Legislature(2021 - 2022)ADAMS 519

03/29/2022 01:30 PM House FINANCE

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* first hearing in first committee of referral
+ teleconferenced
= bill was previously heard/scheduled
Heard & Held
Heard & Held
Heard & Held
+ Bills Previously Heard/Scheduled TELECONFERENCED
Moved HCS CSSB 33(FIN) Out of Committee
                  HOUSE FINANCE COMMITTEE                                                                                       
                      March 29, 2022                                                                                            
                         1:32 p.m.                                                                                              
1:32:55 PM                                                                                                                    
CALL TO ORDER                                                                                                                 
Co-Chair Merrick called the  House Finance Committee meeting                                                                    
to order at 1:32 p.m.                                                                                                           
MEMBERS PRESENT                                                                                                               
Representative Neal Foster, Co-Chair (via teleconference)                                                                       
Representative Kelly Merrick, Co-Chair                                                                                          
Representative Dan Ortiz, Vice-Chair                                                                                            
Representative DeLena Johnson                                                                                                   
Representative Andy Josephson                                                                                                   
Representative Bart LeBon                                                                                                       
Representative Sara Rasmussen                                                                                                   
Representative Steve Thompson                                                                                                   
Representative Adam Wool                                                                                                        
MEMBERS ABSENT                                                                                                                
Representative Ben Carpenter                                                                                                    
Representative Bryce Edgmon                                                                                                     
ALSO PRESENT                                                                                                                  
Senator Gary  Stevens, Sponsor;  Tim Lamkin,  Staff, Senator                                                                    
Gary   Stevens;  Sara   Chambers,   Director,  Division   of                                                                    
Corporations,    Business   and    Professional   Licensing,                                                                    
Department of Commerce,  Community and Economic Development;                                                                    
Genevieve   Mina,  Staff,   Representative  Ivy   Spohnholz;                                                                    
Representative George Rauscher,  Sponsor; Ryan McKee, Staff,                                                                    
Representative George  Rauscher; Representative  Geran Tarr,                                                                    
Sponsor; Kris  Curtis, Legislative Auditor,  Alaska Division                                                                    
of Legislative  Audit; Brenda Stanfill,  Executive Director,                                                                    
Alaska  Network on  Domestic  Violence  and Sexual  Assault;                                                                    
Diane  Casto,   Executive  Director,  Council   on  Domestic                                                                    
Violence and Sexual Assault, Department of Public Safety.                                                                       
PRESENT VIA TELECONFERENCE                                                                                                    
Mark  Palmer, President  and  chief  Executive Officer,  OBI                                                                    
Seafoods; Abby Fredrick,  Director of Communications, Silver                                                                    
Bay   Seafoods;  Nicole   Reynolds,  Deputy   Director,  Tax                                                                    
Division,   Department   of  Revenue;   Representative   Ivy                                                                    
Spohnholz,  Sponsor;  Nancy  Merriman,  Executive  Director,                                                                    
Alaska  Primary  Care   Association;  Tom  Chard,  Executive                                                                    
Director, Alaska Behavioral  Health Association; Andy Mills,                                                                    
Legislative  Liaison,   Department  of   Transportation  and                                                                    
Public Facilities.                                                                                                              
HB 265    HEALTH CARE SERVICES BY TELEHEALTH                                                                                    
          HB  265  was  HEARD  and  HELD  in  committee  for                                                                    
          further consideration.                                                                                                
HB 291    EXTENDING COUNCIL ON DOMESTIC VIOLENCE                                                                                
          HB  291  was  HEARD  and  HELD  in  committee  for                                                                    
          further consideration.                                                                                                
HB 296    DONATIONS/GIFTS FOR DOTPF SIGNAGE                                                                                     
          HB  296  was  HEARD  and  HELD  in  committee  for                                                                    
          further consideration.                                                                                                
CSSB 33(FIN)                                                                                                                    
          SEAFOOD PRODUCT DEVELOPMENT TAX CREDIT                                                                                
          HCS CSSB(FIN)  was REPORTED out of  committee with                                                                    
          seven "do  pass" recommendations and with  one "no                                                                    
          recommendation"   recommendation   and  with   one                                                                    
          previously    published   fiscal    impact   note:                                                                    
Co-Chair Merrick reviewed the agenda for the day.                                                                               
CS FOR SENATE BILL NO. 33(FIN)                                                                                                
     "An Act relating to a fisheries product development                                                                        
     tax credit; and providing for an effective date."                                                                          
1:33:53 PM                                                                                                                    
SENATOR  GARY STEVENS,  SPONSOR, thanked  the committee  for                                                                    
hearing the  bill. He explained  that the bill was  a value-                                                                    
added bill  which would  allow seafood  processors to  use a                                                                    
tax credit to purchase new  equipment for their business. He                                                                    
relayed that  the process  had worked well  in the  past and                                                                    
there  had been  a similar  program for  salmon and  herring                                                                    
processing that  started in 2003. However,  the program came                                                                    
to an  end in  2020 because  it was  not extended.  The bill                                                                    
restored the salmon  and herring tax credit  that had become                                                                    
obsolete  and would  also make  pollock, pacific,  and sable                                                                    
fish products  eligible for the  credit. He  reiterated that                                                                    
the program had  worked well in the past  and suggested that                                                                    
it would also work well in the future.                                                                                          
Co-Chair  Merrick noted  that  Representative Rasmussen  had                                                                    
joined the meeting.                                                                                                             
1:35:20 PM                                                                                                                    
MARK  PALMER, PRESIDENT  AND  CHIEF  EXECUTIVE OFFICER,  OBI                                                                    
SEAFOODS  (via   teleconference),  wanted  to   discuss  the                                                                    
benefits of the  tax credits. He indicated  that the erosion                                                                    
of the trade  market in China due to  hostile trade policies                                                                    
had dramatically  impacted the  amount of raw  material that                                                                    
the United States  could export. He shared  that the Chinese                                                                    
market  had been  the largest  market  for seafood  products                                                                    
from Alaska. As  this changed, his business  had become more                                                                    
reliant on the  domestic market and the  European market. He                                                                    
perceived these markets  to be higher value,  and thought it                                                                    
was important  to market Alaskan  seafood products  to them.                                                                    
He thought there was more  reason to target domestic markets                                                                    
rather  than  exporting  Alaskan  fish.  He  explained  that                                                                    
Russian seafood  products could no  longer be  imported into                                                                    
the  United States  due to  the  war in  Ukraine. This  gave                                                                    
Alaska  an opportunity  to replace  Russian  seafood in  the                                                                    
domestic and  European markets. The  tax credit  proposed by                                                                    
the  bill would  allow  new infrastructure  to  be built  in                                                                    
Alaska.  However,  much  of  the  money  that  OBI  Seafoods                                                                    
invested into  projects was the  company's own  money, which                                                                    
benefited  the  local  communities  and  the  fishermen.  He                                                                    
echoed  Senator  Stevens'  comments  that  the  program  had                                                                    
worked well in the past.                                                                                                        
1:39:11 PM                                                                                                                    
ABBY  FREDRICK,  DIRECTOR   OF  COMMUNICATIONS,  SILVER  BAY                                                                    
SEAFOODS  (via teleconference),  had submitted  a letter  of                                                                    
support for the bill and did not need to make an additional                                                                     
1:40:05 PM                                                                                                                    
Co-Chair Merrick OPENED public testimony.                                                                                       
1:40:19 PM                                                                                                                    
Co-Chair Merrick CLOSED public testimony.                                                                                       
1:40:26 PM                                                                                                                    
AT EASE                                                                                                                         
1:42:59 PM                                                                                                                    
Co-Chair Merrick indicated the committee would be hearing                                                                       
amendments for SB 33.                                                                                                           
1:43:10 PM                                                                                                                    
Representative Wool MOVED to ADOPT Amendment 1, 32-                                                                             
LS0308\N.6, Nauman, 3/14/22 (copy on file):                                                                                     
     Page 3, line 14, following "section":                                                                                      
          Insert "(I)"                                                                                                          
     Page 3, line 16:                                                                                                           
          Delete". For"                                                                                                         
          Insert "; for"                                                                                                        
     Page 3, line 17:                                                                                                           
          Delete "subsection"                                                                                                   
          Insert "paragraph"                                                                                                    
     Page 3, line 18, following "appeal":                                                                                       
          Insert "; or                                                                                                          
               (2) for property that is the same type  of                                                                       
          property as, or that is comparable to, property                                                                       
                    (A) on which a tax credit has been                                                                          
          claimed under this section;                                                                                           
                    (B) that has been removed from the                                                                          
          state; and                                                                                                            
                    (C) that was purchased in the previous                                                                      
          10 years"                                                                                                             
Co-Chair Merrick OBJECTED for discussion.                                                                                       
Representative Wool  explained that Amendment 1  was a back-                                                                    
stop amendment. He drew attention to  Section 1 on page 3 of                                                                    
the   bill,  which   discussed  recapture   percentage.  His                                                                    
