Legislature(2021 - 2022)DAVIS 106

02/15/2022 03:00 PM House HEALTH & SOCIAL SERVICES

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03:03:52 PM Start
03:04:39 PM HB308
03:34:48 PM Adjourn
* first hearing in first committee of referral
+ teleconferenced
= bill was previously heard/scheduled
Heard & Held
-- Invited & Public Testimony --
+ EO 121: DHSS Reorganization TELECONFERENCED
-- Testimony <Invitation Only> --
+ Bills Previously Heard/Scheduled TELECONFERENCED
**Streamed live on AKL.tv**
                    ALASKA STATE LEGISLATURE                                                                                  
      HOUSE HEALTH AND SOCIAL SERVICES STANDING COMMITTEE                                                                     
                       February 15, 2022                                                                                        
                           3:03 p.m.                                                                                            
MEMBERS PRESENT                                                                                                               
Representative Liz Snyder, Co-Chair                                                                                             
Representative Tiffany Zulkosky, Co-Chair                                                                                       
Representative Ivy Spohnholz                                                                                                    
Representative Zack Fields                                                                                                      
Representative Ken McCarty                                                                                                      
Representative Christopher Kurka                                                                                                
Representative Mike Prax                                                                                                        
MEMBERS ABSENT                                                                                                                
All members present                                                                                                             
COMMITTEE CALENDAR                                                                                                            
HOUSE BILL NO. 308                                                                                                              
"An Act relating to dementia awareness."                                                                                        
     - HEARD & HELD                                                                                                             
PREVIOUS COMMITTEE ACTION                                                                                                     
BILL: HB 308                                                                                                                  
SHORT TITLE: DEMENTIA AWARENESS                                                                                                 
SPONSOR(s): REPRESENTATIVE(s) STUTES                                                                                            
02/07/22       (H)       READ THE FIRST TIME - REFERRALS                                                                        
02/07/22       (H)       HSS, FIN                                                                                               
02/15/22       (H)       HSS AT 3:00 PM DAVIS 106                                                                               
WITNESS REGISTER                                                                                                              
FATE PUTNAM, Staff                                                                                                              
Representative Louise Stutes                                                                                                    
Alaska State Legislature                                                                                                        
Juneau, Alaska                                                                                                                  
POSITION STATEMENT:  Presented HB 308 on behalf of                                                                            
Representative Stutes, prime sponsor.                                                                                           
JORDAN LEWIS, PhD, Professor of Medical Education                                                                               
University of Alaska Anchorage                                                                                                  
Anchorage, Alaska                                                                                                               
POSITION STATEMENT:   Gave invited  testimony during  the hearing                                                             
on HB 308.                                                                                                                      
PAM KELLEY, Executive Director                                                                                                  
Alzheimer's Disease Resource Agency of Alaska Inc.;                                                                             
Alaska Dementia Action Collaborative                                                                                            
Anchorage, Alaska                                                                                                               
POSITION STATEMENT:  Testified in support of HB 308.                                                                          
JOSH LONN, Chair                                                                                                                
Community Board                                                                                                                 
Alzheimer's Association  Alaska Chapter                                                                                         
Anchorage, Alaska                                                                                                               
POSITION STATEMENT:   Offered  statistics related  to Alzheimer's                                                             
during the hearing on HB 308.                                                                                                   
NONA SAFRA, Member                                                                                                              
Alaska Commission on Aging                                                                                                      
Homer, Alaska                                                                                                                   
POSITION STATEMENT:  Provided invited  testimony in support of HB
KAROL FINK, Chief                                                                                                               
Chronic Disease Prevention and Health Promotion                                                                                 
Division of Public Health                                                                                                       
Department of Health and Social Services                                                                                        
