Legislature(2021 - 2022)DAVIS 106
03/01/2022 03:00 PM House HEALTH & SOCIAL SERVICES
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Audio | Topic |
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Start | |
HSCR2 | |
Confirmation Hearing(s):|| Alaska State Medical Board | |
Adjourn |
* first hearing in first committee of referral
+ teleconferenced
= bill was previously heard/scheduled
+ teleconferenced
= bill was previously heard/scheduled
+= | HSCR 2 | TELECONFERENCED | |
+ | TELECONFERENCED | ||
+ | TELECONFERENCED |
HSCR 2-DISAPPROVING EXECUTIVE ORDER 121 3:13:24 PM CO-CHAIR ZULKOSKY announced that the first order of business would be HOUSE SPECIAL CONCURRENT RESOLUTION NO. 2, Disapproving Executive Order No. 121. 3:14:19 PM CO-CHAIR ZULKOSKY opened public testimony on HSCR 2. 3:14:55 PM MARIANNE MILLS, President, AGEnet, testified that AGEnet took a position to support [Executive Order 121], which would reorganize the Department of Health and Social Services (DHSS). She reported that currently DHSS has a budget the size of 12 other departments, with a staff tally equaling six departments, and a team of 5 manages 3,500 employees. She posited that narrowing the scope of the agency would improve its ability to effectively serve Alaskans. She asked the committee to oppose HSCR 2. 3:16:28 PM BOB PAWLOWSKI, Chair, Alaska Pioneer Homes Advisory Board, testified that there is a $23 million deferred maintenance backlog for the Pioneer Home program, and he shared his belief that the program would be better served by being under a smaller department. He added that dividing the department [as would happen under EO 121, which HSCR 2 seeks to stop], would be beneficial for the health and safety of the residents and employees at the Pioneer Homes. 3:17:40 PM JULIE SMYTH, representing self, testified in support of HSCR 2. She stated that she receives services through DHSS and has not received any information from the department about how dividing the department would change those services. She opined that the process to split DHSS should be stopped until such questions are answered. 3:18:46 PM ANDREE MCLOUD, representing self, testified in support of HSCR 2 as someone who cared for a person who received benefits from DHSS. She argued that the executive order did not "pass muster" and would upend the lives of many [vulnerable] people as well as legislative authority. She spoke to points of concern she had after listening to previous presentations from DHSS. Presenters from DHSS had listed collaboration between departments to lower costs through economy of scale purchases, and she questioned why they were not already doing so. She mentioned that the division directors reported a need to "clamor for the commissioner's attention" as a large reason for dividing DHSS, and she argued that the commissioner should be able to handle the requests without needing to create an entire new department. She reported that there was a lack of input from the Alaskans that rely on the services provided by DHSS and quoted Commissioner Adam Crum as saying that informing recipients of the change was "not required." She referenced past department initiatives such as the Wellpath rollout and the Medicaid adult dental preventive program, which she described the department as having "messed up," and she questioned whether that was the leadership that should oversee the creation of a new department. She insisted that the legislature should intervene in the governor's plan as it would create "chaos" for the most vulnerable Alaskans. 3:22:14 PM ROBIN O'DONOGHUE, Policy & Communications Manager, Alaska Public Interest Research Group, testified in support of HSCR 2 and cited lack of public participation as one of the largest issues. He reported that there was a consensus that DHSS had many problems, but it was unclear if bifurcation would solve them. He said that high expense and creation of 13 new positions when the state was in a fiscal and employee deficit was troubling. He stated there had been a lack of communication between the department and its beneficiaries, especially when there have already been big changes in how Alaskans navigate their services due to COVID-19. He characterized the department's testimony about the proposal as confusing. He opined that the department to be under-prepared to take on such an important split and that many of the issues could be resolved internally while maintaining one department. He expressed concern that following through with the executive order would create a bad precedent that the executive branch can reorganize large parts of the state government with little input from the public or the legislature, and he referenced a memorandum ("memo") from the legislative legal division that said the executive order was an example of overreach. He asked the committee to pass HSCR 2 to give more time to properly investigate the proposal. 3:24:40 PM LAURA BONNER, representing self, testified in support of HSCR 2 and mentioned that she had a disabled adult daughter who received many services from DHSS. She believed that the governor and commissioner have not provided enough compelling evidence for why the split should happen at this time. She stated that it was a huge and costly decision and should receive more input from the legislature and the community before going forward. She emphasized that the timing was not right and that a change this large should not be considered at the end of the governor's term. 3:26:42 PM MIRANDA WALSO, Executive Director, Governor's Council on Disabilities & Special Education, testified in opposition to HSCR 2. She stated that to solve the issues DHSS was facing, the state needed to increase its capacity at the highest levels. She shared her belief that "things aren't getting better" and that a larger change would be required. She opined that the expansiveness of the regulations and services provided was too diverse for one small group of people to handle, and there was a pressing need to increase oversight. 3:28:36 PM ED MARTIN, representing self, testified in support of HSCR 2. He opined that splitting a department would not be cost- effective. He questioned the zero fiscal note associated with the executive order and stated that there would have to be an addition of government positions either now or in the future, which would cost the state money. He shared his concern over how DHSS handled the COVID-19 crisis and stated that "this whole department under [Commissioner] Crum has been out of control for two years." He shared his belief that splitting the department would lead to more opportunity for the department to "steal liberties" from Alaskans. He urged the committee to stop the governor's "overreach" by passing HSCR 2 out of committee. 