amendment  stated that  if an  entity purchased  a piece  of                                                                    
equipment,  the  entity would  get  a  full 50  percent  tax                                                                    
credit  after  four  years   for  the  purchased  equipment.                                                                    
However,  the entity  could not  buy a  replacement for  the                                                                    
piece  of  equipment  for  10   years.  This  would  prevent                                                                    
companies from  buying equipment  in Alaska and  receiving a                                                                    
tax credit  after four  years, shipping  the equipment  to a                                                                    
different state,  and buying  a new  piece of  equipment and                                                                    
repeating the process.                                                                                                          
Representative Wool  MOVED to  ADOPT conceptual  Amendment 1                                                                    
to Amendment 1.                                                                                                                 
Co-Chair Merrick OBJECTED for discussion.                                                                                       
Representative  Wool  explained  conceptual Amendment  1  to                                                                    
Amendment  1. He  referenced  line 14  through  line 15  [of                                                                    
Amendment 1]  and proposed removing language  to ensure that                                                                    
if an entity purchased the  same type of equipment for which                                                                    
it had already  received a tax credit, it  could not receive                                                                    
an additional tax  credit for another 10  years. Starting on                                                                    
line 14 of  Amendment 1, he proposed deleting:  "as, or that                                                                    
is comparable to, property".                                                                                                    
Representative LeBon asked a clarifying question.                                                                               
1:46:03 PM                                                                                                                    
AT EASE                                                                                                                         
1:46:43 PM                                                                                                                    
Representative Wool  reiterated that conceptual  Amendment 1                                                                    
to Amendment  1 proposed the deletion  of language beginning                                                                    
on line 14 of Amendment 1.                                                                                                      
Co-Chair Merrick WITHDREW her OBJECTION.                                                                                        
There  being  NO  further  OBJECTION,  it  was  so  ordered.                                                                    
conceptual Amendment 1 to Amendment 1 was ADOPTED.                                                                              
1:47:31 PM                                                                                                                    
Representative LeBon  asked if a business  would be entitled                                                                    
to receiving  another tax  credit if it  shipped a  piece of                                                                    
equipment  out  of state  and  replaced  the equipment  four                                                                    
years after receiving a tax credit for the equipment.                                                                           
Representative Wool responded in  the affirmative. An entity                                                                    
would only  be eligible  to receive the  tax credit  for the                                                                    
same type  of equipment every  10 years, but there  would be                                                                    
no  limit  on  the  amount  of  equipment  a  company  could                                                                    
purchase.   However,   this    was   only   applicable   for                                                                    
replacements. If an entity had  an ice machine and purchased                                                                    
an additional  ice machine, it  would still receive  the tax                                                                    
Representative  LeBon  wondered   whether  an  entity  could                                                                    
purchase  a new  and improved  ice machine  and replace  the                                                                    
original and still qualify for the tax credit.                                                                                  
Representative Wool responded  that if it was  the same type                                                                    
of property, it would not be eligible for the credit.                                                                           
Representative LeBon wanted to  not discourage the upgrading                                                                    
of equipment.                                                                                                                   
Representative Wool agreed  and did not think  an upgrade in                                                                    
technology  would be  the same.  He thought  it would  still                                                                    
qualify for the  tax credit because the  upgrades would make                                                                    
the equipment a new type of  machinery. That is why he chose                                                                    
the language "same  type" to ensure that  different types of                                                                    
equipment would remain eligible.                                                                                                
Co-Chair  Merrick WITHDREW  her  OBJECTION  to the  original                                                                    
Amendment 1 as amended.                                                                                                         
There  being  NO  further  OBJECTION,  it  was  so  ordered.                                                                    
Amendment 1 was ADOPTED as amended.                                                                                             
Co-Chair  Merrick   indicated  Amendment  2  would   not  be                                                                    
1:50:01 PM                                                                                                                    
Vice-Chair Ortiz MOVED to ADOPT Amendment 3, 32-LS0308\N.9,                                                                     
Nauman, 3/23/22 (copy on file):                                                                                                 
     Page 2, line 23:                                                                                                           
          Delete "A"                                                                                                            
          Insert "Except as provided in (f) of this                                                                             
     section, a"                                                                                                                
     Page 3, line 9, following "service.":                                                                                      
          Insert "In this subsection, "eligible fish" does                                                                      
     not include pollock, sablefish, or Pacific cod."                                                                           
     Page 3. line 14, following "section":                                                                                      
          Insert "(1)"                                                                                                          
     Page 3, line 16:                                                                                                           
          Delete ". For"                                                                                                        
          Insert "; for"                                                                                                        
     Page 3, line 17:                                                                                                           
          Delete "subsection"                                                                                                   
          Insert "paragraph"                                                                                                    
     Page 3, line 18, following "appeal":                                                                                       
          Insert "; or                                                                                                          
               (2) for property installed on a vessel used                                                                      
     primarily to process pollock, sablefish, or Pacific                                                                        
     Page 4, line 27, following "means":                                                                                        
          Insert ", except as otherwise provided in (c) of                                                                      
     this section,"                                                                                                             
Co-Chair Merrick OBJECTED for discussion.                                                                                       
Vice-Chair  Ortiz  asked  Mr.   Tim  Lamkin  to  review  the                                                                    
TIM  LAMKIN,  STAFF,  SENATOR  GARY  STEVENS,  reviewed  the                                                                    
amendment.  He  indicated  that   Amendment  3  addressed  a                                                                    
hypothetical loophole  that a  value-added tax  credit could                                                                    
be applied  to processing activities in  the facilities that                                                                    
produced pollock,  cod, or sablefish aboard  vessels outside                                                                    
of state waters. The amendment  would ensure that processors                                                                    
of the  aforementioned fish would  have to process  the fish                                                                    
at  onshore processing  facilities  to qualify  for the  tax                                                                    
1:51:44 PM                                                                                                                    
Representative Josephson  shared his understanding  that the                                                                    
tax in question brought in  around $50 million to the state.                                                                    
He asked if this number was correct.                                                                                            
Senator Stevens deferred to Ms. Nicole Reynolds.                                                                                
1:52:25 PM                                                                                                                    
NICOLE REYNOLDS,  DEPUTY DIRECTOR, TAX  DIVISION, DEPARTMENT                                                                    
OF  REVENUE (via  teleconference),  responded  that the  tax                                                                    
collections  for the  fisheries business  tax over  the past                                                                    
four  fiscal years  (FY) ranged  between  $34.6 million  and                                                                    
$46.2 million.                                                                                                                  
Representative  Josephson  reported  that  historically  the                                                                    
credit had been in the  low millions of dollars. He wondered                                                                    
about the  impact of  the proposed reform  on the  growth of                                                                    
the credit and the tax.                                                                                                         
Senator Stevens deferred to Ms. Reynolds.                                                                                       
Ms. Reynolds replied  that the historic value  of the credit                                                                    
between 2017 and  2020 ranged between $2.3  million and $4.4                                                                    
million. She  referred to the  fiscal note submitted  by the                                                                    
Department  of Revenue  (control code  slwkY) and  explained                                                                    
that the  department used  historical value  and utilization                                                                    
rates  of  the  existing   salmon  and  herring  credits  to                                                                    
estimate the way  in which the revenue would  be impacted by                                                                    
adding pollock,  cod, and sablefish to  the eligibility. For                                                                    
FY 23, the department estimated  a negative $1.6 million for                                                                    
the  credit. Between  FY 24  through FY  27, the  department                                                                    
estimated between $3 million and $3.6 million.                                                                                  
1:54:54 PM                                                                                                                    
Representative  Josephson  suggested   that  the  tax  might                                                                    
increase as value was added to the product.                                                                                     
Ms. Reynolds  responded that the  value reflected  the value                                                                    
of the raw  resource. The tax was not applied  to the value-                                                                    
added portion.                                                                                                                  
Representative Josephson thought, "it is what it is."                                                                           
Ms. Reynolds noted that the  tax revenue was not expected to                                                                    
increase due to the credit.                                                                                                     
Representative Wool asked about  the total for fish business                                                                    
Ms.  Reynolds  responded  that the  fisheries  business  tax                                                                    
revenue ranged between $34.6 million  and $46.2 million over                                                                    
the last four fiscal years.                                                                                                     
Representative Wool  shared his  understanding that  half of                                                                    
the  taxes  went to  municipalities  and  half went  to  the                                                                    
state.  He asked  whether  the credit  only  applied to  the                                                                    
state's portion.  He calculated  that that $34.6  million to                                                                    
$46.2  million  would  become roughly  $17  million  to  $23                                                                    
million for the state.                                                                                                          
Ms. Reynolds replied, "that's correct."                                                                                         
