offered to research when out-of-state
physicians would need an Alaska license to clarify the bill's
intent for the future.
2:09:19 PM
CHAIR WILSON stated he would add the suggestion to his list of
potential amendments.
2:09:38 PM
NANCY MERRIMAN, Executive Director, Alaska Primary Care
Association, Anchorage, Alaska, paraphrased her testimony as
follows:
[Original punctuation provided.]
The Alaska Primary Care Association (APCA) supports
the operations and development of Alaska 29 federally
qualified health centers, also known as community
health centers, or FQHC. Health centers provide
comprehensive whole person care which includes
medical, dental, behavioral, pharmacy and care
coordination services. A PCA and Alaska's health
centers support SB 175 because it increases access to
primary care and behavioral health services, and it
expands telehealth in this space. This legislation
does several things that are important to help
centers. First, it includes a range of telehealth
modalities, including audio only, both now and into
the future. Second, it allows patients and providers
to engage in telehealth services outside of clinic
setting if they so choose. And third, it provides
adequate reimbursement for telehealth visits,
providing new points of access to whole person care,
including behavioral health and substance use disorder
treatment.
In 2020, health centers served 105,000 patients
through 450,000 visits. Telehealth and substance use
disorder services are our fastest growing area of
service, and of those visits 40 percent were
accommodated via telehealth. In the subspecialty area
of substance use disorder services, 45 percent of
visits were via telehealth. The temporary telehealth
policy changes have benefited health centers because
they have allowed health centers to be recognized as
telehealth treating providers to furnish some
behavioral health services via audio only technology,
and to be paid for telehealth services furnished to
Medicaid beneficiaries under the health centers
bundled payment reimbursement model.
2:11:47 PM
MS. MERRIMAN continued her testimony:
Health centers serve hard to reach community. The
majority of health center patients experienced
challenges in accessing health care that include long
distances to reach local providers, cost of care,
transportation, language, and cultural barriers. In
Alaska, over half of our patients are from racial or
ethnic minorities, a majority are low income, and most
patients live in rural communities. Health centers
best serve their patient populations if they have the
ability to use technology to meet their patients where
they are at. Additionally, workforce shortages,
particularly in behavioral health providers, impact
health centers uniquely as nonprofit safety net
providers. And telehealth allows health centers to use
their clinical workforce most nimbly.
In 2021, a cohort of health centers reported that of
their telehealth interactions 59 percent occurred by
phone and 40 percent by audio or video. Through the
pandemic demand for tele behavioral health now
represents 35 percent of all telehealth usage. Health
centers have witnessed how telehealth has provided a
stronger continuity of care for patients, reduced
travel costs, and has resulted in fewer dropped
visits, and less delayed and more costly care. And we
understand that delivering quality whole person care
ultimately leads to better health outcomes, saves
lives, and in the long run saves on cost. So, on
behalf of the Alaska Primary Care Association and
health centers across the state, I urge you to support
SB 175. And we appreciate your support.
2:13:39 PM
SENATOR REINBOLD stated she made a commitment when she supported
telehealth six years ago to support Alaska's physicians. She
said she is pleased that SB 175 requires physicians to have an
established patient relationship before offering telehealth
services. She expressed concern that SB 175 might mean more
patients would seek medical care from physicians in the Lower
48, which could be difficult for local providers who established
small clinics. She wants to ensure that patients do not turn to
out-of-area telemedicine and leave local doctors without
patients.
CHAIR WILSON asked Ms. Merriman whether Alaskan providers would
have that concern.
MS. MERRIMAN opined that SB 175 seeks to establish and protect
the patient-provider relationship.
2:15:17 PM
SENATOR REINBOLD stated she supports SB 175 because it prevents
providers from requiring patients to be vaccinated before
receiving treatment. She is concerned about the opioid crisis in
Alaska and whether SB 175 would increase access to opioids in
Alaska.
CHAIR WILSON responded no. He stated that SB 175 would not
increase access because there are still state statutes that out-
of-state providers must follow. He said he would follow up to
ensure that all entities are required to follow Alaska's
prescribing rules.
