Legislature(1993 - 1994)
03/09/1994 03:00 PM House HES
| Audio | Topic |
|---|
* first hearing in first committee of referral
+ teleconferenced
= bill was previously heard/scheduled
+ teleconferenced
= bill was previously heard/scheduled
Number 628
CHAIR TOOHEY brought HB 414 to the table.
HB 414 - COMPREHENSIVE HEALTH INSURANCE ACT
CHAIR TOOHEY stated that the committee would meet Saturday,
March 13, 1994. The committee took a brief technical at-
ease to discuss a common meeting time and decided to meet
from 1:00 p.m. until 3:00 p.m. and that the meeting would be
teleconferenced. Chair Toohey then indicated that there
were several amendments to address and asked Commissioner
Usera to testify.
Number 635
NANCY USERA, Commissioner, Department of Administration
(DOA), testified on HB 414 and offered several amendments.
She stated that the DOA had five amendments in draft form to
address and asked for guidance from the Chair on how to
proceed.
CHAIR TOOHEY asked Commissioner Usera to present the
amendments on Saturday and asked that she stay to answer
questions. She then said that there were four additional
amendments.
REP. OLBERG asked if that meant there is a total of nine
amendments.
CHAIR TOOHEY said yes and it's only the beginning.
COMMISSIONER USERA said that some of the department's
amendments have similar intent to the other four amendments.
Number 735
CHAIR TOOHEY asked Commissioner Usera to indicate where the
similarities are as the discussions progress.
REP. BRICE asked for copies of the department's amendments.
COMMISSIONER USERA asked for copies to be made.
Number 760
CHAIR TOOHEY made a motion to move her Amendment 1.
REP. BRICE objected for purposes of discussion.
CHAIR TOOHEY asked for discussion. She indicated that page
1, line 8, addresses public health, and said she felt it
would be better to include public health within HB 414. She
said, after the word health care on page 1, line 8, delete
the phrase "is a vital public interest" and insert the
phrase "the maintenance of the public's health is vital to
the public interest."
CHAIR TOOHEY further indicated that on page 1, line 11,
after the word "insurance" the word "and" should be deleted;
and on page 1, line 12, after the word "malpractice" the
phrase "the lack of population based public health services"
should be inserted.
COMMISSIONER USERA interjected and asked in regard to the
amendment, "Are we saying that in fact there aren't enough
services or that the services that we have are poorly
coordinated?" She asked if the word "coordination" might be
used instead of the word "services." She felt the
definition would be clearer.
CHAIR TOOHEY read the suggested phrase, "...the lack of
population based public health services coordination." She
asked for discussion.
Number 869
REP. G. DAVIS noted that all three sets of amendments that
were submitted were similar and suggested that any changes
that needed to be made in any of the amendments be done on
Saturday. He felt the Saturday meeting would address the
details of all submitted amendments.
REP. OLBERG asked if there were three people submitting very
similar amendments. He suggested looking at all three
versions at the same time.
CHAIR TOOHEY concurred.
REP. OLBERG noted that Commissioner Usera's Amendment 1 and
Chair Toohey's Amendment 1 were remarkably similar.
REP. G. DAVIS interjected, "...as does Rep. Brice's number
2."
REP. OLBERG suggested that perhaps the three sets of
amendments could be sent to a bill drafter and returned to
the committee as one amendment.
Number 906
COMMISSIONER USERA said there is a lot of similarity between
two of the amendments and there is a tremendous difference
in the third amendment, although they address the same
subject.
REP. BRICE asked what the difference is and suggested that
his amendment is more in depth.
COMMISSIONER USERA said, "This is very similar to the public
health bill, commission bill, that was put in. What this
does is drop those provisions in under this commission,
which philosophically... certainly we're O.K. about... but
my recollection is that that bill had a fairly hefty fiscal
note on it."
REP. BRICE said, "Where's your fiscal note on this?"
CHAIR TOOHEY said it is $800,000.
REP. BRICE asked what the fiscal note is for Amendment 1
from the DOA.