1:57:42 PM                                                                                                                    
Co-Chair Merrick WITHDREW her OBJECTION.                                                                                        
There  being  NO  further  OBJECTION,  it  was  so  ordered.                                                                    
Amendment 3 was ADOPTED.                                                                                                        
Vice-Chair Ortiz  MOVED to  report HCS  CSSB 33(FIN)  out of                                                                    
Committee   with   individual    recommendations   and   the                                                                    
accompanying fiscal note. There  being NO further OBJECTION,                                                                    
it was so ordered.                                                                                                              
HCS CSSB  33(FIN) was REPORTED  out of committee  with seven                                                                    
"do pass"  recommendations and with one  "no recommendation"                                                                    
recommendation  and  with  one previously  published  fiscal                                                                    
impact note: FN2(REV).                                                                                                          
1:58:10 PM                                                                                                                    
AT EASE                                                                                                                         
2:00:05 PM                                                                                                                    
HOUSE BILL NO. 265                                                                                                            
     "An  Act  relating  to   telehealth;  relating  to  the                                                                    
     practice  of medicine;  relating to  medical assistance                                                                    
     coverage  for  services  provided  by  telehealth;  and                                                                    
     providing for an effective date."                                                                                          
2:00:10 PM                                                                                                                    
REPRESENTATIVE IVY SPOHNHOLZ,  SPONSOR (via teleconference),                                                                    
introduced  the  PowerPoint  presentation: "HB  265:  Health                                                                    
Care Services  by Telehealth" (copy on  file). She explained                                                                    
that  the bill  would continue  the expansion  of telehealth                                                                    
flexibilities to make healthcare  more accessible and reduce                                                                    
unnecessary travel  during the  COVID-19 pandemic.  The bill                                                                    
would  provide  a  legislative  framework  to  continue  the                                                                    
state's   success    with   COVID-19    related   telehealth                                                                    
flexibilities with  regard to  state and  federal oversight.                                                                    
She noted  that patients  used to have  to go  to in-patient                                                                    
clinics  in order  to receive  telehealth care,  but it  was                                                                    
discovered  during the  pandemic that  was not  necessary to                                                                    
ensure safe healthcare in the state.                                                                                            
Representative  Spohnholz advanced  to slide  2 and  relayed                                                                    
that the presentation would cover  telehealth in Alaska, the                                                                    
importance of HB 265, and  the specific actions of the bill.                                                                    
She shared that the bill  was a result of collaboration with                                                                    
stakeholders  and  there  were  over 33  letters  of  formal                                                                    
support for the bill.                                                                                                           
Representative Spohnholz  discussed the current  barriers to                                                                    
telehealth  on  slide 3,  such  as  license regulations  and                                                                    
payment  barriers.  The  legislature had  been  working  for                                                                    
years to expand  access to telehealth. She noted  that in SB
74  in 2016,  the  legislature expanded  Medicaid access  to                                                                    
behavioral healthcare  and in  2020, the  legislature passed                                                                    
HB 229 requiring insurance coverage  in a private market for                                                                    
telehealth.  Even with  the  improvements  made through  the                                                                    
bills,  there  continued  to   be  barriers  to  telehealth.                                                                    
Barriers included  the lack of telehealth  parity laws, lack                                                                    
of coverage of some  telehealth services under Medicaid, and                                                                    
a higher burden  for audio-only visits. There  were also in-                                                                    
person  requirements for  select  healthcare providers  that                                                                    
acted  as a  barrier to  service, including  prescription of                                                                    
controlled substances.                                                                                                          
2:04:28 PM                                                                                                                    
Representative  Spohnholz turned  to slide  4 to  review the                                                                    
changes to telehealth in Alaska  since COVID-19. There was a                                                                    
State Public  Health Emergency (SPHE)  and a  Federal Public                                                                    
Health  Emergency  (FPHE),  which both  provided  telehealth                                                                    
flexibility. She  noted that  FPHE was  slated to  expire in                                                                    
April of 2022  and SPHE expired in April of  2021. This made                                                                    
the passage  of HB 265  more urgent. Currently  Medicaid had                                                                    
temporarily expanded access to  telehealth coverage and made                                                                    
it easier to  bill for audio-only visits,  but these changes                                                                    
were not permanent.                                                                                                             
Representative Spohnholz explained why  HB 265 was needed on                                                                    
slide  5. She  wanted  to continue  some  of the  telehealth                                                                    
flexibilities  from the  COVID-19  pandemic  by making  them                                                                    
permanent   in  statute.   The   bill   would  also   reduce                                                                    
bureaucracy  by eliminating  the need  for in-person  visits                                                                    
for all licensed healthcare providers  prior to a telehealth                                                                    
appointment.  It  would  also expand  Medicaid  coverage  of                                                                    
telehealth  services   which  were  reimbursed   during  the                                                                    
pandemic  and  increase  access  to  behavioral  healthcare.                                                                    
Finally, it  would ensure Alaskans  had an option  to access                                                                    
quality care in a timely  manner when an in-person visit was                                                                    
unnecessary or not possible.                                                                                                    
Representative Spohnholz moved to slide  6 to review what HB
265 would do:                                                                                                                   
   1. Creates a framework for telehealth in statute.                                                                          
   2. Enhances the telehealth delivery of substance use                                                                       
     disorder treatment.                                                                                                        
   3. Expands Medicaid coverage for telehealth services and                                                                   
Representative Spohnholz  advanced to slide 7  and explained                                                                    
that  the  bill  created  a   framework  for  telehealth  in                                                                    
statute. There  was a laundry  list of  healthcare providers                                                                    
that could  provide telehealth services in  Alaska. The bill                                                                    
would  remove   additional  barriers  such   as  unnecessary                                                                    
efforts to  document in-person visits prior  to a telehealth                                                                    
appointment.  She  spoke  about  the  importance  of  having                                                                    
telehealth appointments  available for the various  types of                                                                    
providers  eligible  to  provide  telehealth  services.  For                                                                    
example, she  had talked  to a  podiatrist that  diagnosed a                                                                    
blood clot via telehealth.                                                                                                      
Representative Spohnholz  thought it  was important  to note                                                                    
that HB  265 would not  mandate that a patient  receive care                                                                    
through  telehealth  or  that   a  provider  offer  services                                                                    
through telehealth. For example, if  there was a patient who                                                                    
exhibited opioid  addiction problems, it would  be important                                                                    
for  a  provider to  meet  with  them  in person  to  obtain                                                                    
additional information  before making a diagnosis.  The bill                                                                    
would simply remove red tape  barriers to access to care. It                                                                    
would also  extend telehealth services to  emergency medical                                                                    
2:08:52 PM                                                                                                                    
Representative LeBon  asked about the list  of providers she                                                                    
had provided  on slide 7,  including dentist. He  was trying                                                                    
to envision  dental services  being provided  by telehealth.                                                                    
He asked how an annual  dental checkup could be provided via                                                                    
Representative  Spohnholz responded  that  an annual  dental                                                                    
checkup would not be provided  via telehealth. She suggested                                                                    
that  if there  was  a potential  emergency, an  examination                                                                    
could take place  via telehealth. This would  be helpful for                                                                    
individuals in  rural areas to  help them  determine whether                                                                    
they needed to travel  to see a dentist or if  it was not an                                                                    
urgent problem.                                                                                                                 
Representative  LeBon suggested  that  the first  step of  a                                                                    
dental  experience might  be done  via telehealth,  but that                                                                    
eventually a  patient would  have to go  see the  dentist in                                                                    
2:10:24 PM                                                                                                                    
Representative Rasmussen highlighted  that the provided list                                                                    
offered  more flexibility.  She  offered an  example of  her                                                                    
daughter having a bad stomachache  and using telehealth as a                                                                    
first  step. She  ended  up admitting  her  daughter to  the                                                                    
hospital  based on  the information  she learned  during the                                                                    
telehealth call.  She thought  in-person visits  would still                                                                    
be necessary, but  that telehealth could help  in the short-                                                                    
Representative  LeBon drew  attention  back to  slide 5.  He                                                                    
noted that  one of the  boxes indicated that the  bill would                                                                    
eliminate  in-person  visits  for all  healthcare  providers                                                                    
licensed  with the  State of  Alaska prior  to a  telehealth                                                                    
appointment. He wondered if it  was conceivable for a doctor                                                                    
from  out-of-state  to  provide telehealth  services  to  an                                                                    
Alaska resident.  He asked  if an  in-person visit  would be                                                                    
required  prior   to  a   telehealth  appointment   in  this                                                                    
Representative Spohnholz indicated  that any provider giving                                                                    
care in Alaska had to be  licensed in Alaska, whether or not                                                                    
the provider resided  in the state. There  were already many                                                                    
providers who did not reside  in Alaska but were eligible to                                                                    
provide care in the state  via telehealth. The licenses were                                                                    
registered with the state and  the providers were registered                                                                    
with  a  telemedicine registry.  The  bill  dictated that  a                                                                    
patient should  not have to attend  an in-person examination                                                                    
