Legislature(2021 - 2022)BUTROVICH 205
02/04/2021 01:30 PM Senate HEALTH & SOCIAL SERVICES
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| Audio | Topic |
|---|---|
| Start | |
| SB56 | |
| Adjourn |
* first hearing in first committee of referral
+ teleconferenced
= bill was previously heard/scheduled
+ teleconferenced
= bill was previously heard/scheduled
| + | TELECONFERENCED | ||
| += | SB 56 | TELECONFERENCED | |
SB 56-EXTENDING COVID 19 DISASTER EMERGENCY
1:32:50 PM
CHAIR WILSON announced the consideration of SENATE BILL NO. 56
"An Act extending the January 15, 2021, governor's declaration
of a public health disaster emergency in response to the novel
coronavirus disease (COVID-19) pandemic; providing for a
financing plan; making temporary changes to state law in
response to the COVID-19 outbreak in the following areas:
occupational and professional licensing, practice, and billing;
telehealth; fingerprinting requirements for health care
providers; charitable gaming and online ticket sales; access to
federal stabilization funds; wills; unfair or deceptive trade
practices; and meetings of shareholders; and providing for an
effective date."
CHAIR WILSON relayed his intent to let the department finish its
presentation, hear invited testimony, and begin public
testimony. He listed the individuals who were available to
answer questions.
1:35:44 PM
ADAM CRUM, Commissioner, Department of Health and Social
Services (DHSS), Anchorage, Alaska, shared that nobody was happy
to be here to address this issue after a full year, but they
would talk about why the authorities were needed to continue the
response and bring the state across the finish line. He turned
the presentation over to Bryan Fisher to give an overview of the
Disaster Act.
1:36:29 PM
BRYAN FISHER, Operations Manager, Department of Military and
Veteran Affairs, Eagle River, Alaska, said he is currently
serving as incident commander for the state COVID-19 unified
command. He displayed slide 4, Overview of the Alaska Disaster
Act. He shared that these are the laws that provide the
authority and responsibility for government to respond to
disasters, emergencies, and catastrophes that may occur in the
state and affect the citizens. It is the baseline statutory
authority to respond to emergencies. He noted that the slide
describes the purpose of the Disaster Act is described in the
slide.
MR. FISHER stated that slide 5 is in response to a question from
the last hearing about the definition of disaster in AS
26.23.900(e). "Disaster" means the occurrence or imminent threat
of widespread or severe damage, and in particular to this, an
outbreak of disease or a credible threat of an imminent outbreak
of disease that the commissioner of DHSS certifies as having a
high probability of occurring. The certification must be based
on specific information received from a local, state, federal,
or international agency, or another source. At the beginning of
the pandemic and continuing through today, the state utilized
information that came out in winter of last year. Specifically,
the World Health Organization (WHO) on January 30 designated
that the outbreak of SARS-CoV-2 and COVID was a public health
emergency of international concern. He said the state utilized
that international agency to make that certification. Following
that, the Secretary of Health and Human Services for the United
States government declared a national public health emergency on
January 31. On March 11 WHO declared COVID-19 a global pandemic
and on April 9 President Trump declared a major disaster for the
state of Alaska as a result of this pandemic. That certification
was based on credible information from those agencies. The state
continues to receive lots of information, primarily from the
federal government, Health and Human Services, and the Centers
for Disease Control and Prevention (CDC) on the characteristics
and nature of this pandemic.
MR. FISHER stated that AS 26.23.020(c) allows the governor to
declare a disaster when that certification is made. That
particular citation also explicitly states that the legislature
has the authority to extend the disaster beyond 30 days, which
is why SB 56 is in front of the committee. A couple of the key
points in AS 26.23.020 are subsection (e) that addresses the
response and recovery aspects and specifically provides the
authority for the deployment, distribution, and use of supplies,
including medicine; and subsection (g) that has provisions to
specifically allocate or redistribute food, water, fuel,
clothing, medicine, and supplies. The state is relying on those
authorities today for the response, particularly for the vaccine
and therapeutics.
1:41:08 PM
MR. FISHER explained that Sections 26.23.060 and 26.23.140 of
the Disaster Act speak to the authorities and responsibilities
of local governments. The statutes state that DHSS is there to
serve local communities, but it does provide for specific
responsibilities and authorities of local government. For
example, municipalities and political subdivisions can make
their own disaster declarations and implement their own measures
to respond to the outbreak.
MR. FISHER said that to address something that came up
previously, AS 26.23.025 addresses the responsibility of the
legislature in disasters. Subsection (c) of that statute says
the legislature may terminate a disaster emergency at any time
by law.
MR. FISHER explained that AS 26.23.020(g)(1) is the governor's
authority to waive and suspend regulations that may impede or
hinder the state's ability to respond. Many items in the bill
address those specific abilities to suspend regulations to allow
the state to continue to provide an effective response for the
communities and citizens throughout the state. Additional
statutory language allows for the Emergency Management
Assistance Compact, an interstate treaty with all the states in
the nation to provide mutual aid support as needed. If the state
were to need additional resources from the lower 48, a disaster
declaration needs to be in place in order to do that. The
majority of the Disaster Act and the authorities for declaring a
disaster are time limited. The act allows for the temporary
changes to make an effective response. AS 26.23.020 (f) and AS
26.050.70 speak to the governor's role and his authorities to
use the National Guard in support of a declared emergency. The
state is using the great men and women of the Alaska National
Guard in the pandemic response and hope to continue to do that
throughout the pandemic.
COMMISSIONER CRUM said that in the interests of time and to able
to proceed to a discussion as to why an extension is proposed,
he would advance to slide 13. He turned the presentation over to
Director Hedberg.