Number 930
CHAIR TOOHEY said Rep. Sitton's bill has a $3 million fiscal
note.
REP. BRICE said the amendment is similar but would provide a
lot more structure and focus on the direction of the
commission. He said, "I think that the major questions of
the fiscal note would probably be coming about due to the
fact of the meeting of the commission, the establishment of
the commission, the staff of the commission... that type of
stuff. My understanding is quite possibly that as an
advisory committee, this would be a subset of the commission
established by (HB) 414 with probably other members pulled
in. And, I'm sure we can minimalize the fiscal note."
CHAIR TOOHEY said there is a great difference in the amount
of people that Rep. Brice's amendment calls for than that of
HB 414.
REP. BRICE said the differences needed to be discussed
regarding how the public health commission should work.
Number 963
CHAIR TOOHEY asked the committee how they wanted to address
the numerous amendments.
REP. BRICE stated that he would be out of town for the
Saturday meeting and requested that the public health issue
be addressed when he returns the following Wednesday.
REP. VEZEY said, "If you snooze you lose, and we should move
ahead."
REP. G. DAVIS agreed with Rep. Olberg in that the committee
can address the public health issue now.
REP. BRICE asked Commissioner Usera where she saw the fiscal
impact in his amendment.
Number 990
(Rep. Bunde resumed as Chairman for the remainder of the
meeting.)
CHAIR BUNDE recognized Commissioner Usera.
COMMISSIONER USERA said, "In the way that the amendment that
Rep. Toohey... which is similar to the one we have
drafted... does have some fiscal impact." She said there
will be meeting costs and travel costs associated with the
concept. She reiterated that what the DOA is trying to do
is find a cost effective way to address the issue, and no
one will be happy with the limitations put on the commission
by fiscal constraints. She asserted that when a bill
becomes very specific, it must also be priced out
specifically. The more provisions that are mandated, the
more costly the legislation becomes.
Number 031
REP. BRICE disagreed and said the commission needs to have
direction and greater focus. He felt there should be some
type of analysis and that there would be no significant
fiscal impact. He suggested that travel and per diem could
be priced down. He felt as a policy matter that the
legislature should establish clear guidelines for the
function of the commission.
COMMISSIONER USERA suggested that if the word "must" under
subsection B, page 2, is changed to "may," it would avoid
leaving the state open to law suit. She said that she has
seen more suits in the last two years than she wants to see
for the rest of her lifetime because of mandates that use
words like "shall" and "must." She said if the word "may"
is used, it would satisfy Rep. Brice's concerns that there
be guidance for the commission, but would not lock the state
into a mandate situation that could be exposed to possible
litigation.
TAPE 94-41, SIDE B
Number 000
REP. OLBERG asked if there were two sets or three sets of
amendments.
REP. BRICE said he personally had three amendments.
CHAIR BUNDE indicated that he had one set that was numbered
1-4. He then asked Rep. Brice which amendment he was
speaking to.
REP. BRICE said he was speaking to his own amendment.
REP. TOOHEY said she would withdraw her Amendment 1 to
simplify matters.
CHAIR BUNDE stated that Rep. Toohey withdrew her Amendment
1. He then stated that matters would be further simplified
if Rep. Brice were to present a fiscal note on his
amendment.
Number 052
REP. B. DAVIS asked if both Rep. Brice's amendment and the
department's amendment were being discussed.
CHAIR BUNDE indicated that no amendment had been moved and
said all were up for discussion.
REP. OLBERG said, "I believe that there is only one
amendment that makes any changes to page 1."
CHAIR BUNDE said, "That being Amendment 2, by Rep. Brice."
REP. OLBERG said, "No, that being Amendment 1, by
Commissioner Usera."
Number 077
CHAIR BUNDE indicated for clarity that Commissioner Usera's
amendment would be called Administration Amendment 1.
REP. OLBERG said, "...this amendment does not appear to
conflict with any other amendment, and if we dealt with it
individually, then we could cast it aside and clarify things
even more."