in order to receive care  via telehealth. However, it needed                                                                    
to be clinically  appropriate and there were  times where it                                                                    
would  not  be   appropriate;  for  example,  Representative                                                                    
LeBon's example  of dental care. Alternatively,  it would be                                                                    
appropriate to use telehealth to  consult an oncologist out-                                                                    
of-state that specialized in a  particular type of cancer. A                                                                    
person should not  have to fly out of state  to receive this                                                                    
kind of care.                                                                                                                   
Representative   LeBon  clarified   that  the   out-of-state                                                                    
provider licensed  in Alaska would  not be required  to have                                                                    
had  an  in-person  appointment   with  the  patient  before                                                                    
providing telehealth services.                                                                                                  
Representative Spohnholz responded in the affirmative.                                                                          
2:14:21 PM                                                                                                                    
Representative Josephson  asked if  a licensed  provider who                                                                    
was  out-of-state  and   providing  telehealth  services  in                                                                    
Alaska,  would the  provider be  considered licensed  in two                                                                    
Representative  Spohnholz indicated  that  a provider  could                                                                    
choose  to  be licensed  only  in  Alaska  or choose  to  be                                                                    
licensed in  their home state  and in Alaska.  She explained                                                                    
that  licensing laws  in  the United  States  looked to  the                                                                    
state of residence of the patient, not the provider.                                                                            
Representative    Josephson   asked    about   international                                                                    
licensure. He wondered whether  this would welcome providers                                                                    
from other countries to practice in Alaska.                                                                                     
Representative Spohnholz deferred to Ms. Sara Chambers.                                                                         
2:16:00 PM                                                                                                                    
SARA CHAMBERS, DIRECTOR,  DIVISION OF CORPORATIONS, BUSINESS                                                                    
AND   PROFESSIONAL   LICENSING,  DEPARTMENT   OF   COMMERCE,                                                                    
COMMUNITY AND  ECONOMIC DEVELOPMENT, clarified that  as long                                                                    
as  a provider  met the  criteria for  state licensure,  the                                                                    
provider could practice from any location.                                                                                      
2:16:48 PM                                                                                                                    
Representative  Spohnholz  continued  on   slide  8  of  the                                                                    
presentation.  She   reviewed  how  the   legislation  would                                                                    
enhance  telehealth   access  for  substance   use  disorder                                                                    
treatment. The  bill would remove the  in-person requirement                                                                    
to  prescribe controlled  substances through  telehealth for                                                                    
physicians,  podiatrists,  osteopaths, physician  assistants                                                                    
(PAs), and  advanced practice registered nurses  (APRNs). It                                                                    
would   also   allow   registered  practitioners   such   as                                                                    
physicians,  PAs, and  APRNs to  prescribe medicine  such as                                                                    
buprenorphine   via   telehealth   without   an   additional                                                                    
healthcare  provider present  with  the  patient. She  noted                                                                    
that she had  heard from providers that it  was important to                                                                    
prescribe these  types of medicine quickly  because patients                                                                    
could  be   going  through   opioid  withdrawals   and  need                                                                    
immediate  help.  She  reiterated that  all  prescribers  of                                                                    
controlled  substances were  still required  in the  bill to                                                                    
comply with drug enforcement regulations.                                                                                       
2:18:19 PM                                                                                                                    
Representative   Josephson  asked   if  the   definition  of                                                                    
controlled substances included narcotics and opioids.                                                                           
Representative  Spohnholz  responded  that  it  did  include                                                                    
those  substances. It  was important  to include  opioids in                                                                    
the  definition  because there  were  times  when an  opioid                                                                    
could be  prescribed via telehealth in  urgent scenarios and                                                                    
prescribers  would   still  be   required  to   comply  with                                                                    
controlled substance regulations.                                                                                               
Representative  Josephson suggested  there would  be efforts                                                                    
to abuse such  a privilege, by both  patients and providers.                                                                    
He wondered  if there were  protections built into  the bill                                                                    
that would prevent abuse of prescriptions.                                                                                      
Representative  Spohnholz agreed  that  it  was likely  that                                                                    
some people would try to  abuse the privilege. She indicated                                                                    
that  was  why  it  was important  to  continue  to  require                                                                    
providers  to   participate  in  federal   Drug  Enforcement                                                                    
Administration (DEA)  regulations and the  prescription drug                                                                    
monitoring  program  (PDMP).  There  had  been  some  recent                                                                    
advancements in this area and  there was no requirement that                                                                    
a provider  must provide  medication to  a patient  that was                                                                    
thought to  be seeking drugs.  She deferred to her  staff to                                                                    
provide some additional detail.                                                                                                 
2:20:19 PM                                                                                                                    
GENEVIEVE   MINA,  STAFF,   REPRESENTATIVE  IVY   SPOHNHOLZ,                                                                    
explained  that federal  law required  that  a patient  must                                                                    
receive  behavioral   health  treatment   as  part   of  any                                                                    
prescription for  medications for  opioid use  disorder. The                                                                    
bill pertained  to buprenorphine in particular,  which was a                                                                    
medication that was allowed to  be prescribed via telehealth                                                                    
throughout  the COVID-19  pandemic. Providers  registered to                                                                    
prescribe  buprenorphine were  also  required  to submit  to                                                                    
physical  monitoring tools  to  ensure that  misuse was  not                                                                    
occurring,  such   as  regular   urine  tests.   There  were                                                                    
additional restrictions  such as the  seven-day prescription                                                                    
for  opioids, which  required that  there  had to  be a  new                                                                    
prescription on  a weekly  basis. She  echoed Representative                                                                    
Spohnholz's  earlier comments  regarding  the importance  of                                                                    
the  requirement   for  providers  to  participate   in  DEA                                                                    
regulations and the PDMP.                                                                                                       
2:21:43 PM                                                                                                                    
Representative  Josephson understood  the importance  of the                                                                    
bill and  supported it.  However, earlier  discussions about                                                                    
the PDMP  in the committee made  it clear that the  PDMP was                                                                    
not being  followed religiously. He recalled  an instance of                                                                    
an Eagle  River provider  who would have  quick interactions                                                                    
with  patients and  prescribe more  and more  medication. He                                                                    
was  worried about  prescriptions  getting out  of hand.  He                                                                    
asked  if the  physician  would  be required  to  look at  a                                                                    
patient  on a  screen or  could services  be provided  via a                                                                    
phone call.                                                                                                                     
Representative Spohnholz deferred to Ms. Mina.                                                                                  
Ms. Mina responded that prior  to the COVID-19 pandemic, the                                                                    
DEA  required that  patients that  received medications  for                                                                    
opioid use  disorder must receive an  in-person examination.                                                                    
The provision  was waived during  the pandemic and  was tied                                                                    
to  the FPHE  that  was  set to  expire  in  April of  2022.                                                                    
Additionally,  the DEA  allowed audio-only  prescriptions of                                                                    
buprenorphine  during the  pandemic. According  to providers                                                                    
that  she had  spoken  to, patients  thought that  in-person                                                                    
examinations were  a crucial part  of their  treatment. Even                                                                    
if  the   requirement  for  an  in-person   visit  prior  to                                                                    
providing  a  prescription  was removed,  a  provider  could                                                                    
still  choose to  see a  patient in-person  first. The  bill                                                                    
deferred  to the  patient-provider relationship  and allowed                                                                    
the  provider  to  make  the  decision  rather  than  always                                                                    
requiring an  in-person visit  no matter  the circumstances.                                                                    
She  noted that  access to  opioid use  disorder medications                                                                    
had  been crucial  in places  like rural  Alaska during  the                                                                    
2:24:44 PM                                                                                                                    
Representative  Josephson thought  he  would likely  support                                                                    
the bill.  However, he expressed  worry about  the potential                                                                    
for bad  actors. He  relayed that  the occurrences  of abuse                                                                    
that he had read about were egregious.                                                                                          
Representative  Spohnholz  concurred  that  there  were  bad                                                                    
actors and that nothing in  the bill would prevent that from                                                                    
happening.  However,  there  were robust  prescription  drug                                                                    
limits  in place  and additional  enforcement mechanisms  in                                                                    
licensing. She  thought the PDMP  was vital. She  noted that                                                                    
buprenorphine  was  a   medication  assisted  treatment  and                                                                    
controlled substance and could  be prescribed via telehealth                                                                    
under the bill. There were  times where people would need to                                                                    
be on medication assisted treatment  for many years. Some of                                                                    
these  individuals  would be  living  in  remote areas  that                                                                    
would make regularly visiting a  provider very difficult. It                                                                    
was  important for  everyone to  have  access to  medication                                                                    
assisted treatment if they needed it.                                                                                           
Representative Wool agreed that all  bad actors could not be                                                                    
eliminated. He  suggested that a  patient seeing  a provider                                                                    
for   the  first   time  via   telehealth  and   immediately                                                                    
requesting opioids would be a  red flag for the provider and                                                                    
assumed  that  it  would not  be  applicable  to  first-time                                                                    
patients.  He  thought that  the  bill  would not  apply  to                                                                    