1:45:10 PM
HEIDI HEDBERG, Director, Division of Public Health, Department
of Health and Social Services (DHSS), Anchorage, Alaska, said
she would address what the public health emergency authorities
have allowed her agency to do, as shown on slide 14, why her
agency needs to continue, and what will happen if an emergency
is not in place. When there is transmission of a new, very
contagious, infectious disease in Alaska, immediate assistance
to the public is needed to keep illness and death at bay. This
assistance can only happen by declaring a public health
emergency. States that acted early and quickly by setting up
testing sites, establishing robust contact tracing processes,
disseminating information, responding to public concerns,
expanding healthcare capacity, standing up large mass
vaccination sites, and remaining consistent by not letting the
foot off the pedal have lower case numbers, lower death rates,
and lower hospitalizations vs. other states that were slow to
act. Without the ability to be nimble and respond to imminent
threats to Alaskans, the state would not be ranked as the number
one safest state based on lowest deaths, lowest
hospitalizations, lowest case counts, and highest vaccination
rates in the United States. Alaska is also second in the nation
in testing per capita.
1:46:39 PM
SENATOR COSTELLO joined the meeting.
MS. HEDBERG explained that this will change if the state does
not have the ability to respond quickly to requests for support
from the healthcare system and communities. One tool that the
declaration allows is continued use of more efficient
procurement processes. DHSS' standard procurement process is to
follow the invitation for bid or request for proposals as
outlined in AS 36.30.110 and AS 36.30.210. This process can take
between 30 days to six months, depending on the complexities of
the proposal. The public health emergency gives the authority to
use emergency procurement followed up with a competitive bid
process for long-term contracts. This is critical when
hospitals, skilled nursing facilities, and communities do not
have or have exhausted their resources and are looking to the
state for help. Slide 14 recognizes that DHSS would not have
been able to accomplish all that it did without a public health
emergency. Emergency procurement followed with a competitive bid
process for long-term contracts is what separates Alaska from
the other states. Alaska acted quickly to contain the
transmission of COVID. The successes of the response are a
direct result of the authorities within the disaster
declaration. The state needs to continue to be nimble in its
response so that the state can continue to do the right thing
now to prevent further spread of COVID. The nature of the
response has changed over time as the state has built up
response capabilities. The fact is that the state is still in
emergency and must continue to act to protect the public health
and safety of all Alaskans.
MS. HEDBERG shared that of the items on slide 14, she wanted to
highlight that this spring when hospitals, skilled nursing
facilities, and communities could not procure PPE (personal
protective equipment), testing supplies, or hand sanitizer, they
looked to the state to step in and respond. A year later
healthcare facilities are still experiencing some supply chain
constraints due to global impacts of COVID. Additionally,
treatment options are continually being researched in both
outpatient and hospital settings. The one fully approved COVID-
19-specific option is remdesivir. It is an antiviral medication
that is used in a hospital setting for severe illness. The FDA
(U.S. Food and Drug Administration) has issued two emergency use
authorizations for two monoclonal antibodies that are used on
outpatient settings to treat COVID within the first 10 days of
diagnosis. The state does not prescribe treatment options but
does help allocate the scarce resources of monoclonal
antibodies. This disaster declaration provides the state with
the tools to support allocation of scarce resources, such as
medicine to treat those infected and vaccinations.
1:49:50 PM
MS. HEDBERG said that last summer, before tourism season
started, people wanted reassurance that the state was protecting
Alaskans and preventing the healthcare system from being
overwhelmed. Knowing that travelers were one of the main avenues
for COVID to enter Alaska via airports, the state quickly set up
testing and screening for airports that received flights from
the lower 48. This could not have worked without partnerships
with communities and emergency procurement. The state was able
to successfully set up testing and screening at the 10 airports.
She wanted to highlight that since June 6, the state has
screened 471,884 traveler, tested 162,055 travelers at the
airports, and identified 2,355 positive cases. In identifying
those positive cases at the airport, testing has allowed the
state to curtail community transmission. This was instrumental
in keeping Alaska's positive case count low, the lowest in the
country.
MS. HEDBERG stated that when Alaskans want up to date
information on what is happening in their communities and in the
state, they look to DHSS for accurate and timely information.
This is why DHSS created the COVID case count dashboard and the
vaccine dashboard, so that everyone can have access to the same
information. DHSS could not have stood up the dashboards as
quickly as it did without the ability to secure contracts and
hire additional staff. DHSS was overwhelmed last spring and
continues to receive many questions about COVID. DHSS partnered
with the University of Alaska Anchorage (UAA) Center for Human
Development to create a large, virtual platform called Project
ECHO to provide updates. Since March, DHSS has had 362 ECHO
sessions that covered 24 topic areas in four broad categories of
medical, education, community, and government. That were 66,419
attendees via zoom and over 96,000 via Facebook. All sessions
are recorded for those not able to attend live sessions; DHSS
has seen 37,419 views of recorded sessions. This is important
because it provides a consolidated format to reach all Alaskans,
regardless of where they live, to hear the latest in science-
and evidence-based information.
MS. HEDBERG moved to slide 15. She explained that AS 26.23.020
gives DHSS the authority to allocate scarce resources, to
rapidly engage in contracts to respond to new outbreaks, to
continue testing, and to sequence positive specimens. Sequencing
positive specimens is critical to identifying when variants
enter Alaska, so that DHSS can notify Alaskans, understand the
epidemiological impacts, and respond accordingly. As seen in
other countries, a variant can accelerate transmission and
increase the severity of the disease. This is why DHSS is
focused on vaccinating the most vulnerable Alaskans first to
reduce the severity of the disease and the transmission.
