Legislature(2021 - 2022)DAVIS 106

04/01/2021 03:00 PM House HEALTH & SOCIAL SERVICES

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03:06:06 PM Start
03:06:57 PM Confirmation Hearing(s):|| Mental Health Trust Authority|| State Medical Board
04:55:39 PM Adjourn
* first hearing in first committee of referral
+ teleconferenced
= bill was previously heard/scheduled
+ Consideration of Governor's Appointees: TELECONFERENCED
- State Medical Board: David Boswell, Larry
Daugherty, & Richard Wein
- Mental Health Trust Authority: Annette
Gwalthney-Jones, Anita Halterman, Rhonda Boyles,
& Brent Fisher
-- Invited & Public Testimony --
+ Bills Previously Heard/Scheduled TELECONFERENCED
                    ALASKA STATE LEGISLATURE                                                                                  
      HOUSE HEALTH AND SOCIAL SERVICES STANDING COMMITTEE                                                                     
                         April 1, 2021                                                                                          
                           3:06 p.m.                                                                                            
MEMBERS PRESENT                                                                                                               
Representative Liz Snyder, Co-Chair                                                                                             
Representative Tiffany Zulkosky, Co-Chair                                                                                       
Representative Ivy Spohnholz (via teleconference)                                                                               
Representative Zack Fields                                                                                                      
Representative Mike Prax                                                                                                        
Representative Christopher Kurka                                                                                                
MEMBERS ABSENT                                                                                                                
Representative Ken McCarty                                                                                                      
COMMITTEE CALENDAR                                                                                                            
CONFIRMATION HEARING(S):                                                                                                        
Mental Health Trust Authority                                                                                                 
     Annette Gwalthney-Jones  Anchorage                                                                                         
     Anita Marie Halterman  Eagle River                                                                                         
     Rhonda Boyles  Anchorage                                                                                                   
     Brent Fisher  Anchorage                                                                                                    
     - HEARD                                                                                                                    
State Medical Board                                                                                                           
     David Boswell - Fairbanks                                                                                                  
     Richard Wein - Sitka                                                                                                       
     - HEARD                                                                                                                    
     Larry Daugherty - Anchorage                                                                                                
     - SCHEDULED BUT NOT HEARD                                                                                                  
PREVIOUS COMMITTEE ACTION                                                                                                     
No previous action to record                                                                                                    
WITNESS REGISTER                                                                                                              
ANNETTE GWALTHNEY-JONES, Appointee                                                                                              
Board of Trustees                                                                                                               
Alaska Mental Health Trust Authority                                                                                            
Anchorage, Alaska                                                                                                               
POSITION STATEMENT:  Testified as appointee to the Alaska Mental                                                              
Health Trust Authority Board of Trustees.                                                                                       
ANITA MARIA HALTERMAN, Appointee                                                                                                
Board of Trustees                                                                                                               
Alaska Mental Health Trust Authority                                                                                            
Eagle River, Alaska                                                                                                             
POSITION STATEMENT:  Testified as appointee to the Alaska Mental                                                              
Health Trust Authority Board of Trustees.                                                                                       
RHONDA BOYLES, Appointee                                                                                                        
Board of Trustees                                                                                                               
Alaska Mental Health Trust                                                                                                      
Anchorage, Alaska                                                                                                               
POSITION STATEMENT:  Testified as appointee to the Alaska Mental                                                              
Health Trust Board of Trustees.                                                                                                 
BRENT FISHER, Appointee                                                                                                         
Board of Trustees                                                                                                               
Alaska Mental Health Trust Authority                                                                                            
Anchorage, Alaska                                                                                                               
POSITION STATEMENT:  Testified as appointee to the Alaska Mental                                                              
Health Trust Authority Board of Trustees.                                                                                       
DAVID BOSWELL, Appointee                                                                                                        
State Medical Board                                                                                                             
Division of Corporations, Business and Professional Licensing                                                                   
Department of Commerce, Community, and Economic Development                                                                     
Fairbanks, Alaska                                                                                                               
POSITION STATEMENT:  Testified as public appointee to the State                                                               
Medical Board.                                                                                                                  
RICHARD WEIN, MD, Appointee                                                                                                     
State Medical Board                                                                                                             
Division of Corporations, Business and Professional Licensing                                                                   
Department of Commerce, Community, and Economic Development                                                                     
Sitka, Alaska                                                                                                                   
POSITION STATEMENT:  Testified as physician appointee to the                                                                  
State Medical Board.                                                                                                            
ACTION NARRATIVE                                                                                                              
3:06:06 PM                                                                                                                    
CO-CHAIR LIZ SNYDER  called the House Health  and Social Services                                                             
Standing   Committee    meeting   to    order   at    3:06   p.m.                                                               
Representatives  Prax,  Fields, Spohnholz  (via  teleconference),                                                               
Zulkosky,  and  Snyder  were  present   at  the  call  to  order.                                                               
Representative Kurka arrived as the meeting was in progress.                                                                    
^CONFIRMATION HEARING(S):                                                                                                       
^Mental Health Trust Authority                                                                                                  
^State Medical Board                                                                                                            
                    CONFIRMATION HEARING(S):                                                                                
                 Mental Health Trust Authority                                                                              
                      State Medical Board                                                                                   
3:06:57 PM                                                                                                                    
CO-CHAIR SNYDER announced  that the only order  of business would                                                               
be  confirmation hearings  for  appointees to  the Mental  Health                                                               
Trust Authority and the State Medical Board.                                                                                    
3:07:20 PM                                                                                                                    
CO-CHAIR  SNYDER explained  that the  Alaska Mental  Health Trust                                                               
Authority ("the  Trust") is a state  corporation that administers                                                               
a perpetual  trust to  improve the lives  of beneficiaries.   The                                                               
Trust  operates  much  like  a   private  foundation,  using  its                                                               
resources to  ensure that Alaska  has a  comprehensive integrated                                                               
mental  health  program.   The  Trust  Land Office  protects  and                                                               
enhances  the  values  of  the  Trust's  lands  while  maximizing                                                               
revenues  from those  lands over  time.   Duties  of the  Trust's                                                               
board  include protecting  the  Trust,  providing leadership  and                                                               
advocacy planning,  implementing and  funding of  a comprehensive                                                               
integrated  mental health  program,  proposing a  budget for  the                                                               
comprehensive  integrated  mental  health  program,  coordinating                                                               
with  state  agencies  on  programs   and  services  that  affect                                                               
beneficiaries, and  reporting to  the legislature,  the governor,                                                               
and the public about Trust activities.                                                                                          
3:08:42 PM                                                                                                                    
The committee took an at-ease from 3:08 p.m. to 3:13 p.m.                                                                       
3:13:26 PM                                                                                                                    
CHAIR  SNYDER further  explained that  the seven  members of  the                                                               
board  are  appointed  by  the  governor  and  confirmed  by  the                                                               
legislature.   Members are  appointed based  on their  ability in                                                               
financial management  and investment,  in land management,  or in                                                               
services for the  beneficiaries of the Trust.   She requested the                                                               
appointees provide  testimony explaining  why they  are qualified                                                               
and interested in serving on the board.                                                                                         
3:14:14 PM                                                                                                                    
ANNETTE  GWALTHNEY-JONES, Appointee,  Board  of Trustees,  Alaska                                                               
Mental Health Trust Authority, stated  that serving her community                                                               
is one  of her  core values  and that  she has  over 25  years of                                                               
managerial  experience  and  leadership in  human  resources  and                                                               
social  services.   Her career  background includes  program work                                                               