veterinarians  for animal  prescriptions,  even though  they                                                                    
were registered with the DEA.                                                                                                   
Representative  Spohnholz responded  that the  bill did  not                                                                    
apply  to  veterinarians. She  indicated  that  it would  be                                                                    
possible for a first-time  patient to receive a prescription                                                                    
for  medication  assisted  treatments  via  telehealth.  She                                                                    
relayed  that emergency  room  physicians  shared that  they                                                                    
often see  patients who were going  through withdrawals, and                                                                    
it  was  imperative to  ensure  that  the patients  received                                                                    
access  to medication  assisted  treatment immediately.  The                                                                    
situation was  time-sensitive, and  telehealth made  it more                                                                    
possible to respond to the situation in a timely manner.                                                                        
Representative   Rasmussen  asked   if   there  were   other                                                                    
instances where it would be  reasonable to expect first-time                                                                    
patients  to   be  prescribed  controlled   substances.  She                                                                    
provided  potential examples  of situations  that would  not                                                                    
qualify as a  first-time visit, such as  a patient receiving                                                                    
controlled substances after a surgery.                                                                                          
2:29:26 PM                                                                                                                    
Representative  Spohnholz explained  that  there were  other                                                                    
examples   where  a   first-time   patient   would  need   a                                                                    
prescription   immediately,  such   as  a   patient  needing                                                                    
Adderall,  which   was  a  controlled   substance.  Complete                                                                    
examinations with  psychiatrists could occur  via telehealth                                                                    
and could  offer certainty  to a  provider that  the patient                                                                    
was not  seeking drugs.  She did  not want  to unnecessarily                                                                    
require  someone   to  see  a  provider   in-person  for  an                                                                    
examination   when  it   could   be   thoroughly  done   via                                                                    
Representative   Spohnholz  turned   to  slide   9  of   the                                                                    
presentation. She  relayed that  the bill would  also expand                                                                    
Medicaid  coverage  for  telehealth. The  bill  allowed  for                                                                    
reimbursement for  services that  were already  billable via                                                                    
Medicaid  if  the services  were  provided  in person.  Such                                                                    
reimbursable services  included behavioral  health services,                                                                    
home  and  community-based  services,  Medicaid  waiver  and                                                                    
demonstration  services,  and  services  provided  at  rural                                                                    
clinics and federally qualified health centers.                                                                                 
Representative  Spohnholz  concluded   the  presentation  on                                                                    
slide 10.  She reiterated  that HB  265 would  ensure robust                                                                    
patient  protection in  Alaska while  expanding some  of the                                                                    
flexible services  that were  permitted during  the COVID-19                                                                    
pandemic.  She thanked  the  stakeholders  that had  written                                                                    
letters of support for the bill.                                                                                                
Co-Chair Merrick indicated there were invited testifiers.                                                                       
2:32:44 PM                                                                                                                    
NANCY  MERRIMAN,  EXECUTIVE  DIRECTOR, ALASKA  PRIMARY  CARE                                                                    
ASSOCIATION (via  teleconference), expressed support  for HB
265. The  Alaska Primary  Care Association  (APCA) supported                                                                    
the  operations and  development  of  Alaska's 29  federally                                                                    
qualified health centers. She  explained that health centers                                                                    
provided  comprehensive  care   including  medical,  dental,                                                                    
behavioral,  pharmacy, and  care coordination  services. She                                                                    
relayed that  APCA supported the  bill because  it increased                                                                    
access to  primary care and  behavioral health  services and                                                                    
expanded  telehealth  access  in   Alaska.  The  bill  would                                                                    
directly impact  health centers  by allowing  for audio-only                                                                    
telehealth services and allowing  for patients and providers                                                                    
to engage outside  of a clinical setting if  they so choose.                                                                    
The  bill  would  also provide  adequate  reimbursement  for                                                                    
telehealth  visits including  for  substance and  behavioral                                                                    
health treatments.                                                                                                              
Ms.  Merriman shared  that in  2020,  health centers  served                                                                    
over  105,000  patients  and   telehealth  was  the  fastest                                                                    
growing  service  provided  by   health  centers.  About  40                                                                    
percent  of patients  were seen  via  telehealth, and  about                                                                    
half of  total opioid  use disorder  patients were  seen via                                                                    
telehealth.   The  majority   of  telehealth   patients  had                                                                    
experienced  challenges  accessing  healthcare  including  a                                                                    
long distance  to reach providers,  cost of  care, language,                                                                    
and  cultural   barriers.  She  suggested   that  telehealth                                                                    
ultimately  would  lead  to  better  health  outcomes,  save                                                                    
lives, and save money. She urged support for the bill.                                                                          
2:36:54 PM                                                                                                                    
Representative  Rasmussen   asked  if  Ms.   Merriman  could                                                                    
identify  a circumstance  where a  first-time patient  would                                                                    
require a prescription for a narcotic or opioid.                                                                                
Ms.  Merriman  responded  that   she  could  return  to  the                                                                    
committee with that information.                                                                                                
2:37:31 PM                                                                                                                    
TOM  CHARD,  EXECUTIVE  DIRECTOR, ALASKA  BEHAVIORAL  HEALTH                                                                    
ASSOCIATION  (via teleconference),  relayed that  the Alaska                                                                    
Behavioral  Health Association  (ABHA)  fully supported  the                                                                    
bill  because it  improved  Alaskans'  access to  behavioral                                                                    
healthcare. He  stated that the Alaska  Department of Health                                                                    
and Social  Services' (DHSS)  annual Medicaid  report stated                                                                    
there was a  134 percent increase in  telehealth claims paid                                                                    
in FY  21 as compared to  FY 20. The report  noted that four                                                                    
out  of   the  five   top  diagnosis  codes   delivered  via                                                                    
telehealth  were  behavioral   health  diagnoses.  The  data                                                                    
suggested   that   Alaskans   were  struggling   to   access                                                                    
behavioral  healthcare, but  also  pointed  to the  economic                                                                    
opportunity   afforded  by   early  intervention.   National                                                                    
insurance companies were rushing  to offer virtual-first and                                                                    
digital-first benefits  because the companies  realized that                                                                    
it saved money to avoid  expenses like travel. It also saved                                                                    
money by avoiding  the cost of readmission  at hospitals and                                                                    
higher  acute  care.  He  indicated   that  the  state  DHSS                                                                    
reported  that  Medicaid  travel   costs  decreased  by  $45                                                                    
million from FY 20 to  FY 21. By offering preventative care,                                                                    
savings were  provided to the  overall budget.  The economic                                                                    
benefits  were  merely  a  small part  of  the  reason  ABHA                                                                    
supported HB  265. He hoped  that members would  support the                                                                    
legislation as well.                                                                                                            
Co-Chair  Merrick appreciated  hearing from  the testifiers.                                                                    
She thanked the bill sponsor.                                                                                                   
HB  265  was  HEARD  and   HELD  in  committee  for  further                                                                    
2:40:48 PM                                                                                                                    
AT EASE                                                                                                                         
2:41:31 PM                                                                                                                    
HOUSE BILL NO. 296                                                                                                            
     "An Act  relating to program receipts;  and relating to                                                                    
     the acceptance of gifts, donations,  and grants for the                                                                    
     purpose  of  providing  signage for  assets  under  the                                                                    
     control of the Department  of Transportation and Public                                                                    
2:41:41 PM                                                                                                                    
REPRESENTATIVE GEORGE  RAUSCHER, SPONSOR, suggested  that it                                                                    
was  important for  legislators  to acknowledge  individuals                                                                    
who had contributed  to their community. One of  the ways to                                                                    
achieve recognition  was to name a  geographical location or                                                                    
structure  after  a person  of  note.  However, this  naming                                                                    
could  be expensive  to  implement and  the  cost alone  had                                                                    
caused legislators  to vote against legislation  proposing a                                                                    
commemorative  naming.  He  explained   that  HB  296  would                                                                    
provide a  mechanism for funding  a commemorative name  to a                                                                    
project by  allowing receipt authority to  the Department of                                                                    
Transportation  and  Public  Facilities (DOT)  so  it  could                                                                    
collect  donations for  signage.  It would  not require  the                                                                    
costs  to be  paid by  outside groups,  but it  would ensure                                                                    
that the process not be necessarily reliant on state funds.                                                                     
2:43:47 PM                                                                                                                    
RYAN MCKEE,  STAFF, REPRESENTATIVE GEORGE RAUCHER,  read the                                                                    
sectional analysis:                                                                                                             
     Section  1:  AS 37.05.146(c)  Page  1,  Lines 5-7  This                                                                    
     section adds  gifts, donations, and grants  received by                                                                    
     DOT  & PF  to the  definition of  program receipts  and                                                                    
     non-  general  fund  programs  receipts  found  in  the                                                                    
     Fiscal Procedures  Act in accordance with  section 2 of                                                                    
     this bill.                                                                                                                 
     Section 2:  AS 44.42.060  Page 1,  Lines 8-14,  Page 2,                                                                    
     Lines  1-3 This  section adds  that the  department may                                                                    
     receive  gifts,  donations,  and grants  in  accordance                                                                    
     with  a  memorandum  of understanding  with  the  donor                                                                    