3:30:35 PM CO-CHAIR ZULKOSKY, after ascertaining there was no one else who wished to testify, closed public testimony on HSCR 2. 3:31:00 PM REPRESENTATIVE FIELDS stated that he was personally against the bifurcation due to not enough collaborative stakeholder engagement and the lack of an accompanying bill. He expressed a need to make sure there was proper legislation for this departmental change so that there was not a precedent for the executive branch to rewrite large sections of statute through an executive order. He opined that there needed to be more time and thought put into the bifurcation process, and he advised that a bill should be drafted for the next legislative session, under the governor at that time. He emphasized the importance of ensuring a balance between the powers of the legislative and executive branches. 3:32:47 PM REPRESENTATIVE MCCARTY commented that a common theme in the discussions about the issues within DHSS was its management. He shared how his personal experience working in health care has left him very disgruntled about the management of the department he has seen over the years, which he said has been mirrored in the overall discussion. He said that the question was not whether there are issues but how to fix them. He mentioned several of the areas where DHSS has been struggling. He shared that he was not opposed to bifurcation but would want to see it accompanied by measurable goals for growth that show results within a year. He stated that it was within the power of the committee to create a bill that year to clean up the language of the executive order and ensure it was moving toward the goal of serving Alaskans. 3:36:07 PM REPRESENTATIVE SPOHNHOLZ expressed agreement that there are many issues in DHSS and that the department needs more capacity, but she stated that the stakeholder engagement has been lacking. She reiterated that engagement has been one-way, with stakeholders feeling as though they were "essentially informed" that there would be a division of the department, but that their input on reorganization was not being considered. She argued that the current offer was an incomplete package - an executive order without companion legislation, which she described as "absolutely necessary" for the success of the reorganization. She posited that the executive branch did not submit the companion legislation out of fear that the bill would be "Christmas treed," but said it was her position that if adequate stakeholder engagement had occurred, then there would have been a lot of consensus and support for the executive order and its legislation within the legislature. Instead of collaboration, she reported hearing from people within the health care community who fear that their relationship with the administration and their mission within their work would be jeopardized if they spoke candidly on the subject. She stated that this is a problem because these community members run the "mom and pop" or non-profit organizations that provide most of the services that DHSS funds, and she explained that they cannot do their work if they have a bad relationship with the department. REPRESENTATIVE SPOHNHOLZ characterized the proposal from the administration as "half-baked" and said that by presenting it without legislation, the governor was forcing the legislature to fix the issues itself or even draw out the transition process another year while creating the legislation. She stated that transitions are already difficult but can be improved with solid stakeholder engagement and an idea of what it will look like at the end. She said that what the legislature was currently presented with was a transition that would be "a slog without a clear vista," and it is not clear what the state would be getting out of it. She stated that she supported passing HSCR 2 to reject the executive order and approach the issue slowly and methodically, with deep stakeholder engagement, and she mentioned the $500,000 budget amendment to do more robust engagement over the next year. She recommended that the legislature invest in this approach because it would be a smoother process that would yield a better product overall. 3:42:03 PM REPRESENTATIVE PRAX spoke in opposition to HSCR 2 and stated that the problems with the department have been known for over a decade and that there had been as much research as there was time for, so now the state needed to make a decision and move on. He opined that the amount of work and detail put in by the administration has been robust and included input from employees within the organization from over many years. He posited that the preparation was as good as it was going to get, and that there was more risk in not following the executive order than there was in following it. 3:43:58 PM REPRESENTATIVE KURKA asked whether Mr. Dunmire from Legislative Legal Services was still on the line for questions. REPRESENTATIVE ZULKOSKY confirmed that Mr. Dunmire was available. REPRESENTATIVE KURKA voiced his understanding that the Constitution of the State of Alaska does give the governor the ability to split departments using an executive order, which would automatically involve changing the statute. He asked Mr. Dunmire if it would be possible to divide such a large department through executive order without making policy calls and changing statute. 3:46:52 PM ANDREW DUNMIRE, Legislative Counsel, Legislative Legal Services, Legislative Agencies and Offices, opined that it would not be possible to split a principal department by executive order without making policy changes through the process. REPRESENTATIVE KURKA stated that the memorandum ("memo") that Legislative Legal Services created addressed several sections in the executive order that included unnecessary policy changes, and he asked Mr. Dunmire to point these sections out. He specifically mentioned Section 27 and asked for more information about the Alaska Statues that would be changed by that section. MR. DUNMIRE explained that during the drafting of the memo, he compared each line of the executive order with existing statute and made note of every policy change he saw, which were all included in the final memo. He addressed Representative Kurka's question about the policy change made under Section 27, which decided that the new Department of Health (DOH) commissioner would sit on the board of the Alaska Mental Health Trust Authority (AMHTA). However, he explained that the executive order also decided that the Alaska Psychiatric Institute (API) would be overseen by the Department of Family Services (DFS), meaning that the commissioner who oversees that program would not have input into its regulatory board. He deferred to the legislature to decide whether the policy changes he found were unnecessary. 