and   development  within   many   Trust  beneficiaries   serving                                                               
organizations  in  the  Anchorage  area,  including  the  Arc  of                                                               
Anchorage, the  Salvation Army Booth  Memorial Home  and Covenant                                                               
House.  She has a  Master's in Business Organizational Management                                                               
with   dual  emphasis   in   human   resources  and   information                                                               
technology,  an   undergraduate  degree  in  psychology   and  an                                                               
undergraduate  degree in  human  services.   She  became a  court                                                               
appointed special advocate  volunteer as well as  a single parent                                                               
in the Alaska  Foster Care Program.  After marrying  her U.S. Air                                                               
Force husband, she worked in  human resource management and staff                                                               
development  capacities while  located at  her husband's  various                                                               
duty  stations  in  the  Lower   48.    Following  her  husband's                                                               
retirement  and their  return  to Alaska  she  has continued  her                                                               
career as  a human  resources professional at  Lowe's and  now at                                                               
Furniture Enterprises.                                                                                                          
MS.  GWALTHNEY-JONES   stated  that   her  background   in  human                                                               
resources  and internal  development  and training  will bring  a                                                               
relevant  perspective  to the  work  of  the Board  of  Trustees.                                                               
Since   September  2020   she  has   actively  demonstrated   her                                                               
dedication  to  the  role  of   trustee,  which  is  a  five-year                                                               
appointment and  commitment.  She  will meet the  time commitment                                                               
and offer  her skills  working with her  fellow trustees  to help                                                               
advance the  Trust's important efforts  to improve the  lives and                                                               
circumstances of  its beneficiaries.   A key strength  she brings                                                               
to this board  is in her duty  of care ethos, and  she will apply                                                               
her  skills,  expertise, and  passion  to  help steer  the  board                                                               
toward an even greater success.                                                                                                 
3:20:34 PM                                                                                                                    
CO-CHAIR  ZULKOSKY  acknowledged  the large  amount  of  business                                                               
experience that  Ms. Gwalthney-Jones  brings to  her appointment.                                                               
She  requested  the appointee  to  speak  to her  experience  and                                                               
familiarity with mental health services in Alaska.                                                                              
MS. GWALTHNEY-JONES  replied that the  Booth Memorial Home  was a                                                               
residential  treatment   facility  for  young  ladies   who  were                                                               
pregnant and needed  a therapeutic place to grow  and evolve, and                                                               
at  the Covenant  House she  was a  counselor.   So, she  is very                                                               
familiar with working  in mental health fields  and believes that                                                               
her experience  and knowledge are  very beneficial to  the Trust.                                                               
She allowed  she has been  gone from Alaska  and the field  for a                                                               
relatively long time but said that  in the field of mental health                                                               
the needs don't change, they just get bigger.                                                                                   
3:22:20 PM                                                                                                                    
REPRESENTATIVE   PRAX   offered   his  understanding   that   Ms.                                                               
Gwalthney-Jones was appointed in September 2020.                                                                                
MS. GWALTHNEY-JONES confirmed that is correct.                                                                                  
REPRESENTATIVE PRAX  noted the Board  of Trustees  is responsible                                                               
for the  Trust, which is a  large fund.  He  asked Ms. Gwalthney-                                                               
Jones whether  she has received  experience and  familiarity with                                                               
the "trust trustee part of the job" since her appointment.                                                                      
MS.  GWALTHNEY-JONES  answered  that she  received  an  excellent                                                               
orientation  from  the Mental  Health  Trust,  which provided  an                                                               
overall introduction to the Trust Authority.                                                                                    
3:23:55 PM                                                                                                                    
CO-CHAIR SNYDER noted  that for this specific  board the governor                                                               
is to consider a  list of persons that is prepared  by a panel of                                                               
six people.   That panel is to consist of  an individual from the                                                               
Alaska Mental Health  Trust Board, an individual  selected by the                                                               
Governor's  Council on  Disabilities  and  Special Education,  an                                                               
individual selected by the Advisory  Board on Alcoholism and Drug                                                               
Abuse, an individual selected by  the Alaska Commission on Aging,                                                               
an individual  selected by  the Alaska  Native Health  Board, and                                                               
one person selected  by the Authority.  She  asked Ms. Gwalthney-                                                               
Jones whether she is aware if she was put forward on that list.                                                                 
MS. GWALTHNEY-JONES replied she is not aware.                                                                                   
3:25:02 PM                                                                                                                    
CO-CHAIR ZULKOSKY asked about which  of the Trust focus areas Ms.                                                               
Gwalthney-Jones  believes  is  well   positioned  to  make  great                                                               
progress and what is of great interest to the appointee.                                                                        
MS. GWALTHNEY-JONES responded  that she believes the  Trust is in                                                               
a good position  currently, but hard work will  be needed because                                                               
[the COVID-19 pandemic]  is going to seriously  impact the mental                                                               
health needs in  the next five to  ten years.  It is  going to be                                                               
even  more important  that the  Trust is  protected through  [the                                                               
Board's]  fiduciary  responsibility  and  the  responsibility  to                                                               
enhance the  Trust's assets in  the coming years because  of that                                                               
coming need.                                                                                                                    
MS.  GWALTHNEY-JONES further  responded that  given her  military                                                               
background, suicide  prevention is very important  to her because                                                               
22-plus military  members or veterans  commit suicide  every day.                                                               
As  well, she  is very  invested in  substance abuse  and special                                                               
needs.   It's all very important,  but some aspects of  the field                                                               
are more important than others.                                                                                                 
3:27:17 PM                                                                                                                    
REPRESENTATIVE FIELDS inquired  whether the appointee's positions                                                               
at  Furniture  Enterprises,  Lowe's,  or  West  Corporation  have                                                               
involved mental health in any way.                                                                                              
MS. GWALTHNEY-JONES  answered yes,  in some  respects.   She said                                                               
that  as the  human  resources person  she  deals with  employees                                                               
having mental  health issues.   If it is believed  that substance                                                               
abuse is  involved the  individual would be  sent to  an employee                                                               
program for  counseling.   Every day  her psychology  degree goes                                                               
into  play when  she  meets with  the people  who  come into  her                                                               
office with a variety of mental health and personal needs.                                                                      
3:28:43 PM                                                                                                                    
REPRESENTATIVE SPOHNHOLZ recalled  the appointee's statement that                                                               
"the needs don't change" and said  that since the late 1990s when                                                               
Ms.  Gwalthney-Jones  last  worked   in  the  field,  the  Alaska                                                               
Psychiatric  Institute (API)  has  experienced a  series of  real                                                               
challenges.   She related that  Alaska's mental health  system is                                                               
undergoing massive  reform because of  a huge gap in  services in                                                               
the community,  which resulted  in increased  criminalization and                                                               
homelessness  for people  who  experience  serious mental  health                                                               
issues.   She argued  that the  needs have  changed significantly                                                               
and stated that  the Alaska Mental Health Trust  Authority is one                                                               
of the most important organizations  in Alaska in trying to solve                                                               
these problems.   The  Authority's job is  to work  to accelerate                                                               
change to ensure  that its beneficiaries are  getting their needs                                                               
met.   She  said she  doesn't  doubt the  professionalism of  Ms.                                                               
Gwalthney-Jones but  doesn't know that  human resource work  is a                                                               
good  analogue  for this  kind  of  work.    She asked  what  the                                                               
appointee is doing  to learn about the Mental  Health Trust's big                                                               
and complex work.                                                                                                               
MS.  GWALTHNEY-JONES clarified  that  when she  said, "the  needs                                                               
don't change," she should have  been more specific and said, "the                                                               
needs of  the human psyche  don't change."   She stated  that the                                                               
needs  of a  community might  increase and  the number  of people                                                               
with those needs might change.   With COVID-19 the need of people                                                               
is going  to increase  as well, and  [Alaska's] mental  health is                                                               
going  to  get  slammed  hard.   Currently  she  is  reading  and                                                               
participating in  the different meetings  so she can  learn about                                                               
the  current  needs that  are  impacting  Alaskans and  she  went                                                               
through  a  second  orientation  because  this  is  such  a  huge                                                               