     party. This  section also outlines  that the  funds may                                                                    
     not  be  used  until  the  necessary  funds  have  been                                                                    
     collected from the donor.                                                                                                  
2:45:02 PM                                                                                                                    
Representative Wool asked if the  bill required the approval                                                                    
of a sign before collecting fees.                                                                                               
Representative Rauscher deferred to Mr. Andy Mills.                                                                             
2:45:47 PM                                                                                                                    
ANDY    MILLS,    LEGISLATIVE   LIAISON,    DEPARTMENT    OF                                                                    
TRANSPORTATION AND  PUBLIC FACILITIES  (via teleconference),                                                                    
responded  that  when  a  bill that  sought  to  name  state                                                                    
infrastructure was introduced, it  would include a provision                                                                    
pointing  to the  codifying language  in HB  296 that  would                                                                    
allow the  bill to  be paid  for through  outside donations.                                                                    
The  interested donators  would  then sign  a memorandum  of                                                                    
understanding (MOU) as outlined  in the bill's language. The                                                                    
naming  legislation  would be  taken  from  a legislator  to                                                                    
instigate a fiscal note and  point to statutorily designated                                                                    
program receipts as the source of funding.                                                                                      
Representative Wool  commented that if a  group raised money                                                                    
for  a  sign  and  received the  funding,  the  group  could                                                                    
potentially  influence the  bill. He  was glad  there was  a                                                                    
solution  to  the  funding problem  through  donations,  but                                                                    
thought it was important that the bill had to come first.                                                                       
2:47:44 PM                                                                                                                    
AT EASE                                                                                                                         
2:47:49 PM                                                                                                                    
Co-Chair Merrick  indicated the  Senate version of  the bill                                                                    
was an  exact match and  the committee would be  taking that                                                                    
version up in the future.                                                                                                       
HB  296  was  HEARD  and   HELD  in  committee  for  further                                                                    
2:48:19 PM                                                                                                                    
AT EASE                                                                                                                         
2:49:37 PM                                                                                                                    
HOUSE BILL NO. 291                                                                                                            
     "An Act extending the termination date of the Council                                                                      
     on Domestic Violence and Sexual Assault; and providing                                                                     
     for an effective date."                                                                                                    
2:49:45 PM                                                                                                                    
REPRESENTATIVE GERAN TARR, SPONSOR,  explained that the bill                                                                    
would  extend the  Council on  Domestic Violence  and Sexual                                                                    
Assault (CDVSA) through  June 30, 2028. The  council was set                                                                    
to sunset on  June 30 of 2022 and action  needed to be taken                                                                    
quickly.  She noted  that there  was a  sunset provision  in                                                                    
statute  that  would trigger  an  audit,  which members  had                                                                    
copies of in their bill packets.                                                                                                
Representative  Tarr highlighted  some of  the audit  report                                                                    
conclusions. She read from the audit report (copy on file):                                                                     
     The   audit  concluded   that  the   council  generally                                                                    
     operated  in  the  public's  interest  by  funding  and                                                                    
     monitoring   Alaskan  domestic   violence  and   sexual                                                                    
     assault   programs  and   prevention  activities.   The                                                                    
     council served  as the central coordinator  for related                                                                    
     services  throughout the  state, conducted  meetings in                                                                    
     accordance  with council  bylaws, effectively  met most                                                                    
     statutory duties, and did not  duplicate the efforts of                                                                    
     other entities.                                                                                                            
Representative Tarr referred  to page 13 of  the audit which                                                                    
listed the  audit findings. The  audit recommended  that the                                                                    
council  address  its  statutory responsibility  to  consult                                                                    
with the Department of Health  and Social Services (DHSS) to                                                                    
formulate  standards  and  procedures,  that  the  council's                                                                    
executive  director implement  written procedures  to ensure                                                                    
that  public notices  were posted  timely, and  the director                                                                    
should  improve  grant  award and  monitoring  policies  and                                                                    
procedures. She  relayed that the council  was interested in                                                                    
meeting the recommendations.                                                                                                    
Representative Tarr  indicated that the bill  would add some                                                                    
additional  positions  to  the   council.  The  council  was                                                                    
currently comprised  of four public  members and  five state                                                                    
members, and the bill would  add a fifth public member. This                                                                    
individual would  be part of an  Alaska Native organization.                                                                    
The addition  was recommended to  ensure that  Alaska Native                                                                    
communities were  represented. The  bill also  proposed that                                                                    
the governor confer  with the council and  the Alaska Native                                                                    
Women's Resource  Center (ANWRC) to appropriately  fill this                                                                    
position. An  additional government  agency member  would be                                                                    
added  to  the  council  to balance  the  additional  public                                                                    
member. The issue of whether  the Alaska Mental Health Trust                                                                    
Authority (AMHTA) wanted to participate  in the council came                                                                    
up in  the House State  Affairs Committee. She  relayed that                                                                    
the executive director  of AMHTA was very  interested in the                                                                    
trust having a seat on the council.                                                                                             
2:55:08 PM                                                                                                                    
Representative  Rasmussen  thanked   the  bill  sponsor  for                                                                    
bringing the bill  forward. There was funding  that had been                                                                    
secured to offset  the rising cost of utilities  for many of                                                                    
the  groups that  belonged to  AMHTA, and  she thought  that                                                                    
funding would  be irrelevant if  the bill did not  pass. She                                                                    
hoped the legislation would be passed into law.                                                                                 
Co-Chair  Merrick invited  the  Legislative  Auditor to  the                                                                    
2:55:49 PM                                                                                                                    
KRIS  CURTIS,   LEGISLATIVE  AUDITOR,  ALASKA   DIVISION  OF                                                                    
LEGISLATIVE AUDIT,  conveyed the  conclusions of  the audit.                                                                    
She read from page 7 of the audit:                                                                                              
     The   audit  concluded   that  the   council  generally                                                                    
     operated  in  the  public's  interest  by  funding  and                                                                    
     monitoring   Alaskan  domestic   violence  and   sexual                                                                    
     assault   programs  and   prevention  activities.   The                                                                    
     council served  as the central coordinator  for related                                                                    
     services  throughout the  state, conducted  meetings in                                                                    
     accordance  with council  bylaws, effectively  met most                                                                    
     statutory duties, and did not  duplicate the efforts of                                                                    
     other entities.                                                                                                            
     The  audit  also  concluded  that  the  council  should                                                                    
     improve  document retention,  access  to the  Battering                                                                    
     Intervention Program (BIP)  database, and timeliness of                                                                    
     annual report submission and regulation changes.                                                                           
     In accordance  with AS 44.66.010(a)(5), the  council is                                                                    
     scheduled to terminate June 30,  2022. We recommend the                                                                    
     legislature extend  the council's termination  date six                                                                    
     years, to June 30, 2028.                                                                                                   
Ms. Curtis  referred to  the reports on  page 9  that showed                                                                    
financial information  about the council's  expenditures and                                                                    
revenues. The  grant funding increased  substantially during                                                                    
the audit  period as a  result of increasing  federal funds.                                                                    
She  referred to  page 25,  which depicted  the schedule  of                                                                    
grant  payments. It  showed  which  entities were  receiving                                                                    
funds  in  various  locations in  Alaska.  There  were  four                                                                    
recommendations beginning on page 14 of the audit:                                                                              
     Recommendation  No. 1:  The  executive director  should                                                                    
     allocate  resources  to  ensure the  annual  report  is                                                                    
     submitted in accordance with council bylaws.                                                                               
     Recommendation  No. 2:  The  executive director  should                                                                    
     improve  training  to  help ensure  document  retention                                                                    
     procedures are followed.                                                                                                   
     Recommendation No. 3: The executive director should                                                                        
     work with the Department of Law (LAW) to expedite                                                                          
     regulatory updates.                                                                                                        
     Recommendation  No. 4:  The  executive director  should                                                                    
     continue   to  work   with  DPS   and  the   Office  of                                                                    
     Information Technology  (OIT) to improve access  to the                                                                    
     BIP database.                                                                                                              
Ms. Curtis noted that  the improvements under Recommendation                                                                    
No. 4  would require that new  users of the BIP  database be                                                                    
subject  to  a  background  check  and  fingerprinting.  She                                                                    
indicated that  the new requirements would  make the process                                                                    
cumbersome to users. She  relayed that management's response                                                                    
to  the audit  began on  page  29. The  commissioner of  the                                                                    
Department of Public  Safety (DPS) and the  CDVSA chair both                                                                    
agreed with the findings and recommendations of the audit.                                                                      
Co-Chair Merrick moved to invited testimony.                                                                                    
2:59:46 PM                                                                                                                    