1:53:38 PM
MS. HEDBERG concluded with four points. Without the public
health emergency, the state is extremely limited in how it
responds to the pandemic. Without the public health emergency,
DHSS is concerned about the ability to allocate scarce resources
like vaccines and monoclonal antibodies. Third, without the
public health emergency, there is no centralized management to
allocate scarce resources, which jeopardizes the state's vaccine
administration framework. Fourth, without the public health
emergency, communities without local health powers will be left
behind and limited with no support. Again, without the ability
to be nimble and respond to the imminent threats to Alaskans,
the state would not be ranked as the number one safest state
based the lowest deaths, lowest hospitalizations, lowest case
counts, and highest vaccination rates in the United States. The
state is also second in the nation for testing per capita. This
will change if the state does not have the ability to respond
quickly for requests for support from the healthcare system and
communities. Passage of SB 56 is critical to continue to provide
statewide response to COVID-19 and to address vaccinations and
therapeutics in the coming months. This bill provides a time-
limited extension to the public health emergency, which
continues to be an imminent threat to the citizens of this
state. Everyone is exhausted from this virus. It has been a long
year and everyone has been impacted, one way or another. This
extension is necessary to get Alaskans vaccines and therapeutics
and for the health and wellbeing of all Alaskans.
COMMISSIONER CRUM thanked the committee for giving DHSS the
opportunity to present this case.
CHAIR WILSON stated that the Department of Education and Early
Development (DEED) wanted to share what the disaster declaration
means for the department in how it affects carryover funding for
schools.
1:56:49 PM
HEIDI TESHNER, Director, Finance and Support Services,
Department of Education, Juneau, Alaska, explained that the
waiver put in place under the current disaster declaration was
for FY2020, which was the 2019/2020 school year. Now that
schools are in FY21, without a disaster declaration, the
governor would not have the ability to temporarily suspend the
10 percent carryover limitation set out in statute.
SENATOR BEGICH said Ms. Hedberg answered most of his questions
by expressing how important expedited procurement issues are for
vaccinations. He asked if it is correct that DHSS's ability to
get the 100,000 vaccinations that might be available soon to the
public who wish to have them would be hampered without the
expedited procurement.
MS. HEDBERG answered that procurement is essential for a timely
response to supporting the healthcare community and the
community at large. DHSS is concerned that if the public health
emergency goes away it won't have the authority for
vaccinations. DHSS also won't be able to distribute those
logistically without expedited procurement.
SENATOR BEGICH noted that Ms. Hedberg had mentioned the
authority of other jurisdictions to do what they may choose to
do. He noted that right now, that only applies to home rule
communities and said he was proposing an amendment that will
allow other communities to exercise their own authority during
the pandemic. He asked if that would be a problem for DHSS.
MS. HEDBERG replied that DHSS recognizes that very few
communities have health powers and those communities look to the
state for coordination of resources in implementing and
utilizing mass vaccination sites. Director Fisher can answer
more specific questions.
2:00:38 PM
SENATOR BEGICH responded that that may have answered his
question. Under the older orders, there was worker compensation
coverage for first responders. DHSS testimony talked about
expedited licensing continuing. He asked if it would be contrary
to the intent of the extension of the order if a worker
compensation protection extension was also provided.
2:01:13 PM
COMMISSIONER CRUM asked if anyone at the Department of Labor
could answer the question about worker compensation.
SENATOR BEGICH responded that he would take the answer offline.
He noted that the bill has a retroactivity clause to February
13. It makes an assumption that the legislature may not get the
bill done by February 13, which implies a break in service
before this order is validated. He asked if screening and
testing at airports stop if an order is not completed and
approved by the legislature by that date. Conversely, if it is
completed by the end of February or early, he asked if there
will still have been a break in service or if there will be some
level of authority to continue testing at airports, while the
legislature waits for approval of an order. He said that
concerns him deeply, given the data presented and the actual
economic impacts if the state is no longer first in all these
great categories.
MS. HEDBERG responded that right now, current contracts will
cover the state for the next couple of months. Testing will
continue at airports but the health orders are tied to the
public health emergency. When there is a gap, those health
orders will have to change into possibly recommendations. The
state will see the impact during a gap in the public health
emergency with less compliance from travelers either coming into
Alaska or traveling out to remote communities. That is very
concerning because as she has mentioned, the state has been able
to capture and identify 2,355 positive cases through that
airport testing strategy, which has really helped the state to
contain and mitigate the spread of COVID.
SENATOR BEGICH said the retroactivity clause potentially creates
a problem, which can be discussed offline. If it becomes a
recommendation and then the order passes in early March and
becomes retroactive to February 13, there would be public
members believing it was a recommendation who are now under a
health mandate retroactively. He just wants to make sure the
legislature can do that legally and properly. That is the issue
he is bringing up.
2:04:27 PM
SENATOR HUGHES thanked those at the department who stepped up.
She was proud that in the national news the last few weeks,
Alaska was highlighted as far as numbers and containment. She
knows it has been a stressful year. She also has great concern
for the state. This morning there was news that the cruise
industry is not going to be coming to Alaska. The state economy
needs to be revitalized. The state is not sure about the Biden
administration when it comes to resource development. Just as
the state has learned about the impact on young people and other
population groups, she is concerned about the collective mental
state, emotional and health and psyche as far as what is going
to be happening in the year 2021. While she understands that
DHSS needs certain tools to do what it does, as she looks at the
list on slide 14, a lot of it has to do with having the funds to
be able to do things, to procure and distribute things. If the
legislature could give DHSS those specific tools without
extending the actual date, that would be good for the psyche of
the state to move on and start to recover. For example, allowing
school districts to carry more than ten percent carryover
funding could be fixed by statute. Many of the other things that
DHSS needs as tool could be fixed. She would like to be provided
a list of what laws the executive branch would be breaking to
accomplish the list on slide 14 if the legislature did not fix
them without actually extending the emergency declaration date.
CHAIR WILSON said he will ask the administration if it can
provide a list of all the statutes and regulations that have
been suspended or modified since the disaster and are currently
suspended. That would be helpful to the entire legislative body.