SENATOR REINBOLD recalled that opioid prescriptions were limited
to a 7-day maximum prescription.
2:16:22 PM
SENATOR REINBOLD asked if SB 175 mirrors or complements HB 172
related to psychotropic medication use in sub-acute medical
facilities.
CHAIR WILSON answered no.
2:17:09 PM
SENATOR REINBOLD related her understanding that the local
physicians, physician's assistants, and nurse practitioners were
represented by APCA. She acknowledged that APCA testified in
support of SB 175, but she would like to know if Alaska's
healthcare providers support SB 175.
CHAIR WILSON replied that other invited testimony would speak to
her concern.
2:17:37 PM
JOHN SOLOMON, Director, Behavior Health, Maniilaq Association,
Kotzebue, Alaska, stated that Maniilaq is the only association
serving the Northwest Arctic area villages on the North Slope.
Before becoming an administrator, he was a counselor who flew to
villages to see patients, carrying his backpack and sleeping
bag. He emphasized the importance of telehealth to his region,
which he hopes was happening in other rural Alaska areas.
MR. SOLOMON explained that previously many logistical barriers
prevented patients from obtaining treatment. Still, once
restrictions were removed, the flexibilities allowed telehealth,
which brought about an explosion in the number of clients asking
for and receiving care. Telehealth for substance abuse groups
went up 800 percent in six months. People had been waiting and
wanting care but lacked access to providers. The substance abuse
program grew from five to 70 ongoing clients. He emphasized the
importance of the telephonic provision in SB 175 for rural
Alaskans. The Northwest Arctic has clinics that do not have
behavioral health aides (BHAs) and organizations with clinics
that are not staffed. The telephonic option provides access to
obtain care. In rural Alaska, telehealth is not about better or
best practices but about care or no care for rural Alaskans.
MR. SOLOMON highlighted that Maniilaq has worked to develop the
local workforce in villages, so village BHA's can provide care
to other villages. The hope is to fill the remaining BHA
positions. In closing, he stated that the Maniilaq Association
is a strong advocate for SB 175.
2:20:23 PM
CHAIR WILSON related that BHA stands for behavior health aide.
MR. SOLOMON agreed and elaborated that in the tribal health
organizations, a behavior health aide works as a village-based
counselor.
2:20:43 PM
CHAIR WILSON opened public testimony on SB 175.
2:21:09 PM
SUZANNE ISHII-REGAN, representing self, Anchorage, Alaska, said
she is a member of a family who has benefited from telehealth.
She thanked the state for a quick pivot to provide the
flexibility of telehealth during the pandemic, which helped
protect many vulnerable citizens. She said she has a male family
member who uses a ventilator and has a primary immune
deficiency. She noted that telehealth helped the family stay
connected to doctors and avoid exposure to illnesses and
infection, so they did not bring them home. Telehealth provided
an opportunity for first-time access to services when he needed
to transition to a new provider. It also reduced barriers that
allowed him to continue receiving medical care. Telehealth was
beneficial during extreme cold and icy weather, which further
complicate mobility issues. She said it was easier to
communicate since masks did not have to be worn during the
telehealth appointments.
2:23:40 PM
SARAH ELIASEEN, representing self, Eagle River, Alaska, stated
she is a 96-year-old retired schoolteacher who appreciated being
able to stay home and receive medical care. She has been
declared legally blind and must use a walker. She can no longer
use public transportation but would like to remain as
independent as possible. She surmised that she is not the only
person who finds transportation to Anchorage difficult. She
mentioned that while visiting with her doctor online, an
assistant kept records and facilitated the call. She asked the
committee to make telehealth a permanent option for the elderly,
disabled, those in rural areas, and anyone else who needs it.
She thanked members and urged them to pass SB 175.
2:27:30 PM
CODY CHIPP, Director, Alaska Native Tribal Health Consortium
(ANPHC), Anchorage, Alaska, stated that the telehealth
flexibility that came about through COVID created a greater
ability to provide greater access to care. ANPHC launched a
telehealth behavioral health clinic to address COVID-related
distress. He stated that ANTHC uses OQ 45, the gold standard of
patient-reported outcome measures, to measure clinical outcomes.