CHAIR BUNDE thanked Rep. Olberg for his astute observation
and asked him to continue.
REP. OLBERG made a motion to adopt Administration Amendment
1.
REP. BRICE objected for discussion purposes.
CHAIR BUNDE asked if all members were fixed on the correct
amendment and said that it is the second page of the
Administration hand-out, now labeled Administration
Amendment 1 (Amendment A.1)
Number 120
REP. BRICE said the amendments do not conflict conceptually
except that his amendment is more in depth than the
Administration Amendment 1. He urged that the commission be
established with a purpose and cited the many different
aspects of public health; i.e., clean water and sewer,
public health nurses, and maternal and child health care.
He said he had no problem with Administration Amendment 1,
but it should give focus and direction to the commission.
REP. G. DAVIS agreed and said it would be beneficial to give
as much direction as possible to the commission. He said he
would have faith in the commission that they would carry out
all the provisions within Rep. Brice's amendment.
REP. OLBERG suggested adopting Administration Amendment 1 in
its entirety because it only conflicts in one area with Rep.
Brice's Amendment 2. He said then it could be set aside and
they go on to Administration Amendment 2 and compare it to
the adopted amendment.
CHAIR BUNDE, for clarity, reiterated Rep. Olberg's
suggestion. The committee agreed to proceed accordingly.
REP. NICHOLIA concurred and said that Rep. Toohey's and
Commissioner Usera's amendments were basically the same.
CHAIR BUNDE asked for further discussion. He said the
motion to adopt Administration Amendment 1 was before the
committee. He asked for any objections.
REP. BRICE objected.
Number 268
CHAIR BUNDE called for the vote. Reps. G. Davis, Vezey,
Olberg, B. Davis, Nicholia, Toohey, and Bunde voted Yea, and
Rep. Brice voted Nay. Chair Bunde declared that
Administration Amendment 1 was so moved. He then brought
Administration Amendment 2 to the table.
REP. OLBERG said, "I'd like to get on the record, Mr.
Chairman, the fact that that could have been the pinnacle of
my legislative career right there."
REP. B. DAVIS said, "We better discuss this, so that we have
the intent fully on the record."
Number 312
COMMISSIONER USERA stated that there is concern that HB 414
does not specify a single payer system. She said many of
the amendments address issues that are implicit in the bill
and that the amendments would drive the costs up by being so
specific. She explained that Administration Amendment 2
specifies that one of the comprehensive reform proposals to
be analyzed by the commission would be a single payer
system.
CHAIR BUNDE asked for discussion. He asked for someone to
move the amendment.
REP. TOOHEY said it was so moved.
REP. OLBERG suggested to number all of the Administration
amendments at one time. He then specified Administration
Amendments 3-5 (or A.3 through A.5)
CHAIR BUNDE said Amendment A.2 was before the committee and
asked for further discussion.
Number 369
REP. G. DAVIS said it was his understanding that one of the
key health care reform proposals is a single payer system
and asked Commissioner Usera to address the issue.
COMMISSIONER USERA stated that she thought that option would
be implied in the process. She said, "If I may be frank;
this is politics. This is... Gee, it doesn't specify that
the current single payer system proposal would be one that
would be there... The outline in the governor's bill is that
the plans be evaluated with either those requested by the
governor or by a majority vote of the commission, who are
appointed by the governor, and that there might be some
political brinkmanship going on which would eliminate the
current single payer system as one of those being evaluated.
Certainly we didn't anticipate that kind of pettiness when
we did this, but if it makes people feel better, more
comfortable, that would be a serious consideration for this
commission. We felt it was worth putting in the bill."
Number 400
CHAIR BUNDE said, "New to the legislative process, are you?"
COMMISSIONER USERA said, "No, Sir. I love it."
REP. TOOHEY said the idea is fair because there are people
in the state that would like to see the single payer system
and others who would not.
REP. G. DAVIS asked how employer-based and HMO would be
protected without specifying their inclusion.