SENATOR HUGHES said that, for example, one item on the list of
what the disaster declaration authority allowed was a call
center to help answer questions. She is guessing there is no law
to prevent that as long as DHSS had funding. Some of the items
are not blocked by statute. She wants to know what particular
statutes would need to be changed for DHSS to have the tools
without the date extension.
CHAIR WILSON added along with the regulations that have been
suspended and any statutes that have been modified or suspended
since the beginning of the pandemic.
2:08:23 PM
SENATOR REINBOLD said she probably has a 100 questions and she
will go on as long as the chair permits. She asked Dr. Zink if
the mRNA is a new type of vaccine.
2:08:59 PM
ANNE ZINK, M.D., Chief Medical Officer, Division of Public
Health, Department of Health and Social Services (DHSS)
Anchorage, Alaska, replied that the mRNA COVID-19 vaccine is
new, but the platform has been under investigation and used for
about 15 years.
2:09:34 PM
SENATOR REINBOLD asked her to discuss the mRNA vaccines for
[SARS-CoV-1] past studies and what happened to the animals that
were in the study.
DR. ZINK replied that vaccinologists as well as immunologists on
the team can provide more information, but she is not a
vaccinologist or immunologist. She is aware of the studies but
does not have that information at her fingertips and would like
to provide that in writing.
SENATOR REINBOLD said, "You know what happened in those studies.
Can you just state it on the record, what happened with those
studies? If you don't, I will."
CHAIR WILSON noted that Dr. Zink said that she would provide the
information in writing.
SENATOR REINBOLD replied that she wanted a synopsis of what
happened in those studies in 2002 and 2005, but those were
stopped because animals were dying. Senator Reinbold said she is
not an antivaxxer, but she is concerned about this new type of
vaccine. It is strictly under emergency use authorization so she
has a constitutional responsibility, as all senators do, for the
public health of Alaskans.
SENATOR REINBOLD said, "That is where my heart is, I want
everyone to know. So, yes or no, Dr. Zink, are you requiring
informed consent as required by emergency use authorization for
each and every vaccination, this brand new mRNA vaccination that
still, in my opinion, [is] under trial and I read until two in
the morning last night about the Pfizer. Yes or no, are you
requiring informed consent each and every time one of these
quote unquote vaccines is administered?"
DR. ZINK replied that everyone who administers the vaccine gets
informed consent prior to administering the vaccine.
2:11:31 PM
At ease
2:13:50 PM
CHAIR WILSON reconvened the meeting.
SENATOR REINBOLD noted that Dr. Zink said those who are
administering the vaccine are getting informed consent. She
asked whether every patient receiving this vaccine is getting
informed consent.
DR. ZINK responded that the recommendation is that every
provider who is administering vaccines give informed consent to
every patient prior to giving the vaccine.
SENATOR REINBOLD asked if there have there been any adverse
reactions in Alaska. If so, she asked for a description. She
also asked if there have been any deaths with the Pfizer or
Moderna mRNA vaccination.
DR. ZINK replied that adverse reactions are not reported to the
state. They are reported to the CDC and federal government via
two different processes, VAERS (Vaccine Adverse Event Reporting
System) as well as the V-SAFE (Vaccine Safety Assessment for
Essential Workers). VAERS takes required reports from
clinicians, but patients can make reports as well. The CDC and
the FDA go through those reports and then contact the states if
there are any concerns about adverse reactions and/or deaths. To
date, the state has received two cases about concerns over
adverse reactions, both anaphylactic-type reactions. Those were
reviewed in coordination with the CDC and talked about publicly.
There are many other reports in VAERS, but they have not been
found to be causative or continue to be under investigation. To
date, there are no deaths associated with either the Pfizer or
Moderna COVID-19 vaccine in the United States.
2:15:40 PM
SENATOR REINBOLD responded that is amazing. She said she is
following COVID reactions online and in VAERS and that
contradicts what she is following online. She has a physician
looking into the VAERS data right now. She asked what Dr. Zink's
ultimate goal is in regard to the vaccinations. DHSS keeps
saying it is procurement of vaccines. She asked if vaccines can
be available in any other way, would they be available without
the emergency or is it all about rushing. She asked if the
ultimate goal is herd immunity and if Dr. Zink can guarantee
that she is getting immunity with these vaccinations with safety
and efficacy.
DR. ZINK answered that these vaccines have gone through all of
the normal safety protocols that are happening for any vaccines,
safety phase one, phase two, and phase three clinical trials.
DHSS continues to work carefully with the FDA and CDC to monitor
these. The goal is to make sure that Alaskans who choose to get
vaccinated have access to vaccines. DHSS is trying to get
vaccines available to any Alaskan who chooses to get vaccinated.
CHAIR WILSON said that Ms. Hedberg can answer the first part of
the question about what would happen in terms of vaccine
distribution and priority if the disaster declaration is not in
order.
SENATOR REINBOLD opined that Dr. Zink avoided all the questions.
Senator Reinbold asked what the ultimate goal is and what
happens to Alaskans who have had COVID and get a vaccination.
She asked Dr. Zink if she can ensure safety and efficacy with
these products.
CHAIR WILSON stated that the doctor could provide those answers
in writing. He wanted to move on to invited testimony. He asked
Ms. Hedberg to answer the question about what will happen if the
emergency order goes away in terms of availability and priority
of the vaccines.
MS. HEDBERG answered that DHSS needs the authorities of the
public health emergency to allocate scarce resource. Right now,
the vaccines are a scarce resource. There is not sufficient
vaccine to vaccinate everyone in Alaska or the United States or
the world who wants to be vaccinated. Therefore, the federal
government is allocating to each of the states pro rata vaccine
amount. It comes to the state. DHSS needs authorities from the
public health emergency to allocate to the communities. Without
that authority, the state is in a precarious situation when the
public health emergency expires.
CHAIR WILSON requested a written statement to answer Senator
Begich's question about what happens if the disaster lapses in
terms of allocation, what is at risk with the lapsed time. Chair
Wilson moved to invited testimony.