3:51:42 PM CO-CHAIR SNYDER expanded on Representative Kurka's question and stated it was a valid line of questioning that had been touched on in previous testimony from the Department of Law (DOL) and Legislative Legal Services. She reported that reorganization and reassignment of a department through an executive order was legal, but expansions or shrinking of authority were a gray area. She mentioned that most of the issues were around "problematic" wording that left too much open to interpretation and listed board membership and areas of authority as two areas of concern, but she said that these could be fixed with a piece of companion legislature. She stated that legality aside, it was now "in the legislature's court" to decide how to proceed with the proposed bifurcation. She emphasized her commitment to improve the functionality and oversight of the department and her gratitude towards DHSS for the work accomplished so far. However, she insisted that it was part of the committee's responsibility to give the executive order due diligence and that she continued to have several questions about moving bifurcation forward that did not seem to have answers, which she stated was a concern. CO-CHAIR SNYDER cited continuous budget cuts to the department since 2015 and opined that the state "shouldn't be terribly surprised" about the persistent challenges the department was facing. She listed workforce burnout, low rates of recruitment and retention, and aging technological infrastructure as issues that can be directly tied to DHSS budget volatility. She agreed with Representative Prax's point that the issues are known and further research into that was not needed but argued that the proposal to bifurcate and add more positions would not solve the identified problem. She emphasized the point made by other members of the committee about the precedent that the executive order would set and added that the legislature should consider that precedent fully. She concluded by reiterating her support for HSCR 2 and stated that moving it through in a timely manner would allow the legislature to keep all its options on the table to ensure it practices due diligence before enacting this change. 3:59:05 PM CO-CHAIR ZULKOSKY opined that the discussions around the executive order revealed that a solution to the many programs that are in crisis was crucial, as many of the stakeholders were among Alaska's most vulnerable populations. She expressed that DHSS had done an incredible job in demonstrating its many needs in terms of providing services, but that she had not been convinced that the executive order was the best solution. She echoed the concerns of Legislative Legal Services that the legal and fiscal ambiguities of the executive order could negatively impact the future of the legislature as an institution. She considered the 60-day deadline for a response on the executive order as an inadequate amount of time to fully consider the legal precedent, especially regarding the potential for executive branch overreach. CO-CHAIR ZULKOSKY returned to the topic of the executive order's constitutionality and highlighted that the Legislative Legal Services' memo revealed that there was very little authority on the permissible scope of an executive order. She emphasized that EO 121 dwarfs previous executive orders in size and scope; allowing it to go into effect would signal that a reorganization of this size was permissible and would cede a large portion of the legislature's policy-making power to the executive branch. She stated that legislative powers were bestowed solely on the legislature by Alaska's constitution and that she was unable to separate the incredible work DHSS has done from her concern about the possibly substantive changes to statue included in EO 121 when Legislative Legal Services has advised that a bill would be a more appropriate way to enact the governor's proposal. She added that allowing the executive branch to usurp the legislatures powers, whether intentional or not, would violate constitutional checks and balances. CO-CHAIR ZULKOSKY, having looked back at the last three fiscal years, reported that the legislature had cut $30 million from a number of DHSS divisions through the elimination of many "front- line" service delivery positions. These cuts were made in favor of six figure salaries and additional overhead in the creation of a new commissioner's office, which was not a fiscal or policy choice she supported. She expressed concern that if the state were not able to deliver on the promise of a seamless transition during bifurcation, then it would lead to the addition of positions and massive unforeseen expenses that future legislatures would have to address. She expressed her support of moving HSCR 2 out of committee through a summary of her concerns and stated that moving the resolution would promote further dialogue within the legislature about this multi-faceted issue. 4:06:10 PM CO-CHAIR SNYDER moved to report HSCR 2 out of committee with individual recommendations and the accompanying fiscal notes. 4:06:31 PM REPRESENTATIVE PRAX objected. 4:06:36 PM A roll call vote was taken. Representatives Spohnholz, Fields, Kurka, Snyder, and Zulkosky voted in favor of the motion to report HSCR 2 out of committee with individual recommendations and the accompanying fiscal notes. Representatives McCarty and Prax voted against it. Therefore, HSCR 2 was reported out of the House Health and Social Services Standing Committee by a vote of 5-2.
Document Name | Date/Time | Subjects |
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David Wilson, Medical Board.pdf |
HHSS 3/1/2022 3:00:00 PM |
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Matt Heilala, Medical Board.pdf |
HHSS 3/1/2022 3:00:00 PM |
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EO 121, Letters of Support, 2.28.22.pdf |
HHSS 3/1/2022 3:00:00 PM |
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AMHB.ABADA EO 121 LOS Final.pdf |
HHSS 3/1/2022 3:00:00 PM |
EO 121 |
HSCR 2, Fiscal Note.pdf |
HHSS 3/1/2022 3:00:00 PM |
HSCR 2 |