Anchorage, Alaska                                                                                                               
POSITION STATEMENT:   Responded  to questions during  the hearing                                                             
on HB 308.                                                                                                                      
PAMELA SAMASH, on behalf of self                                                                                                
Nenana, Alaska                                                                                                                  
POSITION STATEMENT:  Testified in support of HB 308.                                                                          
ACTION NARRATIVE                                                                                                              
3:03:52 PM                                                                                                                    
CO-CHAIR LIZ SNYDER  called the House Health  and Social Services                                                             
Standing   Committee    meeting   to    order   at    3:03   p.m.                                                               
Representatives  Kurka,   McCarty,  Zulkosky,  and   Snyder  were                                                               
present  at   the  call  to   order.     Representatives  Fields,                                                               
Spohnholz, and Prax arrived as the meeting was in progress.                                                                     
                   HB 308-DEMENTIA AWARENESS                                                                                
3:04:39 PM                                                                                                                    
CO-CHAIR SNYDER announced  that the only order  of business would                                                               
be HOUSE BILL NO. 308, "An Act relating to dementia awareness."                                                                 
3:06:30 PM                                                                                                                    
FATE PUTNAM,  Staff, Representative  Louise Stutes,  Alaska State                                                               
Legislature,  presented  HB  308   on  behalf  of  Representative                                                               
Stutes, prime  sponsor.  He  said the proposed  legislation would                                                               
adopt  a  dementia awareness  program  within  the Department  of                                                               
Health and Social Services (DHSS)  and is designed to qualify for                                                               
the federal program Building  Our Largest Dementia Infrastructure                                                               
for Alzheimer's Act (BOLD).  The  Act was designed by Congress in                                                               
2018 to raise  awareness of the national concern  for the growing                                                               
problem related to  dementia and directed the  Center for Disease                                                               
Control (CDC) to provide funds  to public health departments that                                                               
address  early   detection  of  early  Alzheimer's   disease  and                                                               
dementia, and HB  308 would help obtain those funds.   Mr. Putnam                                                               
said  the BOLD  Act specifies  federal  funds may  be awarded  to                                                               
states to provide educational programs  to educate and inform the                                                               
public  about  these  diseases  and, thus,  reduce  the  risk  of                                                               
cognitive decline  by supporting  early detection  and diagnosis.                                                               
Further,   the  funds   would  support   caregivers  to   improve                                                               
management of these  conditions.  To be eligible  for the federal                                                               
funds, DHSS would  apply to the CDC for a  core competency award,                                                               
identifying in  the application  how the  plan would  provide the                                                               
public  education.   He  noted that  the  core competency  awards                                                               
range from $350,000 to $500,000 dollars annually.                                                                               
3:09:14 PM                                                                                                                    
MR. PUTNAM explained that HB  308 would require the department to                                                               
plan how to  work with partners and determine the  success of the                                                               
work  done.    He  said  the  bill  would  establish  a  dementia                                                               
awareness  program tasked  with  the  following basic  functions:                                                               
the   creation    of   educational   material    for   healthcare                                                               
professionals;  utilization  of  educational  materials  to  help                                                               
"dementia   professionals"   such    as   judicial   staff,   law                                                               
enforcement, social  service providers, and  emergency responders                                                               
to  recognize  the symptoms  of  those  Alaskans that  experience                                                               
dementia; the creation and maintenance  of a statewide and easily                                                               
accessible list of dementia service  providers in Alaska that can                                                               
diagnose  and treat  those diseases;  consultation with  national                                                               
organizations  providing   dementia  care  concerning   the  most                                                               
appropriate  materials   and  content   needed  for   the  public                                                               
awareness  campaign; coordination  with  the  public and  service                                                               
provider organizations  to implement  programs and  activities to                                                               
educate  the public  about dementia;  a  statewide campaign  with                                                               
various  media forms  to publicize  the  scope of  the issue  and                                                               