monster, there  is a lot  to learn, and  it takes time  to learn.                                                               
She is committed  to taking the time to go  to meetings, to read,                                                               
and learn  what she needs to  know so she can  best represent the                                                               
beneficiaries and improve their lives.                                                                                          
3:32:33 PM                                                                                                                    
REPRESENTATIVE SPOHNHOLZ  related that  the Alaska  Mental Health                                                               
Trust  Authority  Board  of Trustees  is  clearly  prescribed  in                                                               
statute and  defines a clear  list of qualifications for  a board                                                               
member.    She  asked  whether Ms.  Gwalthney-Jones  meets  those                                                               
qualifications and whether the panel  of six people [selected her                                                               
for the governor's consideration].                                                                                              
MS.  GWALTHNEY-JONES replied  that she  doesn't know  any of  the                                                               
behind-the-scenes  workings, but  she received  a phone  call and                                                               
was  made an  offer.   She said  she presumes  that that  is what                                                               
occurred [if being selected by the panel] is required.                                                                          
CO-CHAIR SNYDER stated  she thinks that the  panel's selection of                                                               
a  list  of  appointees  for  the  governor  to  consider  is  an                                                               
important thing.   She  said the  committee appreciates  that the                                                               
individuals may or may not be notified of the process.                                                                          
3:34:03 PM                                                                                                                    
REPRESENTATIVE  KURKA  concurred  with  the  appointee's  concern                                                               
about the significant  increase in mental health  needs in Alaska                                                               
because of  COVID-19 and the  isolation and lockdowns.   He asked                                                               
whether  Ms. Gwalthney-Jones  has  seen any  research or  studies                                                               
that would  indicate the likelihood or  increased need associated                                                               
with isolation in terms of suicides or other consequences.                                                                      
MS. GWALTHNEY-JONES  responded she  has read  a few  studies, and                                                               
some said there  is an increase.   She has looked at  some of the                                                               
numbers the  State of  Alaska has  put online, and  it is  on the                                                               
rise.  From  what she has read,  her opinion is that  it is going                                                               
to  increase, and  she  has seen  this  specifically in  veterans                                                               
because the lockdowns have impacted them even more so.                                                                          
3:35:58 PM                                                                                                                    
CO-CHAIR  ZULKOSKY  requested   the  appointee's  perspective  on                                                               
whether  the  State  of  Alaska  offers  a  sufficient  level  of                                                               
resources  for  mental  health services  that  can  leverage  and                                                               
complement the Trust's annual investments.                                                                                      
MS. GWALTHNEY-JONES  answered she thinks "they're  getting there"                                                               
and that  "there is  a lot  of work  to do."   She  continued: "I                                                               
think  we need  to  move forward  very  quickly, otherwise  we're                                                               
going to  continue to  stay behind  and try  to play  catchup and                                                               
that's what it appears we've been doing for quite a few years."                                                                 
CO-CHAIR ZULKOSKY  requested the appointee to  be more definitive                                                               
in what  she meant  by the  words "getting  there".   She related                                                               
that the House Health and  Social Services Standing Committee has                                                               
worked  on   the  budget  subcommittee  of   the  state's  annual                                                               
investments  in mental  health and  there  have been  significant                                                               
reductions  in  behavioral health  funding  as  well as  flatline                                                               
funding  for intellectual  and  developmental disabilities  (IDD)                                                               
MS.  GWALTHNEY-JONES replied  she  is still  learning and  cannot                                                               
give any  exact things  off the top  of her head.   She  said she                                                               
will follow up with a written response to the committee.                                                                        
3:38:33 PM                                                                                                                    
ANITA  MARIA  HALTERMAN,  Appointee, Board  of  Trustees,  Alaska                                                               
Mental Health  Trust Authority,  said she began  on the  board in                                                               
August  2019  and  quickly   assumed  several  leadership  roles,                                                               
including  vice chair  and chair  of the  board's Audit  and Risk                                                               
Committee, and  chair of the  Finance Committee.  Serving  on the                                                               
board has expanded  her knowledge of the mental  health needs and                                                               
the many programs  offered throughout Alaska.  In  giving back to                                                               
her community by  serving on the board she has  learned about new                                                               
strategies  and   funding  opportunities  that  can   help  shape                                                               
meaningful  reform for  Alaska's mental  health programs  and she                                                               
would like to continue that journey.                                                                                            
MS. HALTERMAN related that she worked  as a chief of staff during                                                               
the  29th  Alaska  State  Legislature, has  been  active  in  her                                                               
community, especially  in telemedicine,  and earned  her Master's                                                               
in  Business Administration  from Wayland  Baptist University  in                                                               
Anchorage.   She has worked  with the [Iowa Department  of Health                                                               
and  Human  Services and  the  Alaska  Department of  Health  and                                                               
Social Services  (DHSS)], including  work experience  in Medicaid                                                               
programs, Division  of Senior and Disability  Services, mediating                                                               
administrative  appeals,  serving  as  a program  manager  and  a                                                               
supervisor,  and child  support.    She has  also  worked in  the                                                               
[Iowa] Department  of Corrections, [Alaska] Department  of Public                                                               
Safety,  and  [Iowa and  Alaska]  division  of public  assistance                                                               
programs.   After leaving the  legislature [in 2016]  she started                                                               
her own  consulting business  as an  insurance producer,  in 2019                                                               
she began  working with an  information technology company  as an                                                               
account  executive, and  in 2020  she joined  a media  production                                                               
company working in sales and  administration.  Her work has given                                                               
her  new  perspectives  about  the  health  care  needs  for  the                                                               
privately  insured   individuals  and   has  helped   expand  her                                                               
understanding of  the more global workforce  issues that Alaskans                                                               
face as they move forward.                                                                                                      
MS. HALTERMAN  concluded by saying  she hopes to continue  to use                                                               
her  experience to  help reform  the programs  for the  future so                                                               
they  can be  sustained for  populations that  need them  most as                                                               
[the   Trust]  works   in  partnership   with   DHSS  and   other                                                               
stakeholders to  build an integrated comprehensive  mental health                                                               
program that better meets the  Trust's beneficiaries' needs.  She                                                               
added that she looks forward  to working with legislators to help                                                               
solve Alaska's mental health problems.                                                                                          
3:43:25 PM                                                                                                                    
CO-CHAIR ZULKOSKY  requested Ms.  Halterman to provide  detail on                                                               
what she envisions as meaningful reforms.                                                                                       
MS. HALTERMAN  responded that the  Trust has been working  on the                                                               
Crisis Now  Intervention program,  a relatively new  program area                                                               
for  her.    The  Trust  has expanded  the  technology  for  many                                                               
providers and  nonprofit providers  that serve  beneficiaries, so                                                               
those  two areas  of program  are very  different than  they were                                                               
previously and hopefully will help  adapt to meet rural community                                                               
needs.   As a whole  Alaska is rural  and there are  some serious                                                               
gaps  and  deficiencies  in  rural communities.    Alaska  has  a                                                               
shortage of many kinds of  providers to meet the needs throughout                                                               
the  state.   She  would  like  to  continue her  involvement  in                                                               
innovative, technology-driven solutions  that explore alternative                                                               
options  which  don't  drain  the existing  system  that  is  not                                                               
currently meeting the needs of beneficiaries.                                                                                   
CO-CHAIR ZULKOSKY  requested Ms.  Halterman to  speak to  how she                                                               
thinks the Crisis Now model will serve Alaskans well.                                                                           
MS.  HALTERMAN  replied her  hope  is  that those  programs  will                                                               
address the  crisis in a  more meaningful way that  is preventive                                                               
and not  as punitive as in  the past.  Rather  than involving law                                                               
enforcement, addressing  mental health issues with  families will                                                               
help repair families and address  some of the mental health needs                                                               
that   go  unaddressed   in  that   correctional  system.     Law                                                               
enforcement  can  be  kept  in  the background  for  when  it  is                                                               
CO-CHAIR ZULKOSKY  asked Ms. Halterman  to speak to  her position                                                               
on the  governor's proposed use  of Mental Health Trust  funds or                                                               
reserve funds  to replace undesignated  general funds  in certain                                                               