2:19:43 PM
MIKE COONS, President, Mat-Su Chapter, Association of Mature
American Citizens (AMAC), Palmer, Alaska, said he was speaking
for the majority of AMAC members. He is also on the Alaska
Commission on Aging. The commission supports all senior citizens
in Alaskans by supporting SB 56. He has approval from Robert
Coulter of the greater Anchorage AMAC chapter and Cheryl
LaFollette of the Fairbanks chapter to state that both chapters
are in full support of SB 56. That is the majority of over 500
chapter members. The extension of the emergency powers as
requested by Governor Dunleavy in SB 56 will have a huge impact
on the lives of more than 142,000 seniors in the state of
Alaska. This gives the governor and his administration the
ability to not only give COVID vaccines but the means to get
those vaccines to the citizens of Alaska, especially those
mature Alaskans who want to regain their freedoms and to be out
in the community and society. They have been told that this
virus is most deadly to seniors and for those with weakened
immunity. They were told to hunker down. Families were told to
protect their parents and grandparents, which was done with
social distancing. This meant no interaction with their parents
and grandparents. People were told to wear masks and now to wear
two. Seniors were asked to do many things by their leaders, from
the president to Governor Dunleavy to Dr. Zink and many others.
Mr. Coons repeated that they were asked, not mandated, like
those in New York, New Jersey, Anchorage, etc. Sadly, some of
those things were not based on solid science and have been
moving targets over the past year. However, the leaders did the
best they could based on the best information they were given.
They can play 20/20 hindsight all day, but by and large,
President Trump and governors like Governor Dunleavy, Noem of
South Dakota, DeSantis of Florida, etc., ensured that the
freedoms were protected as much as possible and any restrictions
vs. mandates were as short lived as possible. The direction of
the new president is not about freedom or freedom of choice. So
Alaska's governor, who values freedom, is needed even more. SB
56 continues to reduce procurement time for the much needed
logistical items to get the vaccine out. Mass vaccinations
throughout the state would not have been possible. Without it,
it is questionable if the state could continue to get vaccines
from the federal government, much less in the quantities needed.
Those in the lower 48 would get the vaccines over Alaskan
citizens. Alaskans cannot forget that the ability to get
therapeutics would be greatly impacted. New York and California
do not have enough beds. This is because they do not get out the
much needed therapeutics to those hospitals. The state of Alaska
does. Therapeutics are one of the major reasons Alaska has low
death rates and short-term hospitalization.
MR. COONS said that people can get infusions and not need a
hospital bed. In response to Senator Reinbold,
hydroxychloroquine has been available to his doctor from day
one. All that capability and more will be lost if SB 56 is not
passed, not to mention all the rules and regulations that have
been suspended and people can see they were not needed. Senator
Reinbold was chair of the committee to review rules and
regulations and repeal them. If she had the knowledge that the
state has now as to the wastefulness of those rules, she could
have had a greater impact all those years ago.
2:25:33 PM
CHAIR WILSON said the committee decorum is not to talk to
committee members directly in that manner.
MR. COONS apologized and continued to say that if anything
unforeseen comes up, the governor can use the tools to ensure
Alaskans are protected without denying freedoms. If the state
reaches the herd immunity goal of 70 percent with therapeutics
and vaccines, the governor could end the emergency powers far
sooner than September. This is not a means of denying liberties
and freedoms. It is a reasoned approach to work a problem with
the least impact on freedoms, liberty, the economy, and mental
health. Alaska need not be like the lower 48 or sadly, even like
Anchorage, to rid itself of this virus. Alaska can show the
lower 48 and the world that it has the means and the
determination to do this right. Please vote yes on SB 56. He
said he was available to take any questions.
SENATOR REINBOLD asked to respond to some things Mr. Coons said
about her.
2:27:14 PM
At ease
2:27:46 PM
CHAIR WILSON reconvened the meeting and recognized Jared Kosin.
2:27:56 PM
JARED KOSIN, President and CEO, Alaska State Hospital and
Nursing Home Association (ASHNHA), Anchorage, Alaska, said
Alaska's hospitals and nursing homes strongly support SB 56. In
response to a question that was asked in the previous meeting
and today, yes, the state does need a declaration in place and
no, while legislation can cover some provisions in SB 56, the
declaration itself is vital for healthcare resources and
flexibilities provided at the federal level. He wanted to
highlight some of the most stressful moments Alaska healthcare
providers experienced over the last year. They experienced a
glove shortage the week of October 12 with less than a two-week
supply and nearly ran out. That same week in October an assisted
living facility in Anchorage had no staff available to work. The
impossible scenario was to pull staff from another stressed
facility or send all the residents to the hospital, the place of
last resort. The week of November 13, over 530 caregivers were
out statewide. A hospital CEO with more than 30 years of
experience told him that the CEO had the hardest day of the
CEO's career from managing the influx of COVID patient
admissions with staff out. December 4, two months to the day,
had the peak number for COVID patients in hospitals. Of the 150
COVID patients, 117 were in Anchorage and the Mat-Su. On that
day, the state was down to five ICU beds, five, in the biggest
population center. Both Mat-Su Regional and Alaska Regional had
zero beds open. That same week a patient from rural Alaska was
transferred to Fairbanks. This type of transfer is unheard of.
It happened because the system was at its highest stress point.
By the numbers, Alaska is certainly better today than November,
but COVID is still here.