promote  early  detection  through screening;  education  of  the                                                               
public about  the risk of  developing dementia and ways  to avoid                                                               
the onset, including diet and  exercise, and methods of diagnosis                                                               
and  treatment; and  an  increase in  the  awareness of  wellness                                                               
visits to patients by providing  easily readable materials on the                                                               
department's  website  to maintain  an  disseminate  the list  of                                                               
statewide dementia care providers.                                                                                              
MR.  PUTNAM   said  Representative  Stutes  is   sponsoring  this                                                               
legislation  because  Alaska has  "a  large  and growing"  senior                                                               
population.    Currently,  approximately 12,500  Alaskans  suffer                                                               
from Alzheimer's  and other  related diseases.   Dementia  is the                                                               
fifth leading cause  of death for those people over  age 65.  Mr.                                                               
Putnam emphasized  the importance  of getting  "in front  of this                                                               
issue before it  becomes an insurmountable problem."   He stated,                                                               
"HB 308 is  an effort to get the best  programs available for all                                                               
Alaskans into a centralized agency  tasked with protecting public                                                               
health."   He noted that currently  there are many groups  in the                                                               
private  sector whose  work  addresses  dementia and  Alzheimer's                                                               
disease, many  of which  focus on the  management of  the disease                                                               
once it  has been diagnosed.   He pointed out  that unfortunately                                                               
once it has  been diagnosed, the treatment to  reduce the impacts                                                               
of the  disease are "very limited."   He said HB  308 is designed                                                               
"to get out  in front of the diagnosis with  early detection" and                                                               
look for ways  to delay the cognitive decline so  people can lead                                                               
healthier lives.   He noted  that the department had  submitted a                                                               
fiscal note  reflecting the cost  of running the program,  and he                                                               
said   the   bill   sponsor's  office   is   working   with   the                                                               
administration to  find ways  to reduce the  cost of  running the                                                               
program.  He acknowledged there is  a need for experts to work on                                                               
the program.   He said  the sponsor encourages the  department to                                                               
seek funds  from the  BOLD Act  to pay  for the  public education                                                               
3:13:16 PM                                                                                                                    
CO-CHAIR  SNYDER  announced  the  committee  would  hear  invited                                                               
3:14:02 PM                                                                                                                    
JORDAN LEWIS, PhD, Professor of  Medical Education, University of                                                               
Alaska Anchorage, noted  that she is a dementia  researcher.  She                                                               
stated  that there  is a  stigma surrounding  dementia preventing                                                               
families and others  from seeking medical care,  which results in                                                               
distress  and sometimes  burnout.   He said  increasing education                                                               
about   dementia    will   decrease   that    stigma,   normalize                                                               
conversations  between families  and their  healthcare providers,                                                               
and educate the public that dementia  is not a normal part of the                                                               
aging process.  He advised  that receiving an early diagnosis can                                                               
relieve anxiety  over symptoms  and help  the provider  work with                                                               
the  person  on  treatment  options.     It  can  also  give  the                                                               
opportunity  for families  to maximize  their  time together  and                                                               
find resources  and support  programs.  Further,  it can  save on                                                               
medical costs and  the cost of long-term care,  both for families                                                               
and  state  government.   He  reported  that early  diagnosis  of                                                               
Alzheimer's  would collectively  save the  U.S. approximately  $7                                                               
trillion  in health  and  long-term care  costs.   He  encouraged                                                               
support of HB 308.                                                                                                              
3:15:56 PM                                                                                                                    
PAM  KELLEY,  Executive  Director, Alzheimer's  Disease  Resource                                                               
Agency  of   Alaska  Inc.  and  Chair,   Alaska  Dementia  Action                                                               
Collaborative,  stated  that people  with  dementia  come to  the                                                               
Alzheimer's Resource of Alaska after  they or family members have                                                               
begun  to experience  symptoms, at  which point  is too  late for                                                               
prevention.    The  agency  has helped  "tens  of  thousands"  of                                                               
Alaskans over  the last 38  years to  slow the rate  of cognitive                                                               