parts of the state's budget.                                                                                                    
MS. HALTERMAN answered that this  complicated question deserves a                                                               
full legal response.   She referred the committee  to the Trust's                                                               
1/26/[21]  letter written  to the  Senate  outlining the  Trust's                                                               
position on the use of the reserve's funds.                                                                                     
CO-CHAIR  ZULKOSKY inquired  whether Ms.  Halterman supports  the                                                               
position taken within that letter.                                                                                              
MS. HALTERMAN replied yes.                                                                                                      
3:47:10 PM                                                                                                                    
CO-CHAIR SNYDER asked whether Ms.  Halterman knows if she was one                                                               
of  the persons  on  the list  put  forth by  the  panel for  the                                                               
governor to consider.                                                                                                           
MS.  HALTERMAN responded  she was  not selected  from that  list.                                                               
She said  she is aware  of the process  because she "sat  on that                                                               
board for ... Brent Fisher."                                                                                                    
3:48:47 PM                                                                                                                    
RHONDA  BOYLES,  Appointee,  Board  of  Trustees,  Alaska  Mental                                                               
Health  Trust, related  that  after  44 years  of  living in  the                                                               
Interior  she took  her husband  to  Phoenix for  three years  of                                                               
medical help  for Diffuse Lewy Body  Disease.  After his  death a                                                               
year  ago,  she   bought  a  home  in  Anchorage.     During  her                                                               
professional  career in  the Fairbanks  area, she  worked several                                                               
years  as the  school lunch  director, then  built three  Wendy's                                                               
restaurants  and  purchased  Clinkerdagger's Restaurant.    While                                                               
owning   the  restaurants   she   served  on   many  boards   and                                                               
commissions, including  positions of  leadership.   After selling                                                               
her restaurants she  served as mayor of the  Fairbanks North Star                                                               
Borough   from  2000-2003,   during  which   time  she   had  the                                                               
opportunity to  make a large  difference in the budget,  the mill                                                               
rates, land  management issues, and  planning and zoning.   After                                                               
serving as  mayor, she worked  in the Pioneer Home,  including in                                                               
the dementia  wing.  She  then worked five years  for Congressman                                                               
Don Young before retiring to care for her husband.                                                                              
MS. BOYLES shared  that when she was called about  serving on the                                                               
Board of  Trustees, it was  a part of her  life that she  had not                                                               
spent much time  on, outside of personal  family experiences with                                                               
alcoholism, drug  addiction, brain  injuries from  accidents, her                                                               
father's  Parkinson's  Disease, her  mother-in-law's  Alzheimer's                                                               
Disease, and  caring for her husband.   She came into  the Mental                                                               
Health Trust with  the na?ve belief that she was  going to change                                                               
the  world in  dementia in  Alaska  only to  find it  is a  steep                                                               
learning curve  because the Trust  serves so many of  the state's                                                               
dependents and beneficiaries.   She pointed out  that trustees do                                                               
not receive  pay and it's a  part-time job.  Ms.  Boyles said her                                                               
strength  on  the  Board  of   Trustees  is  financial  and  land                                                               
management, not  as an expert  in dementia even though  she's had                                                               
several years  attached to it.   She stated that when  a board is                                                               
managing  millions of  dollars, the  role  of a  trustee must  be                                                               
understood, which is  fiduciary in every way.  When  the Board of                                                               
Trustees gives out $20 million  in grants, the questions asked of                                                               
the hopeful  grant recipients  are very  thorough.   The Trustees                                                               
take the staff's report, do their reading, and ask questions.                                                                   
3:55:25 PM                                                                                                                    
REPRESENTATIVE PRAX  asked when Ms.  Boyles was appointed  to the                                                               
Board of Trustees.                                                                                                              
MS.  BOYLES  replied she  has  served  since being  confirmed  in                                                               
January  2020.   Prior to  that  she worked  through the  lengthy                                                               
process  to  be  invited  to  join the  Trust.    Her  telephonic                                                               
interview by  [the previously mentioned  panel] occurred  at 6:00                                                               
p.m.  while  she was  standing  in  the  lobby  of the  House  of                                                               
Representatives  in  Washington, DC.    She  knew she  was  being                                                               
looked at, being interviewed, but  she cannot say whether she was                                                               
approved by  that [panel]; she  just assumed she'd  been approved                                                               
by that [panel] when it went to the next step for confirmation.                                                                 
REPRESENTATIVE PRAX inquired  about what is involved  in the role                                                               
and responsibility of  a trustee.  He further  inquired about the                                                               
expertise that Ms. Boyles brings to that position.                                                                              
MS. BOYLES responded that she sees  [the role of a] trustee as 70                                                               
percent  or more  fiduciary.   She said  that when  serving as  a                                                               
trustee of  a formal or informal  trust the trustee has  a direct                                                               
responsibility to the beneficiaries.   The Trust is designed with                                                               
rules and regulations  that a trustee must honor,  because if the                                                               
trustee doesn't,  the beneficiaries  can sue  the trustee  or ask                                                               
the trustee  to leave.  The  trust itself is like  a corporation,                                                               
it's a body,  and it could ask  a trustee to leave.   It's a very                                                               
important, serious  position when it  comes to the assets  or the                                                               
non-cash assets  of the Alaska Mental  Health Trust.  That  is in                                                               
the directive of  the litigation that was settled  after 10 years                                                               
in  1994  when  the  state  was  found  remiss  in  handling  its                                                               
fiduciary responsibilities.   The Mental Health  Trust was formed                                                               
and  a board  of seven  trustees was  hired.   The trustees  have                                                               
diverse backgrounds,  but every  trustee has  been told  and each                                                               
trustee does take very  seriously, the financial responsibilities                                                               
of administering  the fund, to  making decisions,  and protecting                                                               
for the future beneficiaries.                                                                                                   
3:59:13 PM                                                                                                                    
CO-CHAIR ZULKOSKY noted  that the legislature did  not convene in                                                               
joint session  for confirmation of  the governor's  appointees in                                                               
2020.   She requested Ms.  Boyles to clarify her  statement about                                                               
being confirmed as a trustee.                                                                                                   
MS.  BOYLES  answered that  [appointees]  were  confirmed on  the                                                               
House floor  at the very  end of  the legislative session  when a                                                               
vote was taken on the  governor's COVID-19 emergency declaration.                                                               
[Appointees] were  confirmed to serve until  12/15/2020 when that                                                               
emergency declaration  could not  be renewed.   Appointees served                                                               
like they  were supposed to.   She understood she could  vote and                                                               
that the  decisions made during  that time were valid,  which was                                                               
asserted  by  the  Department  of  Law.   In  December  when  the                                                               
emergency   declaration  was   not  renewed,   90-some  confirmed                                                               
commissioners went away  and had to be reconfirmed.   That is why                                                               
she and Ms.  Halterman went through four  confirmation hearings a                                                               
year  ago  and are  now  back  at  it  because of  the  emergency                                                               
declaration approach.                                                                                                           
4:01:13 PM                                                                                                                    
REPRESENTATIVE  SPOHNHOLZ   stated  she  clearly   remembers  the                                                               
emergency  disaster  declaration  bill  and  the  provision  that                                                               
allowed  appointees who  had not  been confirmed  to continue  to                                                               
serve  in those  positions through  December.   That  was not  an                                                               
official confirmation;  what was said was  that [appointees] were                                                               
neither confirmed nor denied as  long as confirmations took place                                                               
before the  end of 2020.   A confirmation session  never actually                                                               
took place.   There is some legal disagreement  about whether the                                                               
governor  could reappoint  essentially candidates  who have  been                                                               
serving  for  the last  year  and,  so far,  [the  legislature's]                                                               
attorneys  have   believed  that   the  governor  can   do  that.                                                               
Representative  Spohnholz concurred  that Ms.  Boyles is  correct                                                               
that  she was  legally able  to continue  to serve  as a  nominee                                                               
through that point  in time by a statute that  was passed at that                                                               
point  in time.    However,  the [nominees]  last  year were  not                                                               
confirmed, which is a very important legal distinction.                                                                         
4:02:38 PM                                                                                                                    
CO-CHAIR  SNYDER noted  that the  three abilities  highlighted as                                                               