COMMISSIONER USERA replied that the DOA could try to
identify the key proposals, but it is difficult to
anticipate the end result of the various proposed plans, and
pointed out how dramatically the Clinton plan has changed in
the period of a month. She asserted that at least one
proposal based on a single payer strategy and at least one
based on a managed care approach would be reviewed by the
commission.
CHAIR BUNDE said, "I would just observe for the record that
this amendment does not indicate the single payer as the
program that would have the priority."
COMMISSIONER USERA said that is correct.
REP. B. DAVIS made a motion to adopt Amendment A.2.
CHAIR BUNDE, hearing no objections, said the amendment was
so moved. He indicated that there were witnesses on
teleconference that wanted to testify on the legislation in
general. He further indicated that there was a person on
teleconference from Seattle, Washington.
Number 430
STEVE LEBRAUN, Account Manager, Aetna Health Plan, testified
via offnet in support of HB 414. He stated that Aetna
carries the largest share of health insurance in Alaska
concentrated in benefits for larger employers in the public
and private sector. He said Aetna supports the general
direction of HB 414 because it provides for immediate and
achievable steps towards health care reform along with more
thorough analysis of structure, costs, and alternatives of
universal care. He stated that the alternative legislation
dismantles and throws out much of the current system and
leaves tremendous power to an appointed commission. He said
the federal health care plan is likely to pass congress and
many of the provisions would be mandatory in all states.
Individual employers should have the opportunity to review
and evaluate the most important details of health care
reform, costs, benefit level, impact on quality, and impact
on choice before having to decide whether to afford major
changes in the Alaska delivery system. He maintained that
many details of the proposals, both federal and state, are
not available and said there is no consensus on the best way
to change the current system to allow for universal and more
affordable health care.
MR. LEBRAUN further stated that he supported the requirement
for a single payer form and the creation of voluntary
purchasing pools for small employers and individuals. He
said the use of purchasing pools would address the
portability problems under the current system. He also
recommended purchasing pools be used for people in between
employment. He further recommended the use of electronic
filing systems and electronic medical records and billing
systems to reduce the "hassle factor" for consumers and to
improve data collection capabilities.
MR. LEBRAUN stated that the disclosure of provider rates
would better inform the consumer and would facilitate better
coordination of public health programs with emphasis on
preventive care. He indicated that the long term objective
for the commission would be to provide the simplest and most
cost effective means of providing universal care by
directing alternate benefit plans, ranging from catastrophic
care to comprehensive. The commission should estimate the
cost of each alternative and suggest the most appropriate
way to administer the plans. Mr. Lebraun suggested that if
federal health care acts pass this year, the commission
could also determine whether Alaska should take action. He
indicated that there are provisions within HB 414 regarding
the proposed form of rate regulation and the arbitration
section and Aetna was concerned about those issues. He said
that further commentary would be sent in writing upon
request to the committee regarding those issues.
Number 587
CHAIR BUNDE asked for the written commentary. He then asked
for teleconference testimony from BONNIE NELSON. There was
no response from teleconference. He then said that
Administration Amendment 3 (A.3) was before the committee.
REP. OLBERG made a motion to adopt Administration Amendment
3 and also pointed out that there are three proposed
amendments regarding page 5, line 6, and they are
conflicting. He indicated that he had carefully reviewed
the page and line references of all the amendments and
sorted out any conflicts.
CHAIR BUNDE asked Commissioner Usera to clarify a technical
amendment to her amendment.
COMMISSIONER USERA said the amendment is a list of what the
commission shall do and would add a new Section 7 after the
adoption of the first amendment and would be renumbered
accordingly.
Number 643
REP. BRICE said he did not see where his amendment and
Commissioner Usera's amendment were conflicting.
REP. OLBERG said that Administration Amendment 1 establishes
a public health advisory committee and Rep. Brice's
amendment establishes a public health improvement plan
advisory committee. He asked if the two were synonymous.
Number 657
REP. BRICE suggested that may be the same.
CHAIR BUNDE asked the members to address Amendment A.3.