MR. KOSIN asked why the state needs a declaration and not just
legislation. Early in the pandemic the Center for Medicare and
Medicaid Services (CMS) issued 125 blanket waivers for 32
categories of healthcare services and provider type. These
waivers set aside or waived specific federal requirements for
operational flexibility. Here is ASHNHA's concern: at least 20
of the waivers are only valid if they are "not inconsistent with
the state's emergency preparedness pandemic plan." ASHNHA
believes that if the state no longer formally recognizes the
public health disaster emergency, then the blanket waivers will
be "inconsistent" with Alaska's pandemic plan and be void. There
would no longer be an emergency for which a plan is required. If
the state loses the federal blanket waivers, the consequences
will be real and significant. There would be no waiver of
provisions of the federal Emergency Medical Treatment and Labor
Act. For example, emergency rooms have with safety protocols. If
patients show up with flu-like symptoms to the ER, patients wait
in their cars so they can be safety screened and triaged without
exposing other patients. This would end because there would be
no waiver of environment of care standard for hospitals. For
examples, an alternate care site with 27 hard beds is active
today. The Alaska Airlines Center is another alternate care site
that is active for infusion therapy and vaccination. These would
close. A hospital constructed temporary walls around the COVID
unit, alternate entrances and egresses, with power supplies and
cords in place. All of these would be federal violations without
the waivers. Without the declaration, Alaska would presumably
lose support from the National Guard. Other states use the guard
for vaccine distribution. When Alaska gets larger supplies in
the coming months, the state may need the National Guard to
speed up vaccination. That is not possible without a
declaration. Alaska hospitals and nursing homes need a
declaration in place. This is an issue about access to federal
resources and flexibilities and certainty. It is not about
mandates.
2:33:19 PM
At ease
2:33:42 PM
CHAIR WILSON reconvened the meeting and recognized Michael
Bailey.
MICHAEL BAILEY, Deputy Executive Director, Hope Community
Resources, Anchorage, Alaska, said that he also served on the
board of the Alaska Association on Developmental Disabilities.
Everyone had hoped the pandemic would be over by now, but it is
not. He appreciates the guidance and leadership of DHSS. Alaska
has fared better than most of the states in the country. He also
thanked Governor Dunleavy for listening to DHSS and leveraging
his emergency declaration powers only to the extent necessary
with the measures described by Director Hedberg, flattening the
curve, allowing local community leaders to determine the
mitigation measures customized to their demographics, and for
maintaining some hospital capacity, even though it did get very
low.
MR. BAILEY shared that as home and community-based providers
went into the pandemic last year, they were braced for 40
percent mortality rates that had been seen in the lower 48 and
worked closely with the hospital association and the state to
ensure that frontline workers were considered key and essential
to mitigating the more devastating effects that could have been
expected in Alaska. Time is of the essence. This bill is a
vehicle to address provider concerns for the welfare and safety
of Alaskans if these current emergency declarations expire
February 14 without prompt legislative action. Vaccination
efforts have begun and Alaska leads the nation in per capita
vaccinations. It is essential that this momentum is perpetuated
into and throughout the summer months to regenerate seasonal and
economic activities. About 25 percent of Hope's employees are
vaccinated and more clinics are planned. His prior employment
with Trident Seafoods, and he worked in Akutan for many years.
As seen in the news, 20 percent of its workforce is offline
before the summer season starts. It represents a risk to the
local villages. He is concerned for the economics of the state
as well. This bill serves both. Service providers who are
already facing workforce shortages have also endured additional
disruption to workforce availability. Up to 15 percent at any
time can be quarantined.
MR. BAILEY said Hope had over 1,600 employees and recipients who
have been quarantined in the past year, many of them repeated
times. The flexibility that has been available through public
health emergency declarations providing alternative service
modalities, telehealth, telemedicine, and regulatory expansions
related to professional and occupational license, and travel
considerations is necessary to protect Native and local
communities. It has allowed service provider to remain as active
partners in statewide efforts. Telemedicine has many benefits;
some of Hope's own data suggests that two-thirds of telemedicine
is behavioral health related. Some nursing care coordination
requires face-to-face visits that have only been possible
through electronic means. He noted that Mr. Kosin mentioned some
of the blanket waivers. Some of those that have been critical to
maintaining essential supports are closely tied to the state
declarations. Hope needs those to be extended. The partnership
between the federal and state declarations is essential. The
Alaska Association of Developmental Disabilities (AADD) is
planning to submit a request to the state of Alaska for some of
the flexibility to continue on beyond the pandemic because of
the effectiveness and efficiencies. AADD has a membership of 60
providers with over 4,000 vulnerable Alaskans. If they had to be
put into the hospital system, it would totally overwhelm the
hospital system. The state needs to continue the current
strategies. This act is essential for the state to recover its
freedom and economy.
2:39:31 PM
CHAIR WILSON opened public testimony on SB 56.
2:39:39 PM
NILS ANDREASSEN, Executive Director, Alaska Municipal League,
Juneau, Alaska, said that the league represents 155 cities and
boroughs across Alaska. These cities and boroughs have played a
fundamental role in supporting the state throughout this
disaster response, both on the public health emergency side and
economic side. The league is in full support of extending the
disaster declaration. Essential to this is the implementation of
the Alaska Disaster Act, which provides all the necessary
statutory language to address the concerns that have been raised
by so many. The league is concerned about losing many things.
First, dozens of local declarations that were linked to the
state's declaration may be lost. They would either expire
completely or need to be amended. That would be roughly two-
thirds of local governments that implemented or adopted
emergency ordinances. The state would lose the ability to waive
procurement regulations. The state would lose ability to send
strike teams to high-risk communities with dangerous spikes and
to those communities that do not have public health powers or
the capacity to respond. The state will lose the ability to
organize mass vaccination clinics. The non-congregate shelter
contracts will be lost to some extent. The preemption of local
government authority will be lost. There may be an ad hoc
approach to travel restrictions or establishment of new critical
infrastructure guidelines. The state will lose the ability to
establish vaccination tiers.
2:42:04 PM
LISA MORLEY, Executive Director, Alaska Commission on Aging,
Anchorage, Alaska, said that individuals 65 or older are at the
highest risk for being diagnosed with COVID and make up 80
percent of fatalities. Passing this bill will allow DHSS to
continue interventions allowed by this disaster declaration. It
will ultimately save lives and prevent illness in Alaska
seniors.