necessary experience  for serving  on the  Board of  Trustees are                                                               
ability  in   financial  management   and  investment,   in  land                                                               
management, or  in services for  the beneficiaries of  the Trust.                                                               
She requested Ms.  Boyles to provide some background  on her land                                                               
management  experience  given  Ms. Boyles'  statement  that  land                                                               
management was one of her strengths.                                                                                            
MS. BOYLES  replied that "land  management is spaces  and steps",                                                               
and  you have  to  clear one  before you  can  go into  another,"                                                               
whether it  be permitting, or  establishing the protocols  of the                                                               
development, or the  prognosis of the development,  and more than                                                               
anything it  is when investing  in that land management,  in that                                                               
land  development.   Land  that  is not  being  developed and  is                                                               
sitting  there  is  costing  money, so  she  takes  an  assertive                                                               
approach.  When the land  management division presents a proposal                                                               
there are  questions to be  asked, such as  "Are we going  to get                                                               
our money back?"   Or, if it is a lease, the  legal terms must be                                                               
looked  at.   Many things  must be  judged when  developing land,                                                               
just like when  buying a piece to  build a house on.   She had to                                                               
learn that  20 years  ago and  learned it the  hard way  when she                                                               
purchased her  own property commercially to  build restaurants as                                                               
opposed to owning the land versus long-term leasing.                                                                            
CO-CHAIR SNYDER asked whether she  is correct in summarizing that                                                               
Ms. Boyles' personal experience in  land management is related to                                                               
her experience in owning and managing restaurants.                                                                              
MS. BOYLES  responded no.   She  explained that  much of  what is                                                               
done in the Fairbanks North  Star Borough is comprised of dealing                                                               
with  land  -  planning  and   zoning,  appropriate  uses,  title                                                               
conveyance.  During her three years  as the mayor, she would have                                                               
been inept  at her job had  she not understood that  when putting                                                               
forth resolutions with  her signature.  She learned  more in land                                                               
management from a commercial aspect  and the borough's large body                                                               
of land.   Of the one  million-plus acres within the  borough, 92                                                               
percent is owned by the federal  government, so the borough has a                                                               
lot of things to look at on the 8 percent that is left.                                                                         
4:06:14 PM                                                                                                                    
REPRESENTATIVE  FIELDS requested  Ms. Boyles  to elaborate  about                                                               
her nursing education at Yale University.                                                                                       
MS. BOYLES answered  that she was given  a three-year scholarship                                                               
to Eli  Whitney School  of Nursing which  is in  Yale University.                                                               
She  spent 18  months there  and found  she did  not like  it and                                                               
wasn't cut out  to be a nurse.   She moved to Alaska  and went to                                                               
the University  of Alaska  where she  received an  Associate's in                                                               
Business and  waited tables  until she  determined she  wanted to                                                               
build her own restaurant and built Wendy's.                                                                                     
REPRESENTATIVE FIELDS related that  according to admissions staff                                                               
at  Yale University  there  is no  attendance  record of  someone                                                               
named Rhonda Boyles or Kerwin.                                                                                                  
MS.  BOYLES  replied  it  was   Eli  Whitney  School  of  Nursing                                                               
affiliated with Yale University during the years 1971-1973.                                                                     
REPRESENTATIVE SPOHNHOLZ inquired whether  Ms. Boyles attended or                                                               
graduated  [Eli  Whitney at  Yale]  before  coming to  Alaska  to                                                               
pursue something different.                                                                                                     
MS.  BOYLES responded  she attended  for 18  months.   In further                                                               
response, she confirmed she did not graduate from Yale.                                                                         
4:08:51 PM                                                                                                                    
BRENT FISHER, Appointee, Board of  Trustees, Alaska Mental Health                                                               
Trust Authority, stated he is a  veteran of the U.S. Army Medical                                                               
Service  Corps  and started  his  career  in the  military  after                                                               
college.  His degrees include  a BA from Brigham Young University                                                               
with a  double major in  International Relations  and Portuguese,                                                               
and  an  MBA  from  the   University  of  Texas  at  Austin  with                                                               
specialties   in    International   Strategic    and   Healthcare                                                               
Management.  He  is board certified in both  hospital and medical                                                               
group management  and has been  elected a fellow in  the American                                                               
College  of Healthcare  Executives  and the  American College  of                                                               
Medical  Practice  Executives.   His  career  has been  primarily                                                               
associated with  healthcare but also  includes a wide  variety of                                                               
organizations.   His  writings  have been  published in  numerous                                                               
journals,  trade  magazines,  and  newspapers.   He  believes  in                                                               
giving back  to his  community and  has served  on the  boards of                                                               
directors of professional associations,  and civic, business, and                                                               
religious  organizations.   He expressed  his  gratitude for  the                                                               
opportunity to serve on the  Alaska Mental Health Authority Board                                                               
of Trustees.                                                                                                                    
4:10:45 PM                                                                                                                    
REPRESENTATIVE PRAX requested Mr. Fisher  to elaborate on what he                                                               
would bring to his role as a trustee.                                                                                           
MR.  FISHER  replied  that  the Trust  operates  primarily  as  a                                                               
foundation, as  mentioned in  its mission.   He  said he  has had                                                               
responsibilities as  a fiduciary  trustee in  other organizations                                                               
and in academic  endowments, and therefore has  experience in the                                                               
management of trust  funds or foundation funds.   He also started                                                               
a foundation  that looked at improving  educational opportunities                                                               
in the areas of sleep medicine and sleep disorders.                                                                             
4:12:25 PM                                                                                                                    
REPRESENTATIVE SPOHNHOLZ  noted that  Mr. Fisher  was recommended                                                               
by  the  panel that  is  defined  in  statute  and his  name  was                                                               
forwarded to the  governor as a highly  qualified candidate based                                                               
on his previous experience.                                                                                                     
4:12:49 PM                                                                                                                    
CO-CHAIR  ZULKOSKY requested  Mr. Fisher  to speak  to how,  as a                                                               
trustee,  he would  utilize his  experience  in telemedicine  and                                                               
telehealth to deliver mental health services to all Alaskans.                                                                   
MR. FISHER responded  that he believes in and is  a big supporter                                                               
of  telemedicine.   He said  that having  been a  Medical Service                                                               
Corps officer  in the military, any  methodology of communication                                                               
and  providing services  to  those who  need  physical or  mental                                                               
health  care has  always been  on the  forefront with  him.   For                                                               
eight years  he worked  in the arena  of emergency  medicine, and                                                               
emergency departments  tend to be  a place where many  folks with                                                               
mental  or behavioral  health issues  end up.   If  there is  any                                                               
place  in  the  U.S.  where   telemedicine  ought  to  be  freely                                                               
available to  people and reimbursed  with parody it is  the state                                                               
of Alaska.   There are so  many exceptions that Alaska  should be                                                               
getting  from  primarily  federal statutes  because  of  Alaska's                                                               
geographic  challenges with  providing any  kind of  health care,                                                               
especially mental  health care.   He was involved  in discussions                                                               
when the  first legislation came up  about providing telemedicine                                                               
services and  prescription services within Alaska  for those with                                                               
mental health or psychiatric disorders.   He sits on the board of                                                               
the Alaska  Collaborative For Telemedicine  & Telehealth  and has                                                               
been involved with that  for a number of years.   He and his wife                                                               
are the  majority owners  of the Alaska  Sleep Clinic,  which has                                                               
diagnostic  testing facilities  in Anchorage,  Soldotna, Wasilla,                                                               
and Fairbanks,  and which has done  telemedicine and telemedicine                                                               
consults  for at  least 12  years.   Many  mental and  behavioral                                                               
health issues are associated with  sleep disorders.  Telemedicine                                                               
and   telehealth  provide   access   to   professionals  and   to                                                               
appropriately  given  prescriptions  for   folks  who  need  care                                                               
regarding sleep as well as straight psychiatric care.                                                                           
4:16:24 PM                                                                                                                    
REPRESENTATIVE FIELDS recalled  that in 2015 Mr.  Fisher wrote an                                                               