REP. OLBERG stated that Amendment A.3 adds Section 7 to page
5 after line 6; but Amendment A.1 and Rep. Brice's amendment
conflict because they both establish a public health
improvement plan advisory committee.
COMMISSIONER USERA said Rep. Brice's amendment is not on the
table for discussion.
CHAIR BUNDE indicated that Amendment A.1 has been adopted
and asked for Rep. Brice to address his amendment.
REP. BRICE asserted that if his amendment was adopted it
would be Section 8.
REP. OLBERG maintained that all Amendment A.3 does is add
Section 7 to page 5, line 6.
COMMISSIONER USERA indicated that it is the DOA's intention
for the commission to collect information in aggregate from
providers who would by regulation be required to provide the
information in that form. She also said that the state
would need federal waivers because of some of the
confidentiality provisions in federal programs needed to
collect necessary information. She indicated that a fiscal
note of approximately $100,000 is associated with the
amendment, because to travel to Washington, D.C., costs
time, money and lawyers. She said the estimate came from
the Division of Insurance as what they felt it would cost to
obtain federal waivers.
Number 712
CHAIR BUNDE said, "We're looking at a program now that
costs... let's just round that off to $1 million."
REP. G. DAVIS asked Commission Usera if there is anything in
the federal health care proposals that might reduce or
eliminate the waivers.
COMMISSIONER USERA said she would defer to Deputy Commission
Jay Livey on that question.
Number 720
JAY LIVEY, Deputy Commissioner, Department of Health and
Social Services, testified on HB 414. He stated that the
federal waivers are ERISA (Employee Retirement Security Act)
waivers that state that states do not have the authority to
regulate people who self-insure. The amendment would allow
the state to obtain waivers so the proper information could
be obtained for those who are self-insuring. He was not
sure if this was relative to all the bills that address
comprehensive health care.
Number 740
REP. G. DAVIS said that federal legislation would amend
ERISA.
COMMISSIONER LIVEY agreed.
CHAIR BUNDE asked for further testimony or discussion on
Amendment A.3.
REP. B. DAVIS made a motion to adopt Amendment A.3.
CHAIR BUNDE, hearing no objections, said Amendment A.3 was
so moved. He then brought Administration Amendment 4 to the
table.
REP. OLBERG made a motion to adopt Amendment A.4 and
explained that it would add verbiage to four different
pages.
Number 764
COMMISSIONER USERA stated that pooling to provide insurance
coverage for children needed to be addressed and the
amendment addresses that concern.
CHAIR BUNDE asked for questions or objections. Hearing
none, Chair Bunde stated that Amendment A.4 had been
accepted. He then brought Administration Amendment 5 to the
table.
REP. OLBERG made a motion to adopt Amendment A.5.
Number 794
COMMISSIONER USERA addressed the amendment. She said there
is a need to ensure greater consumer participation in the
health care process and the intent of the amendment would
require providers to have a rate sheet for standard
procedures. Additionally, it requires, upon request of the
consumer, that a specific estimate be provided for the costs
based on an evaluation of the consumer's physical condition.
She said if the provider fails to comply and a complaint is
filed, an annual penalty of $500 would be charged to the
provider. She then said that once a penalty had been
enforced in a calendar year, the provider would not be
assessed any additional penalties. She maintained that
currently most providers have rate sheets, and only
penalizing one time for a considerable dollar amount would
help curtail providers from engaging in the appeal process.
TAPE 94-42, SIDE A
Number 000
CHAIR BUNDE asked if it would be the provider's
responsibility to inform the consumer that there is a rate
sheet.
COMMISSIONER USERA explained that there is a provision
within HB 414 that requires the provider to disclose to the
consumer that they are entitled to the rate sheet and
estimate information. It must either be posted or it must
be contained in some type of a disclosure form.
CHAIR BUNDE said it was his hope that people could look
after themselves.
COMMISSIONER USERA indicated that the amendment would read,
"A provider shall place the following statement either on a
form to be signed by the patient or in a conspicuous
location on an easily readable sign: You are entitled to a
charge estimate for a medical procedure before the procedure
is performed by your health provider."