BRENDA  STANFILL,  EXECUTIVE  DIRECTOR,  ALASKA  NETWORK  ON                                                                    
DOMESTIC  VIOLENCE AND  SEXUAL  ASSAULT (ANDVSA),  supported                                                                    
the passage  of HB  291 and adding  two additional  seats to                                                                    
the council.  She explained that  ANDVSA was  different than                                                                    
CDVSA and that  people often mistake one for  the other. She                                                                    
indicated that ANDVSA  was made up of the  membership of the                                                                    
direct service  providers within  Alaska. The  providers met                                                                    
quarterly  to discuss  possible improvements  in the  field,                                                                    
how  to   support  one  another,   and  to   note  potential                                                                    
statistical trends.  The network  worked in tandem  with the                                                                    
council  to   ensure  that  issues  were   being  worked  on                                                                    
throughout Alaska in a unified  manner. Both entities worked                                                                    
toward   ending  domestic   violence  in   Alaska  but   had                                                                    
distinctly different roles.                                                                                                     
Ms. Stanfill  indicated that ANDVSA members  worked together                                                                    
on  the ground  to provide  support to  victims while  CDVSA                                                                    
worked to  ensure that  funding was  being dedicated  to the                                                                    
cause and  was being spent in  the way it was  intended. The                                                                    
network relied on the council  to hold quarterly meetings to                                                                    
allow  space  for  individuals   to  speak  about  what  was                                                                    
happening   in   their   communities.   The   council   also                                                                    
commissioned  studies and  ensured  that the  administration                                                                    
was aware  of the work  that was  being done on  the ground.                                                                    
She  reiterated  that  the network  strongly  supported  the                                                                    
addition of two  seats to the council. She  shared that when                                                                    
she began  working in  behavioral health  25 years  ago, the                                                                    
shelters in the state were  being filled up with individuals                                                                    
with substance abuse  issues and it was  unclear what should                                                                    
be  done to  address  the  problem. The  issue  was just  as                                                                    
pervasive  today,   and  there  was  still   no  appropriate                                                                    
solution.   Additionally,   Alaska    Native   people   were                                                                    
overrepresented in  every shelter in every  situation in the                                                                    
state.  She thought  it  was  important for  there  to be  a                                                                    
designated seat on the council  for a representative from an                                                                    
Alaska Native organization. It was  also important for ANWRC                                                                    
to  have a  voice in  selecting the  induvial who  would get                                                                    
appointed for the seat.                                                                                                         
3:05:06 PM                                                                                                                    
DIANE  CASTO,   EXECUTIVE  DIRECTOR,  COUNCIL   ON  DOMESTIC                                                                    
VIOLENCE AND  SEXUAL ASSAULT,  DEPARTMENT OF  PUBLIC SAFETY,                                                                    
thanked   the   committee   for   hearing   the   bill   and                                                                    
Representative Tarr for introducing  it. She appreciated the                                                                    
audits  and  reviews of  the  council  because they  brought                                                                    
about improvements. She  relayed that in FY 18  there was an                                                                    
in-depth  audit done  through funding  from  the Victims  of                                                                    
Crime  Act (VOCA).  It was  a  long and  complete audit  and                                                                    
there  were  14  recommendations, which  was  a  significant                                                                    
amount.  The audit  was a  catalyst for  change and  brought                                                                    
about critical  improvements in  the council's  process. For                                                                    
example,  the council  began to  require federal  funding be                                                                    
given  to grantees  as reimbursement,  not  an advance.  The                                                                    
changes  improved  the council's  work,  but  also placed  a                                                                    
large strain on  the agency's funding. Overall,  it made the                                                                    
council better.  In FY 21, there  was an audit of  the chief                                                                    
financial officer  (CFO) of the Department  of Justice (DOJ)                                                                    
and  the  three  federal  grants   from  DOJ  programs  were                                                                    
examined. She shared that there  was only one recommendation                                                                    
from that  audit. She  thought all  the changes  the council                                                                    
had made were significant and overall improved the program.                                                                     
3:08:56 PM                                                                                                                    
Ms. Casto relayed that CDVSA was  created in 1981 to build a                                                                    
sustainable  structure to  fund and  support community-based                                                                    
services  and to  address the  needs of  victims, survivors,                                                                    
and  others  impacted  by   domestic  and  sexual  violence.                                                                    
Ultimately, CDVSA  was created  to accept federal  money and                                                                    
distribute  it  appropriately  to address  these  needs.  In                                                                    
addition  to the  nine-member board,  there were  nine full-                                                                    
time staff  members at  the council.  The council  funded 35                                                                    
community-based  agencies   serving  Alaskans   impacted  by                                                                    
domestic violence  and within the agencies,  managed a total                                                                    
of 101  grant awards. There  were many grant  types included                                                                    
within the  101 grant awards.  Another finding in  the audit                                                                    
in  FY 18  was that  the  council was  comingling its  grant                                                                    
awards,  but  when  there were  separate  funding  services,                                                                    
there  needed to  be  a separate  grant  award. The  council                                                                    
managed 26 victim services programs  and 18 enhanced service                                                                    
programs,  which  included  child  advocacy  centers,  legal                                                                    
services, and  mental health services for  youth. There were                                                                    
also 13 community  prevention grants and a total  of 10 BIPs                                                                    
that were approved by the state.                                                                                                
3:12:02 PM                                                                                                                    
Ms. Casto  indicated that the  council had made  progress on                                                                    
the  recommendations  made in  the  most  recent audit.  She                                                                    
spoke  to  the  first  recommendation,  which  was  for  the                                                                    
executive  director  to  allocate resources  to  ensure  the                                                                    
annual  report  was  submitted in  accordance  with  council                                                                    
bylaws. There were  a number of challenges in  2020 and 2021                                                                    
due to  the significant drop  in federal funding  during the                                                                    
COVID-19 pandemic.  There was also an  18-month period where                                                                    
the council  only had  six to seven  staff due  to vacancies                                                                    
and hiring  difficulties during the pandemic.  As of Monday,                                                                    
April 4,  2022, the council  would be fully staffed  for the                                                                    
first  time  in  two  years.  She noted  that  there  was  a                                                                    
perception  that there  was a  lack of  transparency in  the                                                                    
council, but all information and  minutes from the quarterly                                                                    
meetings was  required to be  posted on the  state's website                                                                    
for publicly  noticed meetings. The  council was  not trying                                                                    
to hide  anything by not  having an annual  report available                                                                    
on time.  The following year's  report would be on  time and                                                                    
would be released soon.                                                                                                         
3:15:23 PM                                                                                                                    
Ms.  Casto  spoke about  the  second  recommendation of  the                                                                    
audit  which   was  to  train   staff  to   ensure  document                                                                    
retention.  She indicated  that the  more important  element                                                                    
above training  staff was  to ensure  that the  many changes                                                                    
that had been made were  operationalized better. At the time                                                                    
the audit had  occurred, all staff were not yet  up to speed                                                                    
on  the  new  operational  changes.  She  thought  that  the                                                                    
council was  now "out  of that  forest" and  that everything                                                                    
would be well documented going forward.                                                                                         
Ms. Castro referred  to recommendation 3, which  was for the                                                                    
executive director to work with  the Department of Law (DOL)                                                                    
to  expedite  regulatory  updates.  During  the  audit,  DOL                                                                    
appointed a  regulatory lawyer  for the  council to  have at                                                                    
its  disposal.  Once  legislative   session  was  over,  the                                                                    
council  would  be in  the  queue  to distribute  regulatory                                                                    
information to  the public.  Anything in  current regulation                                                                    
that was  not in-line with federal  requirements was covered                                                                    
in  special conditions  for the  grant awards.  Although the                                                                    
regulations were not  up to speed, all of  the grantees that                                                                    
were  receiving funds  adhered to  the federal  requirements                                                                    
due  to  the  special  conditions  written  into  the  grant                                                                    
3:18:21 PM                                                                                                                    
Ms. Casto continued to the  topic of recommendation 4, which                                                                    
was for the  executive director to work with DPS  and OIT to                                                                    
improve access to  the BIP database. She  felt strongly that                                                                    
BIP  was a  critical  piece of  ending  domestic and  sexual                                                                    
violence.  The  council  needed to  have  strong  prevention                                                                    
programs, available  services for  victims, and  services to                                                                    
address  the  root causes  of  abusive  behavior. All  three                                                                    
elements  were vital  to make  progress. She  explained that                                                                    
when she first came to the  council, she reviewed all of the                                                                    
programs  and one  of the  programs in  particular horrified                                                                    
her  because   it  was  not  being   properly  managed.  The                                                                    
mismanagement  was  due  to  insufficient  funding  and  the                                                                    
person who had been managing  the program resigned, and then                                                                    
the  position  was  removed  altogether.  She  made  it  her                                                                    
mission to tackle the issues with the BIP program.                                                                              
Ms. Casto indicated  that she started a work  group in April                                                                    
of 2021 to  determine how to build  successful programs that                                                                    
would impact  behavior. She needed  data which she  was told                                                                    
was not  available when  she first  joined the  council. She                                                                    