Telehealth was found to be accessible, safe, and effective. The
clinical outcomes were equal to or greater than the national
averages. Client surveys expressed patient gratitude for easy
access to services previously not available. Alaska's fiscal
analysis has shown that telehealth could also save the state
money, as noted in the Medicaid Reform report in response to SB
74. Telehealth also saves individuals time and money because it
eliminates driving time.
2:29:32 PM
CHAIR WILSON held SB 175 in committee with public testimony
open.
| Document Name | Date/Time | Subjects |
|---|---|---|
| SB 192 Sponsor Statement 3.2.22.pdf |
SHSS 3/3/2022 1:30:00 PM SHSS 3/10/2022 1:30:00 PM |
SB 192 |
| SB 192 Supporting Doc Why We Need CPM 3.2.22.pdf |
SHSS 3/3/2022 1:30:00 PM SHSS 3/10/2022 1:30:00 PM |
SB 192 |
| SB 192 Audit Recommendations DLA 6.19.2020.pdf |
SHSS 3/3/2022 1:30:00 PM SHSS 3/10/2022 1:30:00 PM |
SB 192 |
| SB 192 FN DCCED CBPL 2.25.22.pdf |
SHSS 3/3/2022 1:30:00 PM SHSS 3/10/2022 1:30:00 PM |
SB 192 |
| SB 192 FN DCCED IO 2.25.22.pdf |
SHSS 3/3/2022 1:30:00 PM SHSS 3/10/2022 1:30:00 PM |
SB 192 |
| SB 192 Leg Legal Memo 1.18.22.pdf |
SHSS 3/3/2022 1:30:00 PM SHSS 3/10/2022 1:30:00 PM |
SB 192 |
| SB 192 Leg Legal Memo 2.11.22.pdf |
SHSS 3/3/2022 1:30:00 PM SHSS 3/10/2022 1:30:00 PM |
SB 192 |
| SB 192 Letters 3.2.22.pdf |
SHSS 3/3/2022 1:30:00 PM SHSS 3/10/2022 1:30:00 PM |
SB 192 |
| SB 192 NARM letter of Support 3.23.21.pdf |
SHSS 3/3/2022 1:30:00 PM SHSS 3/10/2022 1:30:00 PM |
SB 192 |
| SB 175 Sectional Analysis v. I 3.1.2022.pdf |
SHSS 3/3/2022 1:30:00 PM SHSS 3/10/2022 1:30:00 PM |
SB 175 |
| SB 175 Sponsor Statement v. I 3.1.2022.pdf |
SHSS 3/3/2022 1:30:00 PM SHSS 3/10/2022 1:30:00 PM |
SB 175 |
| SB 175 Explanation of Changes v. A-I 3.2.2022.pdf |
SHSS 3/3/2022 1:30:00 PM SHSS 3/10/2022 1:30:00 PM |
SB 175 |
| SB 175 v.I Work Draft 3.2.22.pdf |
SHSS 3/3/2022 1:30:00 PM SHSS 3/10/2022 1:30:00 PM |
SB 175 |
| SB 175 FN DOH MS 2.18.22.pdf |
SHSS 3/3/2022 1:30:00 PM |
SB 175 |
| SB 175 FN DOH BH 2.18.22.pdf |
SHSS 3/3/2022 1:30:00 PM |
SB 175 |
| SB 175 FN DOH HCS 2.18.22.pdf |
SHSS 3/3/2022 1:30:00 PM |
SB 175 |
| SB 175 FN DCCED 2.18.22.pdf |
SHSS 3/3/2022 1:30:00 PM |
SB 175 |
| SB 175 (HB 265) Letters 03.02.22.pdf |
SHSS 3/3/2022 1:30:00 PM SHSS 3/10/2022 1:30:00 PM |
HB 265 SB 175 |
| SB 192 Sectional Analysis 3.3.22.pdf |
SHSS 3/3/2022 1:30:00 PM SHSS 3/10/2022 1:30:00 PM |
SB 192 |