Number 057
REP. TOOHEY said she would prefer to see a sign displayed at
the front reception area of a doctor's office. She said
there should also be a list of charges posted to make the
consumers aware of their choices.
REP. BRICE suggested that perhaps provider's rates could be
included in their advertising as well.
REP. OLBERG indicated that there are four references to page
7, line 22, interspersed among the submitted amendments. He
said two of the amendments are similar and two are not. He
suggested that if Amendment A.5 were adopted, then it could
be fine tuned with Rep. Toohey's Amendment 3, then Rep.
Brice's and Toohey's Amendment 4 could be included as
friendly amendments.
CHAIR BUNDE thanked Rep. Olberg for his guidance.
REP. B. DAVIS proposed an amendment to the amendment and
indicated that the language specifies up to $500, not a flat
$500 penalty. She said she would like the penalty to be up
to $1000.
COMMISSIONER USERA said she would consider it a friendly
amendment.
CHAIR BUNDE asked Rep. B. Davis to move the amendment.
REP. B. DAVIS made a motion to amend Amendment A.5 to change
the penalty to "up to $1000." She then specified the line
change in the amendment.
CHAIR BUNDE asked for questions, discussion, or objections.
Hearing none, Chair Bunde stated that the amendment to
Amendment A.5 was so moved. He then asked Rep. Toohey if
she would like to propose an amendment.
REP. TOOHEY stated that she would like to amend Amendment
A.5 to include a provision that would require the mandatory
posting of rates and estimates in the providers front
reception area.
COMMISSIONER USERA indicated that the change would go under
subsection A of the adopted Amendment A.5. She then
indicated that some practitioners would have to supply "a
blue book" of the costs, citing that they offer so many
different procedures. She said that the list could be
limited to the top 20 procedures or grouped by diagnosis
related categories. She then asked Rep. Toohey if it would
be practical.
Number 283
REP. TOOHEY agreed that it may not be practical, but there
should be a notice that indicates that prices are available
upon request.
COMMISSIONER USERA said that Rep. Toohey's proposed
amendment could be added to subsection C of Amendment A.5.
She said the phrase for a list of standard charges could be
added at the end of the subsection.
CHAIR BUNDE asserted that the language is redundant because
the consumer would be entitled to a charge estimate and
would also be entitled to a list of procedures. He asked
how many procedures would a consumer inquire about in one
day.
Number 330
REP. BRICE asked what the cost would be to have a data base
established where a consumer could call a state number, use
a touch-tone phone on a menu system to obtain information on
providers in specific areas, and then be transferred to a
voice mail box of a chosen provider who would then have a
menu system to provide procedural costs.
COMMISSIONER USERA stated that there is a provision in an
alternative bill that requires the rates to be reported to
the commission. She said her amendment would not require
that and the fiscal note associated with it would be
astronomical.
REP. BRICE said he knows that the system is being used in
other states and that some one in the private sector is
profiting from it.
CHAIR BUNDE suggested that the list of rates for common
procedures be provided.
REP. TOOHEY said she withdrew her amendment.
Number 406
CHAIR BUNDE stated that Amendment A.5 was before the
committee and asked for a motion.
REP. B. DAVIS made a motion to adopt Amendment A.5.
CHAIR BUNDE, hearing no objections, announced that Amendment
A.5 was so moved.
REP. B. DAVIS asked if Rep. Brice's amendments were going to
be addressed.
REP. BRICE made a motion to adopt his amendment.
Number 421
CHAIR BUNDE asked Rep. Brice to speak to his amendment. He
then indicated that due to technical difficulties earlier,
teleconference testimony from Anchorage had been postponed
and proceeded to ask for teleconference testimony from
BONNIE NELSON.