decline  and  adapt to  future  changes.   She  encouraged  early                                                               
detection  to lower  the  numbers.   She  said  there are  public                                                               
awareness efforts  being made "on  the retail level," and  HB 308                                                               
would allow a "wholesale" campaign.   She asked, "Don't we owe it                                                               
to ourselves to try?"                                                                                                           
3:18:18 PM                                                                                                                    
JOSH  LONN, Chair,  Community  Board,  Alzheimer's Association                                                                  
Alaska  Chapter,  stated  that  Alaska  can  soon  expect  to  be                                                               
impacted by dementia  at a higher rate per capita  than any other                                                               
state in the Union.  He  reported that the population of Alaskans                                                               
with Alzheimer's, which is only one  of the ten most common types                                                               
of dementia, accounts for approximately  8,500 of Alaska's 12,500                                                               
dementia cases, and it is  expected to impact 3,000 more Alaskans                                                               
by  2025.    This  means the  overall  dementia  population  will                                                               
surpass  17,000   Alaskans.    He  stated,   "A  dementia  public                                                               
awareness campaign  is instrumental  in preparing Alaska  for the                                                               
approaching dementia tsunami."   He talked about  the benefits of                                                               
early  detection   and  commented  on  the   effect  on  Alaska's                                                               
workforce due to burnout of  caregivers.  He stated, "Progression                                                               
of  this  disease  leads  to  public  safety  issues,  behavioral                                                               
change, wandering, and the inability  to perform basic tasks such                                                               
as using  the bathroom."   He urged  the committee to  support HB
308 "in  honor of Alaska's families,  who are and continue  to be                                                               
impacted by dementia and wish they had known the signs sooner."                                                                 
3:21:00 PM                                                                                                                    
NONA SAFRA, Member,  Alaska Commission on Aging,  stated that the                                                               
Alaska Commission  on Aging voted  to support  HB 308.   She said                                                               
the workforce and state budget will  be affected by the number of                                                               
people that will  be diagnosed with dementia in  the next decade,                                                               
thus she advised  the state needs a better  approach in preparing                                                               
for this  public health crisis.   She said HB 308  would make the                                                               
public aware  of lifestyle and  behavioral changes  and therefore                                                               
be able  to mitigate  the onset  of dementia.   Ms.  Safra shared                                                               
that she has  a brain injury that increases her  odds for getting                                                               
dementia.  She is also  a caregiver for someone with Alzheimer's.                                                               
She stated,  "It's too late  for him, but  it's not too  late for                                                               
others."  She  called HB 308 a "game changer,"  and she urged the                                                               
committee to support the bill.                                                                                                  
3:23:20 PM                                                                                                                    
REPRESENTATIVE MCCARTY  referred to language  in HB 308,  on page                                                               
2,  beginning on  lines  2  and 26,  regarding  a  list of  state                                                               
providers, and  he asked whether  there were "qualifiers  to what                                                               
those providers have to do to be acknowledged."                                                                                 
MR. PUTNAM  answered that  most people  who provide  services for                                                               
dementia would be part of this program.                                                                                         
REPRESENTATIVE   MCCARTY   recalled   years   back   there   were                                                               
requirements for expensive accreditation  that limited the number                                                               
of providers that could provide services.                                                                                       
MR. PUTNAM responded  that he is not aware  of those requirements                                                               
for this program.                                                                                                               
3:25:20 PM                                                                                                                    
REPRESENTATIVE  KURKA drew  attention to  the fiscal  note, which                                                               
reflected  over $16,000  in fiscal  year  2023 (FY  23) and  over                                                               
three-quarter of a million "next year."   He observed a new staff                                                               
person would  be added,  and the  services category  is $521,000.                                                               
He  asked whether  that was  envisioned  by the  bill sponsor  as                                                               
state-covered expenses.                                                                                                         
MR. PUTNAM  answered that  the sponsor's  office is  working with                                                               
the department "to  see if that fiscal note may  be little higher                                                               
than  anticipated."   He  reiterated that  the  BOLD Act  funding                                                               