article in which he stated  that before expanding Medicaid Alaska                                                               
should ask some  hard questions.  He inquired  about Mr. Fisher's                                                               
current  view on  Medicaid expansion,  its successes,  and health                                                               
care challenges in Alaska it has not yet solved.                                                                                
MR. FISHER  answered he doesn't  recall exactly what he  wrote in                                                               
2015 about  Medicaid expansion,  but his  intent in  writing that                                                               
article  was to  at least  raise  some questions  about what  the                                                               
value would bring to increasing  Medicaid.  Medicaid does not pay                                                               
for itself,  it pays variable costs,  it does not pay  for any of                                                               
the  infrastructure that  is needed  to  actually provide  health                                                               
care, no  matter what  kind it  is.  So,  caution is  needed when                                                               
expanding Medicaid to make sure a  thorough look is taken at what                                                               
is being  done to  the infrastructure that  is actually  paid for                                                               
primarily by commercial insurance.                                                                                              
4:18:08 PM                                                                                                                    
REPRESENTATIVE  FIELDS inquired  about Mr.  Fisher's view  on the                                                               
role  of Medicaid  expansion in  helping to  serve Mental  Health                                                               
Trust fund beneficiaries.                                                                                                       
MR. FISHER replied  it depends on what it is,  mental health is a                                                               
broad area.   Certainly, he  explained, some things are  going to                                                               
be covered by  Medicaid, but a lot of services  aren't covered by                                                               
a health care  insurance or a health care and  payer program.  He                                                               
qualified that he  is a new trustee having  started 1/18/[21] but                                                               
said  one part  of  the  agenda is  to  have representatives  and                                                               
beneficiaries from organizations that  have received Trust funds,                                                               
to come  talk about how  they benefitted through the  program and                                                               
through the Trust funds provided  to them and their organization.                                                               
One  important thing  to  him when  talking  about the  expanding                                                               
needs of  support and  assistance in the  mental health  world is                                                               
that what  is wanted  is to  try to  prevent as  well as  to help                                                               
people out  of the  problems and  challenges that  they've gotten                                                               
into because  of a mental  health disorder.  In  one presentation                                                               
beneficiaries  talked about  how a  grant allowed  them to  start                                                               
their own  home businesses, which  brought self-esteem  and value                                                               
into their lives  because they were providing  goods and services                                                               
to  others by  their work.   It  also allowed  them to  do things                                                               
within their capabilities and to  provide for themselves at least                                                               
partially in  that way.  That  is not something that  is going to                                                               
be provided  by a Medicaid  expansion, yet  to get people  out of                                                               
complete dependence that  kind of program adds real  value to the                                                               
beneficiaries.    So, a  look  must  be  taken at  what  Medicaid                                                               
expansion does  and what is  going to help the  beneficiaries the                                                               
most.   Is it Medicaid  expansion that provides certain  kinds of                                                               
services?  Or  is it going into some of  these nonprofit programs                                                               
that provide things outside of  traditional health care that gets                                                               
individuals with  mental health  challenges to  become productive                                                               
members of society?                                                                                                             
4:21:03 PM                                                                                                                    
REPRESENTATIVE  FIELDS explained  he  is  asking these  questions                                                               
because  he  values  the   Trust's  advocacy  for  beneficiaries,                                                               
including looking  at different  resources like  federal Medicaid                                                               
resources.   He  related  three  of the  questions  asked by  Mr.                                                               
Fisher  in the  article,  which he  thought good:    1) Will  all                                                               
payers  pay  less for  health  care  under  expansion?   2)  Will                                                               
uninsured have better health care  access with expansion?  3) Why                                                               
is   Alaska   Medicaid   reimbursement  higher   than   Medicare?                                                               
Regarding the  first question, Representative Fields  shared that                                                               
in the last couple years Alaska has  seen an end of growth in the                                                               
cost of  health care and  State of  Alaska employees have  seen a                                                               
small reduction  in the cost  of their  state plan premiums.   He                                                               
said  a research  report he  requested found  that with  Medicaid                                                               
expansion  insuring an  additional  65,000 people,  uncompensated                                                               
care was reduced  which in turn produced savings  for the private                                                               
insured market.   Even though  growth has been arrested,  he said                                                               
progress  still needs  to  be made  given  that major  reductions                                                               
haven't   been   seen.       Regarding   the   second   question,                                                               
Representative Fields shared that  65,000 more people are insured                                                               
under  expansion,  but there  have  been  mixed experiences  with                                                               
additional private  insurers coming  into the market  with motive                                                               
being  here  and  then  not  being here.    Regarding  the  third                                                               
question,  Representative Fields  shared that  he has  heard from                                                               
providers  that  Medicare doesn't  cover  the  cost of  providing                                                               
care.   He  said a  look needs  to be  taken at  raising Medicare                                                               
reimbursement  in  Alaska  and  that Mr.  Fisher  is  correct  in                                                               
referencing that  a look  must be  taken at  the actual  costs of                                                               
providing  care.   Representative Fields  maintained the  federal                                                               
government  is  not  meeting  its  obligations  for  Medicare  in                                                               
Alaska,  creating market  distortions because  it is  effectively                                                               
subsidizing   through  private   insurance  which   is  hard   on                                                               
employers.   Medicaid expansion, he  continued, is huge  in terms                                                               
of  providing care  through [Alaska's]  community especially  for                                                               
Trust beneficiaries.                                                                                                            
4:23:56 PM                                                                                                                    
REPRESENTATIVE  SPOHNHOLZ noted  the Trust  has been  involved in                                                               
the Section  1115 Medicaid waiver  ("1115 waiver") process.   She                                                               
recalled  Mr. Fisher  stating that  many nonprofit  organizations                                                               
provide services that help Mental  Health Trust beneficiaries get                                                               
back on their  feet.  She asked whether Mr.  Fields is aware that                                                               
most  of those  nonprofit organizations  bill Medicaid  for those                                                               
MR.  FISHER   responded  that  there   are  different   kinds  of                                                               
nonprofits.  He said he  is sure some get Medicaid reimbursement,                                                               
but he knows  that some don't and that lots  of programs are only                                                               
provided by donations,  government grants on the  state level, or                                                               
by trusts and foundations.                                                                                                      
REPRESENTATIVE SPOHNHOLZ inquired whether  Mr. Fisher can provide                                                               
examples of those organizations.                                                                                                
MR. FISHER answered  he doesn't have any examples off  the top of                                                               
his head.                                                                                                                       
REPRESENTATIVE SPOHNHOLZ  stated that  the Salvation  Army raises                                                               
lots  of  money  from  the community,  but  most  Salvation  Army                                                               
programs, such as  the Clitheroe Center and  McKinnell House, are                                                               
funded by  Medicaid and  grants from  the State  of Alaska.   She                                                               
further stated  that many of the  programs, including faith-based                                                               
programs, that are  often thought of as  being entirely supported                                                               
by  charitable  contributions are  supported  by  Medicaid.   She                                                               
asked whether  Mr. Fisher has  had a  chance to learn  more about                                                               
the  Section 1115  Medicaid waiver  since becoming  involved with                                                               
the Mental Health Trust Authority.                                                                                              
MR. FISHER responded he has not.                                                                                                
REPRESENTATIVE  SPOHNHOLZ encouraged  Mr.  Fisher  to learn  more                                                               
about  the 1115  waiver program,  which was  designed to  make it                                                               
easier for  people who  experience a  mental health  or substance                                                               
abuse  issue  to get  community  supports  to prevent  them  from                                                               
having to  go into expensive  in-patient psychiatric  or hospital                                                               
emergency rooms where there is a lot of that uncompensated care.                                                                
4:27:08 PM                                                                                                                    
REPRESENTATIVE SPOHNHOLZ inquired whether  Ms. Boyles is familiar                                                               
with  the Legislative  Budget &  Audit performance  audit of  the                                                               
Mental Health Trust Authority that was done in February 2018.                                                                   
MS. BOYLES replied that it  has been referenced in presentations,                                                               
but she has not read the audit.                                                                                                 
REPRESENTATIVE  SPOHNHOLZ  encouraged  Ms.  Boyles  to  read  the                                                               