2:43:12 PM
RYAN MCGHAN, M.D., representing self, Wasilla, Alaska, shared
that in addition to being a pulmonary and critical care
physician, he has a master's degree in public health. He works
at Providence Alaska Medical Center and Mat-Su Regional Medical
Center. This has been completely unlike anything he has
experienced in over 20 years of pulmonary and critical care
medicine. December was a nightmare. He is grateful that
Southcentral is doing better now. The state still has active
outbreaks in western Alaska. New variants of coronavirus are
circulating. This is not the time for the state to take the eye
off the ball. The governor has restricted his use of emergency
powers. There is no question they need to be extended through
the end of the summer.
2:44:32 PM
ABNER HOAGE, Emergency Manager and Incident Commander for COVID
Response, City of Ketchikan, Ketchikan, Alaska, said he is the
president of Alaska Fire Chiefs Association, serves on the
state's emergency response committee, cochairs the local
emergency planning committee association, and until his term
expired in November, served eight years as a member and previous
chair of the Alaska Council on Emergency Medical Services. This
relief in SB 56 is important. COVID is not the flu. Without
going into a lot of data, he could tell the committee that it
appears that COVID is roughly three to six times more deadly
than annual flu. Alaska data indicates that 253 deaths were due
to COVID compared to roughly 60 to 70 in a normal flu season.
Spread is more aggressive than the flu. Symptoms are generally
worse, and the infectious period is longer. This has caused huge
stress on the healthcare system and supply chain. The
outstanding work at DHSS and previous disaster declarations
issued by the governor have provided significant support to
local governments. They have used this in various ways, from
testing, to PPE, and many other ways discussed by the director
of public health and the state incident commander. COVID is an
ongoing disaster emergency. It is not over. Testing and
additional support are still needed by local communities.
Passing SB 56 is critical to ongoing success of Alaska COVID
response.
2:46:28 PM
KATY BOTZ, representing self, Juneau, Alaska, shared that she
has a major depressive disorder. Anything relating to health
mandates for COVID-19 has a serious effect on her mental health.
She said a mask mandate silences the people of Alaska into
submission. It is clear that the administration wants to believe
it is not accountable for any mandates. It is unconstitutional.
There are hidden messages beneath the health mandates.
CHAIR WILSON reminded the public that written testimony can be
emailed to shss@akleg.gov.
2:50:01 PM
JAYNE ANDREEN, Alaska Public Health Association, Douglas,
Alaska, said this pandemic emerged at a time when the public
health system was at a deficit due to budget cuts over the last
few years. Alaska has lost about 20 percent of its public health
nursing staff and about 25 percent of public health centers have
been closed down. Since then, the state of Alaska and DHSS have
been able to build up capacity quickly. This pandemic is far
from over. Just when they start to see the light at the end of
the tunnel with the rollout of vaccines, there are new variants
that could be more deadly and infectious and could continue to
impact health and wellbeing. The state of Alaska needs to have
more than a 30-day type of response. The state has done well
with the statewide travel restrictions, but a piecemeal approach
is going to impact the effectiveness of Alaska's approach. The
state has been able to build up the necessary workforce and rank
highly in the way it has been able to respond for the health and
wellbeing of its citizens. The association would like to see the
governor issue even stronger mandates. The association would
like to see a mask mandate across the state. The association
commends DHSS for the excellent support and guidance it has
given to communities, which have then been able to act in the
best interests of their residents. She would like SB 56 to pass
for continued support for Alaska's response to COVID-19.
2:52:27 PM
VERNE BOERNER, President/CEO, Alaska Native Health Board (ANHB),
Anchorage, Alaska, said SB 56 is a crucial bill to extend the
public health disaster emergency. ANHB is the statewide voice
for the Alaska tribal health system that services 229 federally-
recognized tribes. Alaska Natives are overrepresented in
Alaska's hospitalization and death rates due to COVID-19. Alaska
Natives make up 27.1 percent of all hospitalizations and 38.1
percent of all COVID-related deaths. That is over a quarter of
all Alaska hospitalizations and more than a third of all deaths.
Rural Alaska continues to be at particular risk of COVID-19 and
its new variants due to factors such as crowded,
multigenerational homes, lack of running water and sanitation,
and distance from advanced medical care, requiring air travel to
reach hospitals. The public health emergency has been critical
to protect communities. Since the start of the public health
emergency, there has been a 303 percent increase of telehealth-
related Medicaid services statewide, which keeps providers and
patients safe. The vast majority of this has been delivered
through the Alaska tribal health system. The public health
emergency allows for rapid procurement in hiring for the
response, essential elements when it comes to Alaska's vaccine
distribution plan and enabling the tribal health system to set
up mass vaccine clinics quickly to put shots in arms. It
provides flexibility in the delivery of healthcare through means
such as telehealth and maximizing the workforce through
expedited and courtesy licensing, especially in fields where the
state is shorthanded and through other regulatory flexibility
triggered by the public health emergency disaster declaration.
This allows providers to respond efficiently. Only under
disaster provisions under AS 26.23.020(g)(10) can the governor
allocate or redistribute food, water, fuel, clothing, medicine
or supplies, which includes scarce vaccines and therapeutics for
COVID.