provides  a  window  of funding  between  $350,000  and  $500,000                                                               
annually.   He added that  the sponsor  supports the need  of the                                                               
department to hire  a subject matter expert in order  to fund the                                                               
program.  Further, the materials need  to be produced early on in                                                               
the  program.   He deferred  to the  department to  offer further                                                               
REPRESENTATIVE KURKA  noted that although there  is no additional                                                               
staff hired after the first year,  the amount of funds needed for                                                               
services goes  up by  50 percent  for FY 24.   He  questioned the                                                               
reason for that.                                                                                                                
MR.  PUTNAM pointed  to  the back  of the  fiscal  note where  it                                                               
explains that  90 days  after passage of  HB 308,  the department                                                               
would be  recruiting, and  it would  be well into  FY 23  at that                                                               
point; therefore, the department would  need the funds only for a                                                               
portion of  the year.   However,  in FY  24 and  beyond, "they're                                                               
going  to need  that package  for that  individual specialist  in                                                               
3:28:10 PM                                                                                                                    
CO-CHAIR SNYDER requested someone  from the department talk about                                                               
putting the  fiscal note in  context with that of  other programs                                                               
of similar size.                                                                                                                
3:29:03 PM                                                                                                                    
KAROL  FINK,   Chief,  Chronic  Disease  Prevention   and  Health                                                               
Promotion, Division  of Public Health,  Department of  Health and                                                               
Social Services, explained that most  of the numbers are built by                                                               
looking at the budgets in  place for other programs; however, she                                                               
said there  are no economies  of scale  because the work  of each                                                               
program  differs.   In  response  to  a follow-up  question,  she                                                               
confirmed the  department looked at a  tobacco prevention program                                                               
and nutrition program,  and also marijuana education.   Each have                                                               
different funding streams and sources of dollars.                                                                               
3:31:08 PM                                                                                                                    
CO-CHAIR SNYDER opened public testimony on HB 308.                                                                              
3:31:35 PM                                                                                                                    
PAMELA SAMASH, on  behalf of self, noted that she  is a member of                                                               
the Alaska  Commission on Aging,  which voted to support  HB 308,                                                               
and she is  testifying today on her own behalf  in support of the                                                               
proposed legislation.   She emphasized the need  for awareness of                                                               
dementia and Alzheimer's because  the senior population of Alaska                                                               
is growing  substantially, and  [HB 308]  can help  people become                                                               
more prepared.   She said Interior Alaska needs  more housing and                                                               
skilled nurses to  handle this population and  the chronic health                                                               
issues  that come  with it.   She  highlighted the  importance of                                                               
learning  prevention measures  such  as diet  and  exercise as  a                                                               
measure to drastically reduce the  number of individuals who will                                                               
have to  face dementia.   She urged  the committee to  support HB
308 and Alaska's seniors.                                                                                                       
3:33:13 PM                                                                                                                    
CO-CHAIR SNYDER,  after ascertaining that  there was no  one else                                                               
who wished to testify, closed public testimony on HB 308.                                                                       
CO-CHAIR SNYDER announced that HB 308 was held over.                                                                            
3:34:48 PM                                                                                                                    
There being no  further business before the  committee, the House                                                               
Health  and  Social  Services   Standing  Committee  meeting  was                                                               
adjourned at 3:35 p.m.                                                                                                          

Document Name Date/Time Subjects
HB 308, Sponsor Statement.pdf HHSS 2/15/2022 3:00:00 PM
HB 308
HB 308, Sectional Analysis.pdf HHSS 2/15/2022 3:00:00 PM
HB 308
HB 308, Ver. A.PDF HHSS 2/15/2022 3:00:00 PM
HB 308
HB 308, Alzheimer's Association 10 Warning Signs.pdf HHSS 2/15/2022 3:00:00 PM
HB 308
HB 308, Behavioral Change Info for Medical Providers.pdf HHSS 2/15/2022 3:00:00 PM
HB 308
HB 308, Letters of Support.pdf HHSS 2/15/2022 3:00:00 PM
HB 308
HB 308, Texas State Flyer for Medical Providers.pdf HHSS 2/15/2022 3:00:00 PM
HB 308
HB 308, Alz Association First Responders Tip Sheet.pdf HHSS 2/15/2022 3:00:00 PM
HB 308
HB 308- Oppose.pdf HHSS 2/15/2022 3:00:00 PM
HB 308
HB 308, Fiscal Note.pdf HHSS 2/15/2022 3:00:00 PM
HB 308
EO 121, Legislative Legal Department Memo, 2.14.22.pdf HHSS 2/15/2022 3:00:00 PM
EO 121 Memo