audit,  which identified  land management,  investment practices,                                                               
and meeting practices  of the Trust that were  not complying with                                                               
statute.   Regarding  land management  expertise, she  said there                                                               
were some issues  with the policies and procedures  of the Mental                                                               
Health  Trust  Authority that  were  very  well documented.    An                                                               
effort was  made to  reform the  Trust policies,  procedures, and                                                               
bylaws to make sure the law  was being complied with, or that the                                                               
Trust come to the legislature with  a proposal to change the law.                                                               
She asked whether  the Board of Trustees has  discussed either of                                                               
those things.                                                                                                                   
MS. BOYLES  answered she doesn't  know and deferred  the question                                                               
to administration.                                                                                                              
4:29:09 PM                                                                                                                    
CO-CHAIR SNYDER opened public testimony  on the appointees to the                                                               
Alaska  Mental Health  Trust Authority  Board of  Trustees.   She                                                               
closed  public  testimony after  ascertaining  no  one wished  to                                                               
4:29:37 PM                                                                                                                    
CO-CHAIR SNYDER moved to the  confirmation hearing for appointees                                                               
to  the State  Medical Board.   She  explained that  the governor                                                               
appoints a  Board of Examiners to  be known as the  State Medical                                                               
Board and  consisting of  five physicians  licensed in  the state                                                               
and residing in as many  separate geographical areas of the state                                                               
as possible;  one physician assistant  licensed; and  two persons                                                               
with  no direct  financial interest  in the  healthcare industry.                                                               
Among  other  things,  the duties  include  the  examination  and                                                               
issuance  of  licenses  to  applicants,  development  of  written                                                               
guidelines  to   ensure  that  licensing  requirements   are  not                                                               
unreasonably  burdensome,  that  after   a  hearing  they  impose                                                               
disciplinary sanctions on persons who  violate the chapter of the                                                               
regulations or  orders of the  board, and they  adopt regulations                                                               
ensuring  that renewal  of  licenses is  contingent  on proof  of                                                               
continued competency on the part of the licensee.                                                                               
4:31:19 PM                                                                                                                    
DAVID  BOSWELL,  Appointee,  State  Medical  Board,  Division  of                                                               
Corporations, Business and  Professional Licensing, Department of                                                               
Commerce, Community, and Economic  Development (DCCED), stated he                                                               
has been  the senior minister  for the Northern Lights  Church of                                                               
Christ  in downtown  Fairbanks for  the  past 16.5  years.   Over                                                               
those years he has served as  a volunteer with the Fairbanks Food                                                               
Bank,  the  Denali  Center  and Pioneer  Home,  and  the  hospice                                                               
program in  Fairbanks.   He was  a foster  parent for  five years                                                               
during which time he had nine  children and adopted four of those                                                               
children.   While serving as  a member of the  Governor's Council                                                               
for Disabilities and  Special Education he was  introduced to the                                                               
opportunity to volunteer and serve  on the State Medical Board as                                                               
a public  member.  As a  foster parent he had  many opportunities                                                               
to  utilize various  medical facilities  throughout the  state in                                                               
ways  he had  never imagined  before.   He was  appointed to  the                                                               
board  at a  time that  was unique  to the  state of  Alaska, the                                                               
nation,  and  the world.    Since  last  March  he has  been  the                                                               
secretary of the  State Medical Board and at the  last meeting he                                                               
was asked  to continue in  that role.   Over the past  months the                                                               
State Medical  Board has  met weekly to  prepare members  for the                                                               
impending necessity of formulating  emergency regulations to meet                                                               
the  needs  of the  pandemic.    During  this  past year  he  has                                                               
received    trainings   provided    by   Medical    Board   legal                                                               
representatives  and administrative  staff; attended  conferences                                                               
of  the  Federation  of  State  Medical  Boards  via  Zoom;  been                                                               
introduced  to the  national issues  facing  other state  medical                                                               
boards;  and  gained access  to  resources  he  will be  able  to                                                               
utilize in the future should  similar issues need to be addressed                                                               
in  Alaska.   He looks  forward to  continuing to  serve on  this                                                               
important board  as it is  a worthy donation of  time, attention,                                                               
and energy.                                                                                                                     
4:33:54 PM                                                                                                                    
CO-CHAIR ZULKOSKY  asked Mr. Boswell  to speak to  the challenges                                                               
faced  by the  board during  a global  pandemic and  some of  the                                                               
decisions that had to be made.   She further asked Mr. Boswell to                                                               
speak more definitively about his  service over the past year and                                                               
what has served him well with regard to continued service.                                                                      
MR. BOSWELL concurred the board  came in at a unique, challenging                                                               
time.  He  said the amount of information that  board members had                                                               
to absorb  was like drinking  a waterfall  through a funnel.   It                                                               
was  well managed  by the  State  Medical Board's  administrative                                                               
staff  and legal  representatives  who did  an  excellent job  of                                                               
informing board members.  Members  addressed and overcame some of                                                               
the obstacles  from the audit  of the State Medical  Board, steps                                                               
were taken to  prepare for this coming year, and  the board is in                                                               
a good position to continue.                                                                                                    
4:35:56 PM                                                                                                                    
REPRESENTATIVE SPOHNHOLZ observed that  Mr. Boswell does not have                                                               
much  medical experience.   She  noted that  this board  is about                                                               
regulating  the practice  of medicine  in Alaska  and asked  what                                                               
motivated Mr. Boswell to serve on this board.                                                                                   
MR.  BOSWELL replied  that one  of  the things  that qualifies  a                                                               
prospective public  member is not  being financially tied  to the                                                               
medical commission.   He said he did three  years of pre-medicine                                                               
in  his time  at  the  University of  Alberta,  Canada, prior  to                                                               
finishing his degree  in seminary.  He has  always been following                                                               
medical things  and when this  opportunity arose, he  was willing                                                               
to put forward his name.                                                                                                        
REPRESENTATIVE SPOHNHOLZ noted the  State Medical Board regulates                                                               
abortion procedures.   She requested Mr. Boswell to  speak to the                                                               
current litigation  against the board about  some new regulations                                                               
that have been established regarding the practice of abortion.                                                                  
MR. BOSWELL  responded that the  first introduction to  the State                                                               
Medical  Board  that  he  and   other  individuals  received  was                                                               
informing them that their names  had been added in their capacity                                                               
on the  State Medical Board to  a lawsuit that was  being imposed                                                               
upon the board.   Since it is a current legal  matter, he said he                                                               
is unsure how much he is  legally allowed to speak about it other                                                               
than to say he is aware of it, and it is ongoing at present.                                                                    
REPRESENTATIVE SPOHNHOLZ  related that a search  she did revealed                                                               
the  lawsuit   is  because  regulations  were   implemented  that                                                               
restricted those  who can perform  abortions.  She  asked whether                                                               
any changes have been made  to the standards to practice abortion                                                               
in Alaska since Mr. Boswell has been on the board.                                                                              
MR. BOSWELL  answered that the  lawsuit was already  taking place                                                               
based on  something that happened  previously.  He said  he isn't                                                               
sure about the motivation for the  timing of the lawsuit but that                                                               
it was  prior to his time  serving on the  board.  He said  he is                                                               
aware the lawsuit is taking place.                                                                                              
REPRESENTATIVE SPOHNHOLZ inquired whether  any changes have taken                                                               
place in regulations to practice  abortion in the state of Alaska                                                               
since Mr. Boswell has been on the board.                                                                                        
MR. BOSWELL  replied, "Not to  my knowledge," and added  that the                                                               
board has been working primarily with pandemic related issues.                                                                  
4:39:25 PM                                                                                                                    
RICHARD  WEIN, MD,  Appointee, State  Medical Board,  Division of                                                               
Corporations, Business and  Professional Licensing, Department of                                                               
Commerce,  Community, and  Economic Development  (DCCED), pointed                                                               
out that over  a year ago all members of  the State Medical Board                                                               