2:55:49 PM
AMBER GLASSER, representing self, Anchorage, Alaska, urged a no
vote. She said the sooner the state is not in an emergency the
sooner Anchorage will be out of its state of emergency. She has
been in the hospitality industry for 22 years. She started at
the Lucky Wishbone and has been at Simon and Seafort's for the
last 12 years. She is furloughed because of the pandemic. So
many of her friends, restaurant and small business owners,
servers, bartenders, bussers, dishwashers, hotel workers,
brewery workers, and so many others, are struggling. They have
money in their bank accounts and a roof over their heads, but
for how long. A lot of people just want the right to choose and
the right to be open all the way with masks being encouraged,
not forced. She wanted to applaud Sarah Price, an Eagle River
high school student, and echo what she has been saying for
months and in her February 3, 2021, testimony to Senate
Judiciary. Ms. Glasser thanked Senator Reinbold for sharing
their thoughts and truly being a public servant and not just a
politician. If Florida and South Dakota can be open, why not
Alaska. Everyone can come together and figure it out. Alaska can
keep its most vulnerable safe while being open at same time.
2:58:21 PM
DEAN CANNON, representing self, Anchorage, Alaska, said experts
agree that the best way to control the spread of COVID-19 is
through travel restrictions, which is happening in Alaska right
now. Alaska's natural advantage is the isolation which enables
it to restrict that travel. This is key to Alaska's reaction to
COVID. He was one of those positive cases at the airport; thank
God that testing is going on. He is hearing that the reason for
the extension and orders is a lack of trust in the public, an
inability to govern without them, and too many entities losing
money if they are not extended. COVID has revealed failures in
the system that emergency orders will not repair. What is
required is a little hard work and a willingness to work
together. The public is losing control over their lives with
these emergency orders. Many feel too much authority is being
collected in unelected bodies like DHSS. One person talked about
the worst day in someone's career. People are having the worst
years of their lives. In 2017 the CDC warned of the societal
impact of orders like this and the long-term effect of
restrictions during pandemics. Then the CDC lacked the data on
societal impacts because there was no modern precedent like
COVID. Now the societal impacts are obvious. The Imperial
College model was based on the Spanish flu, which is ten times
deadlier than COVID and that model's author had to resign. The
number of ICU beds in Anchorage changes every time he asks. This
doesn't seem to include surge beds or COVID-dedicated beds.
People are highly suggestible after a year of stress, and a
mental health crisis is inevitable and no one from DHSS is
talking about that. The capricious use of emergency orders in
Anchorage is fracturing society and destroying democratic norms.
That should concern everyone. DHSS seems to be in a professional
competition with themselves and other states for prestige. A
massive gap is growing between government and the governed in
Alaska. It is time to put these orders back in the drawer and
resume democracy.
3:01:04 PM
CHAIR WILSON closed public testimony on SB 56 and noted that
written testimony could be submitted to shss@akleg.gov.
SENATOR REINBOLD asked if others were online to testify.
CHAIR WILSON responded yes, but the committee is out of time.
SENATOR REINBOLD asked if the testimony would be extended next
Tuesday.
CHAIR WILSON replied that public testimony was being closed at
this time and people could submit written testimony as part of
the record to the Senate HSS email address.
3:01:59 PM
At ease
3:04:43 PM
CHAIR WILSON announced that he would reopen public testimony at
the next meeting. He asked Senator Reinbold if she had any
closing comments.
SENATOR REINBOLD replied that it was too late to respond to Mr.
Coons.
SENATOR BEGICH said it was not acceptable for testifiers to
attack anyone and he thanked the chair for stopping that. In the
past the chair has left the hearing open, which has led to a lot
of people expecting to testify. In one instance, with a bill
Senator Begich was concerned about, the chair closed testimony
to send the message that testimony was over, saying that the
chair would reopen testimony if there were an opportunity. The
committee adjourned at that time, which was near the end of the
session, so there wasn't an opportunity. The chair has indicated
that he plans to open public testimony again. The chair has made
that clear to the people online and to the people in the
committee. "Let's be sure to enforce that and make it happen and
thank you for doing that. I really wish I had had that
opportunity for that bill many years ago, but that's the past,
so thank you for being clear to the people listening online and
just to reiterate, please Mr. Chairman, and all of us, let's
hold those who testify in a manner that is not becoming
accountable."
SENATOR HUGHES said that the list [of those who signed up to
testify] has many private individuals. The bulk of the public
testimony was people representing health-related organizations.
It is important to hear from Alaskans across the state,
individuals, and what their wish is. She encourages them to
provide written testimony and also to try to join the committee
again as the chair is able to open testimony. It is vital to
hear from all of them, as much as possible. She encouraged the
committee members to read the written testimony. There is
definitely concern coming from around the state.
SENATOR REINBOLD said that she was not able to ask a lot of
questions. She keeps being guaranteed that she will be able to
ask her questions, but they are limited. The administration is
protected from answering a lot of the questions. She finds that
disingenuous. She should have had the opportunity to clear the
record with the person who was making odd accusations about her.
She was not able to ask questions for invited testimony or even
able to set the record straight. Half an hour or 45 minutes
after it happened is not the appropriate time. She has a lot of
questions and DHSS has not provided good answers. She thanked
everyone waiting to testify. She knows that many have been
negatively impacted by the disaster declaration and the
mandates. They have allies on this committee and they will not
shut their voices out, so she will offer an opportunity in
Judiciary for them to testify next week. She will be posting
that tonight. She wants to hear their concerns on SB 56 and
anything in regard to the mandate. If they were shut out today,
they will have another opportunity.
3:10:06 PM
CHAIR WILSON stated for the record that no one was shut out. The
committee allows people to testify and testimony will be open
again.
[Chair Wilson held SB 56 in committee.]
| Document Name | Date/Time | Subjects |
|---|---|---|
| SB 56 Letters of Support 2, Redacted, 2.4.21.pdf |
SHSS 2/4/2021 1:30:00 PM |
SB 56 |
| SB 56 Letters of Opposition 2, Redacted, 2.4.21.pdf |
SHSS 2/4/2021 1:30:00 PM |
SB 56 |
| SB 56 LEG COVID-19 Expenditures Report run_1-29-2021.pdf |
SHSS 2/4/2021 1:30:00 PM |
SB 56 |