Number 425
BONNIE NELSON, Representative, Alaska Public Interest
Research Group (AKPIRG), testified via teleconference on HB
414. She stated that AKPIRG supports a single payer system
and urged the committee to include the plan. She also said
that she would like to see the elimination of the
restrictions on preexisting conditions. She said she also
would like to see that type of discrimination eliminated
from private insurance companies. She indicated that the
Americans with Disabilities Act requires employers to hire
handicapped persons, but if the person is medically
expensive, their claim affects the businesses' premium rates
and she felt that it was unfair for both large and small
businesses.
MS. NELSON further stated that AKPIRG also recommends that
the commission be comprised of a broad range of consumers.
She said the Clinton proposal indicates that a commission
member may not have any official relations to companies or
providers that pose a conflict of interest, i.e. health care
providers and insurance companies. She continued to read
from the provisions in the Clinton proposal that specified
the varying types of conflicts of interest.
Number 604
CHAIR BUNDE stated that the committee had the information
that Ms. Nelson was reading from and thanked her for her
testimony.
REP. TOOHEY asked if Ms. Nelson was recommending that
commission members not be members of the medical community.
MS. NELSON said she was not recommending that they not be
from the medical community and suggested that a retired
doctor could participate as a member. She said there should
be no monetary conflict of interest. She felt there should
be persons with expertise, but conflicts of interests should
be avoided.
Number 635
REP. BRICE said, "...possibly on page 2, section B, to
alleviate the concerns of the department maybe we can... on
that line... state... the plan developed by the committee
under A of this section should recognize the need... to
probably take it down a step with a little bit... take it
down a step from shall and to make sure that there's a lot
of concern here to address these questions."
COMMISSIONER USERA offered language that she felt would
address the concern. She indicated that Amendment A.1,
subsection A, would be referenced to page 1, section A of
Rep. Brice's amendment. She said the sentence, "The
commission shall consider public and private health care
professionals, labor organizations, businesses, the
educational system, the Alaska Public Health Association,
the Alaska Mental Health Board, and the Alaska Native Health
Board to serve on the public health advisory committee as
well as recognizing the need for geographic, ethnic, and
cultural diversity..." would be inserted at the end of the
subsection.
REP. BRICE said the language was acceptable to him.
Number 699
CHAIR BUNDE asked if the change was too much to be a
technical amendment or is it an amendment to the amendment?
REP. BRICE suggested that it would be an amendment to the
amendment.
CHAIR BUNDE asked if Rep. Brice would propose that
Amendment A.1 be amended with the aforementioned language.
REP. BRICE said, "So moved."
CHAIR BUNDE asked Commissioner Usera to repeat the language.
COMMISSIONER USERA said in Amendment A.1, Section 6,
subsection A, line 3, after the period following the word
commission, the following sentence would be inserted: "The
commission shall consider public and private health care
professionals... and the Alaska Native Health Board to serve
on the Public Health Advisory Committee as well as recognize
the need for geographic, ethnic, and cultural diversity."
CHAIR BUNDE stated that the motion was before committee. He
asked for discussion or objections. Hearing none, Chair
Bunde indicated that the amendment to Amendment A.1 had been
adopted.
Number 732
COMMISSIONER USERA suggested an amendment that would add
subsection C to Amendment A.1. She said, "...establish a
public health advisory committee which... there would be a
subsection C... may develop a public health implementation
improvement plan... which (1) recognizes the need for...
goes down as is included in Rep. Brice's amendment. And,
(2) may include... and the rest of that section remains the
same."
REP. BRICE made a motion to adopt the proposed amendment to
Amendment A.1.
CHAIR BUNDE, hearing no objections, stated that the
amendment was so moved. He then said he hoped to see the
revised workdraft before the next meeting and suggested that
the committee would further discuss the bill before passing
it out of committee.
COMMISSIONER USERA indicated that the department would
update fiscal notes accordingly to accompany the new
committee substitute (CS).
REP. TOOHEY reminded all those present that there would be a
meeting on Saturday, March 12, 1994 to further discuss and
work on HB 414.
Seeing no further business before the committee, CHAIR BUNDE
ADJOURNED meeting at 4:43 p.m.
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