were completely  new and within  two weeks of their  being seated                                                               
the  world was  turned  upside down.    Despite having  full-time                                                               
practices and lives,  the board met more than any  other board in                                                               
the state  to meet  the needs of  Alaska's medical  community and                                                               
patients.  With  all new members, none of the  board's work could                                                               
have been  accomplished without the incredible  resources offered                                                               
to  board  members,  along  with   help  and  guidance  from  the                                                               
executive  administrator and  her staff,  the Department  of Law,                                                               
the Investigative  Unit, and the leadership  of division director                                                               
Sara Chambers.   He  received his Doctor  of Medicine  from Tufts                                                               
University School  of Medicine in  Boston.   He has more  than 40                                                               
years  of  experience  as  a   physician,  surgeon,  and  patient                                                               
advocate,  20 of  those  years  in New  Jersey  and  20 years  in                                                               
Alaska.  Upon moving to Alaska, he  was on staff and a surgeon at                                                               
the   Southeast  Alaska   Regional  Health   Consortium  (SEARHC)                                                               
Hospital  in  Sitka  for  ten  years.    He  has  provided  "7/24                                                               
coverage" across multiple  specialties.  He also  served on staff                                                               
at Sitka  Community Hospital for  seven years.   Additionally, he                                                               
has served on the Sitka City  & Borough Assembly.  His commitment                                                               
to the  State Medical Board  should be apparent from  his service                                                               
over  the last  year  as chairman  and  attending numerous  other                                                               
meetings,  such as  the chair's  meeting,  the prescription  drug                                                               
monitoring  program (PDMP)  user group,  and the  many peripheral                                                               
meetings  and duties  that are  needed to  have the  Alaska State                                                               
Medical  Board  represented.   He  expressed  his willingness  to                                                               
continue serving on the board.                                                                                                  
4:43:55 PM                                                                                                                    
REPRESENTATIVE KURKA asked whether Dr.  Wein is familiar with the                                                               
Barrington Declaration,  an alternative approach to  dealing with                                                               
DR. WEIN replied he is aware of the Barrington Declaration.                                                                     
REPRESENTATIVE  KURKA  requested  Dr.   Wein's  thoughts  on  the                                                               
Barrington Declaration.                                                                                                         
DR. WEIN  responded that a  very complex situation exists  in the                                                               
pandemic.   There  was  much confusion  when  the pandemic  first                                                               
arrived.   At the beginning  there was  a greater deal  of unity,                                                               
but as  more and  more information  came out  a number  of people                                                               
through  many walks  of the  scientific  community and  elsewhere                                                               
developed  other   diverse  opinions   related  to   the  current                                                               
research.  The  Barrington Declaration was a group  of people who                                                               
developed  opinions  based  on information  that  they  felt  was                                                               
appropriate.  He has read it and  what he says to [the authors of                                                               
the  declaration]  and  others  is  that he  is  happy  they  are                                                               
attempting to make sense of a very complicated situation.                                                                       
REPRESENTATIVE KURKA inquired about  Dr. Wein's assessment of the                                                               
declaration  and  whether he  thinks  it  off  base or  has  some                                                               
legitimate points as  far as a treatment approach  to COVID-19 on                                                               
a larger scale.                                                                                                                 
DR.  WEIN  answered  that not  everybody  agrees,  especially  in                                                               
medicine, and it  is good to have second opinions.   He said that                                                               
for him there are always kernels  of truth in diverse opinion and                                                               
he tries to glean those important  things and weave them into how                                                               
he proceeds.   As chairman of  the State Medical Board,  he tries                                                               
not  to develop  opinions  or  take too  many  stands because  he                                                               
doesn't want  that to get in  the way of his  ability to function                                                               
in how he proceeds.                                                                                                             
4:48:15 PM                                                                                                                    
REPRESENTATIVE SPOHNHOLZ  referred to  comments made by  Dr. Wein                                                               
in a public  forum when the [Sitka] Assembly met  on 2/10/21 that                                                               
the CDC  had published vaccination  problems and 501  deaths were                                                               
so  far associated  with  the vaccine.   She  asked  Dr. Wein  to                                                               
describe the context of that statement.                                                                                         
DR. WEIN replied that he tells stories  to make a point.  In that                                                               
situation he was interrupted and so  no one ever knew what he was                                                               
going  to say  or  what  was his  meaning.    The journalism  was                                                               
incomplete  because  he was  not  asked  the context  before  the                                                               
article was published.                                                                                                          
4:50:24 PM                                                                                                                    
REPRESENTATIVE  SPOHNHOLZ said  the reason  she is  asking is  to                                                               
give Dr. Wein the opportunity to give context.                                                                                  
DR. WEIN  explained there was  an article in the  newspaper which                                                               
came from the  vaccine database that is supported  by the Federal                                                               
Drug  Administration (FDA)  and the  Centers for  Disease Control                                                               
and Prevention (CDC).   He said one aspect with  this database is                                                               
that  anyone from  the  public can  input  any potential  adverse                                                               
effect that they may have  had from any vaccine, including COVID-                                                               
19.   Another aspect is that  anyone can search the  database and                                                               
query any  problem.   Somebody queried the  database and  came up                                                               
with  certain information,  one piece  of information  being that                                                               
501 people had  died from the COVID-19 vaccine.   Dr. Wein stated                                                               
that his  point in context was  that [the public] has  been given                                                               
so much confusing  data - wear no mask, then  wear one mask, then                                                               
wear  two  masks,  not  sure whether  this  medication  works  or                                                               
whether  that medication  works, and  so  forth.   His point,  he                                                               
continued, was that people are  wondering about vaccine hesitancy                                                               
to which  his answer is that  he wishes the CDC  and others would                                                               
have a  more consistent message  and therefore [people]  may have                                                               
more   consistent  understanding   of  the   various  needs   for                                                               
vaccination.    Most  people  would  agree  there  is  a  lot  of                                                               
confusion out  there.  Anybody  can call up the  nonverified data                                                               
on  the  database and  draw  their  own conclusions,  which  just                                                               
increases confusion  in a time  when people need  to legitimately                                                               
buy into  the reasons that  their leaders  are giving them.   Dr.                                                               
Wein further stated  that he was asking why that  article was out                                                               
there.   He  explained  that  the CDC  must  review those  deaths                                                               
within 24  hours, so if that  is the CDC's mandate,  then why not                                                               
hold back  the ability to call  up that information before  it is                                                               
released to  the public?   His  purpose was  to say  that vaccine                                                               
hesitancy  is in  part a  responsibility of  the leaders  who are                                                               
giving  out this  information.   He said  he wanted  to make  the                                                               
statement, "Let's clean up some of  the data and ... things would                                                               
be  much  better in  the  delivery  of  health care  and  vaccine                                                               
REPRESENTATIVE SPOHNHOLZ offered her  appreciation for Dr. Wein's                                                               
4:54:45 PM                                                                                                                    
CO-CHAIR SNYDER opened public testimony  on the appointees to the                                                               
State  Medical   Board.    She  closed   public  testimony  after                                                               
ascertaining no one wished to testify.                                                                                          
CO-CHAIR  SNYDER said  the committee  will continue  hearing from                                                               
additional  appointees in  the coming  days.   [The  confirmation                                                               
hearings for the following governor's  appointees were held over:                                                               
Annette  Gwalthney-Jones,  Anita  Halterman, Rhonda  Boyles,  and                                                               
Brent Fisher  for the  Alaska Mental  Health Trust  Authority and                                                               
David  Boswell and  Richard  Wein for  the  State Medical  Health                                                               
4:55:39 PM                                                                                                                    
There being no  further business before the  committee, the House                                                               
Health  and  Social  Services   Standing  Committee  meeting  was                                                               
adjourned at 4:56 p.m.                                                                                                          

Document Name Date/Time Subjects
Anita Halterman Board Application_MHTA_4.1.pdf HHSS 4/1/2021 3:00:00 PM
Annette R. Gwalthney-Jones Resume_MHTA_4.1.pdf HHSS 4/1/2021 3:00:00 PM
Anita Halterman Resume_MHTA_4.1.pdf HHSS 4/1/2021 3:00:00 PM
Brent Fisher Board Application_MHTA_4.1.pdf HHSS 4/1/2021 3:00:00 PM
Brent Fisher Resume_MHTA_4.1.pdf HHSS 4/1/2021 3:00:00 PM
Rhonda Boyles Board Application_MHTA_4.1.pdf HHSS 4/1/2021 3:00:00 PM
Rhonda Boyles Resume_MHTA_4.1.pdf HHSS 4/1/2021 3:00:00 PM
Dave Boswell Board Application_SMB_4.1.pdf HHSS 4/1/2021 3:00:00 PM
Larry Daugherty Board Application_SMB_4.1.pdf HHSS 4/1/2021 3:00:00 PM
Richard Wein Resume_SMB_4.1.pdf HHSS 4/1/2021 3:00:00 PM