investigated and  discovered that there was  a database, but                                                                    
that all OIT  employees that were aware of  the database had                                                                    
since resigned.  The council was currently  working with OIT                                                                    
and the  IT program  within DPS  to move  the database  to a                                                                    
different platform, such as a  cloud-based platform, to make                                                                    
it  easier for  grantees to  access the  database and  enter                                                                    
data. She reminded the committee  that the process currently                                                                    
required fingerprinting to access  the database. The process                                                                    
became so egregious that it  was no longer deemed worthwhile                                                                    
to  submit data.  She hoped  that  the new  system would  be                                                                    
completed  within the  next  six months  and  that it  would                                                                    
require everyone  to submit data.  The influx of  data would                                                                    
inform the council's decision on  what needed to be added to                                                                    
the BIP system.                                                                                                                 
3:22:38 PM                                                                                                                    
Representative Rasmussen asked if  there was anything in the                                                                    
database  that  would  track offenders  and  the  number  of                                                                    
victims  they had  abused. She  thought recidivism  would be                                                                    
better if these numbers were provided.                                                                                          
Ms.  Casto responded  that  the council  did  not track  the                                                                    
specific  data  Representative  Rasmussen was  looking  for.                                                                    
However,  there was  some  data that  looked  at whether  an                                                                    
offender  had   prior  victims  and  whether   the  offender                                                                    
continued to be engaged with  victims after an incident. She                                                                    
thought the  issue of recidivism  was difficult  because the                                                                    
only way to  tell if an offender had recidivated  was if the                                                                    
offender was  caught again.  The question  was how  to track                                                                    
elements   beyond   recidivism.   The   council   had   been                                                                    
researching other methods  and looking at the  ways in which                                                                    
other   states  collected   data.  Researchers   found  that                                                                    
Alaska's database  was one  of the  best and  included great                                                                    
information; it was simply a  matter of having access to it.                                                                    
The  database  in Alaska  looked  at  the Adverse  Childhood                                                                    
Experiences  (ACEs)   of  offenders,  which  laid   a  great                                                                    
foundation for discovering the root cause of abuse.                                                                             
3:25:03 PM                                                                                                                    
Representative  Rasmussen thought  much of  the conversation                                                                    
was about modernizing domestic abuse  policy. She spoke of a                                                                    
video   she   saw   on  Facebook   showing   abuse   without                                                                    
repercussion.  She  thought there  needed  to  be a  broader                                                                    
discussion that looked at childhood.                                                                                            
Ms.  Casto  agreed and  stated  that  domestic violence  and                                                                    
child abuse  were interconnected. Many  children experienced                                                                    
abuse  in   the  home  and  a   violent  atmosphere  created                                                                    
tremendous  trauma. She  started her  career in  child abuse                                                                    
and neglect  prevention and the  issue was important  to her                                                                    
as well.                                                                                                                        
3:27:03 PM                                                                                                                    
Representative  LeBon  asked  for  an example  of  the  data                                                                    
points that would be entered into the database.                                                                                 
Ms.  Casto assumed  Representative LeBon  was talking  about                                                                    
the BIP  database. She  explained that  arrest data  was not                                                                    
collected.  She had  a link  that she  could provide  to the                                                                    
committee  that  showed  all collected  data.  It  was  also                                                                    
important for  victims to  be served  and protected  in some                                                                    
way.  One of  the things  that was  found was  that when  an                                                                    
individual  was going  through  a  domestic violence  class,                                                                    
program,  or treatment,  the individual  would often  become                                                                    
more aggressive  because they were being  challenged. Victim                                                                    
safety was a key piece of the program.                                                                                          
Representative LeBon  noted Ms.  Casto had presented  to the                                                                    
Public  Safety Finance  Subcommittee on  the same  topic. He                                                                    
was aware of  a fiscal note and wondered if  the fiscal note                                                                    
would be addressed.                                                                                                             
Co-Chair  Merrick   indicated  she   was  not   planning  on                                                                    
addressing  it  but  would  discuss  it  if  Ms.  Casto  was                                                                    
Representative LeBon  noted that  in 2021, the  reduction in                                                                    
VOCA funding  was consequential.  He referred to  the fiscal                                                                    
note  [by  the Department  of  Public  Safety, control  code                                                                    
PqrQf]  and  asked if  Coronavirus  State  and Local  Fiscal                                                                    
Recovery Funds  (CSLFRF) funding  was used to  back-fill the                                                                    
council's budget. He asked whether  she was confident in the                                                                    
federal funding.                                                                                                                
Ms. Casto was  not confident in the federal  funding. In the                                                                    
prior year, the  council received a 34  percent reduction in                                                                    
VOCA funding  from 2020 to  2021. It was a  significant loss                                                                    
of money  and it had  been dropping significantly  in recent                                                                    
years. It had dropped from almost  $8 million in 2018 at the                                                                    
time of the  award to $2.8 million in 2021.  The council was                                                                    
unprepared for  the substantial 34 percent  reduction in one                                                                    
year. She noted that one  of the federal grants through DHSS                                                                    
provided  to  the council  three  American  Rescue Plan  Act                                                                    
(ARPA)  grants. She  relayed that  the  council was  piecing                                                                    
together one-time funding sources to  build the FY 22 and FY                                                                    
24 budgets. There  were grants that the council  hoped to be                                                                    
awarded to help contribute to  the budget. She had been told                                                                    
that the  crime victim  fund, which  was what  supported the                                                                    
VOCA  funding, was  at its  lowest level  ever. The  council                                                                    
would be seeking additional funding in FY 24 and FY 25.                                                                         
3:35:32 PM                                                                                                                    
Representative LeBon pointed to  the designated general fund                                                                    
(DGF) money  listed on the  fiscal note. He asked  where the                                                                    
$2  million listed  came from,  whether it  was predictable,                                                                    
and whether it was subject to the sweep.                                                                                        
Ms. Castro  responded that  it was  predictable now  and had                                                                    
also been  predictable in  the past. It  was money  that had                                                                    
been given to  CDVSA in FY 18  that came about due  to SB 91                                                                    
and came  from the marijuana  tax fund. So far,  the funding                                                                    
had been  steady. She was  worried when SB 91  was rescinded                                                                    
but the money  was not impacted. The  money was specifically                                                                    
designated  to   fund  the  13   community-based  prevention                                                                    
Representative  LeBon asked  if the  money was  spent before                                                                    
the sweep.                                                                                                                      
Ms. Casto  responded that the  money was spent and  none was                                                                    
left on the table.                                                                                                              
3:37:13 PM                                                                                                                    
Representative Rasmussen asked  if Ms. Casto knew  if any of                                                                    
the organizations  that received  funding qualified  as non-                                                                    
profits.  She  knew that  some  organizations  were able  to                                                                    
qualify and receive money through avenues like pull-tabs.                                                                       
Ms. Casto  responded that she  did not know. She  had worked                                                                    
for  organizations in  the past  that were  able to  utilize                                                                    
pull-tab  money. She  elaborated that  normally the  council                                                                    
supplemented  the budget  with fundraising  events, but  the                                                                    
pandemic had gotten in the way of those efforts.                                                                                
Representative  Rasmussen noted  legislation in  circulation                                                                    
that   would   allow   for   the   expansion   of   pull-tab                                                                    
requirements. The  addition of electronic  pull-tabs invited                                                                    
new participants  and the amount  of money was  sizable. She                                                                    
was open to working on the issue.                                                                                               
Co-Chair Merrick  thanked the testifiers. She  noted that in                                                                    
House State  Affairs Committee there  was one "do  not pass"                                                                    
recommendation  and  wondered  about   the  reason  for  the                                                                    
Representative Tarr responded that Representative Eastman                                                                       
voted "do not pass" because he did not support the addition                                                                     
of a member from an Alaska Native organization.                                                                                 
HB 291 was HEARD and HELD in committee for further                                                                              
Co-Chair Merrick relayed the agenda for the following day.                                                                      
3:41:19 PM                                                                                                                    
The meeting was adjourned at 3:41 p.m.                                                                                          

Document Name Date/Time Subjects
HB 265 Supporting Document - Testimony - Received as of 03.14.22.pdf HFIN 3/29/2022 1:30:00 PM
HB 265
CS HB 265 v D - PowerPoint Presentation 03.14.22.pdf HFIN 3/29/2022 1:30:00 PM
HB 265
CS HB 265 v D Sponsor Statement 03.14.22.pdf HFIN 3/29/2022 1:30:00 PM
HB 265
CS HB 265 v D Explanation of Changes 03.14.22.pdf HFIN 3/29/2022 1:30:00 PM
HB 265
HB 265 Supporting Document - Letters of Support - Received as of 03.14.2022.pdf HFIN 3/29/2022 1:30:00 PM
HB 265
HB 296 Sectional Analysis 1.31.2022.pdf HFIN 3/29/2022 1:30:00 PM
HB 296
HB 296 Sponsor Statement .pdf HFIN 3/29/2022 1:30:00 PM
HB 296
HB 291 Letter of Support.pdf HFIN 3/29/2022 1:30:00 PM
SFIN 5/2/2022 9:00:00 AM
HB 291
HB 291 Sponsor Statement.pdf HFIN 3/29/2022 1:30:00 PM
HB 291
HB 291 Summary of Changes.pdf HFIN 3/29/2022 1:30:00 PM
SFIN 5/2/2022 9:00:00 AM
HB 291
HB 291 Supporting Document - Leg Audit Sunset Review.pdf HFIN 3/29/2022 1:30:00 PM
SFIN 5/2/2022 9:00:00 AM
HB 291
CS HB 265 Sectional Analysis - Version D 03.18.22.pdf HFIN 3/29/2022 1:30:00 PM
HB 265
HB 265 Supporting Document - Joint Letter to DEA and HHS 03.03.22.pdf HFIN 3/29/2022 1:30:00 PM
HB 265
HB 265 Supporting Document - Additional HFIN Letters of Support - Received as of 03.28.22.pdf HFIN 3/29/2022 1:30:00 PM
HB 265
SB 33 Seafood Tax Credit Amendment 3 Ortiz.pdf HFIN 3/29/2022 1:30:00 PM
SB 33
HB 291 Additional Info - Response from Alaska Mental Health Trust 03.11.22.pdf HFIN 3/29/2022 1:30:00 PM
SFIN 5/17/2022 1:00:00 PM
HB 291
HB 265 SEIU Letter 032122.pdf HFIN 3/29/2022 1:30:00 PM
HB 265