Legislature(2023 - 2024)DAVIS 106

03/14/2024 03:00 PM House HEALTH & SOCIAL SERVICES

Note: the audio and video recordings are distinct records and are obtained from different sources. As such there may be key differences between the two. The audio recordings are captured by our records offices as the official record of the meeting and will have more accurate timestamps. Use the icons to switch between them.

Download Mp3. <- Right click and save file as

Audio Topic
03:03:58 PM Start
03:06:07 PM Board of Direct Entry Midwives
03:21:11 PM HB363
04:42:43 PM HB187
05:12:35 PM HB205
06:05:03 PM Adjourn
* first hearing in first committee of referral
+ teleconferenced
= bill was previously heard/scheduled
+ Consideration of Governor's Appointees: TELECONFERENCED
Board of Certified Direct-Entry Midwives - Bethel
Belisle
-- Public Testimony --
+= HB 187 PRIOR AUTH EXEMPT FOR HEALTH PROVIDERS TELECONFERENCED
Heard & Held
-- Public Testimony --
*+ HB 363 FOSTER CHILDREN PSYCHIATRIC TREATMENT TELECONFERENCED
Heard & Held
-- Testimony <Invitation Only> --
*+ HB 205 CRIMINALIZE ABORTION; PRIVACY; COURTS TELECONFERENCED
Heard & Held - Assigned to Subcommittee
-- Testimony <Invitation Only> --
+ Bills Previously Heard/Scheduled TELECONFERENCED
**Streamed live on AKL.tv**
                    ALASKA STATE LEGISLATURE                                                                                  
      HOUSE HEALTH AND SOCIAL SERVICES STANDING COMMITTEE                                                                     
                         March 14, 2024                                                                                         
                           3:03 p.m.                                                                                            
                                                                                                                                
MEMBERS PRESENT                                                                                                               
                                                                                                                                
Representative Mike Prax, Chair                                                                                                 
Representative Justin Ruffridge, Vice Chair                                                                                     
Representative CJ McCormick                                                                                                     
Representative Dan Saddler                                                                                                      
Representative Jesse Sumner (via teleconference)                                                                                
Representative Zack Fields                                                                                                      
Representative Genevieve Mina                                                                                                   
                                                                                                                                
MEMBERS ABSENT                                                                                                                
                                                                                                                                
All members present                                                                                                             
                                                                                                                                
COMMITTEE CALENDAR                                                                                                            
                                                                                                                                
CONFIRMATION HEARING(S):                                                                                                        
                                                                                                                                
Board of Certified Direct-Entry Midwives                                                                                      
                                                                                                                                
     Bethel Belisle-Anchorage                                                                                                   
                                                                                                                                
     - CONFIRMATION(S) ADVANCED                                                                                                 
                                                                                                                                
HOUSE BILL NO. 363                                                                                                              
"An  Act  relating  to  the   placement  of  foster  children  in                                                               
psychiatric hospitals."                                                                                                         
                                                                                                                                
     - HEARD & HELD                                                                                                             
                                                                                                                                
HOUSE BILL NO. 187                                                                                                              
"An  Act  relating  to  utilization  review  entities;  exempting                                                               
certain  health  care   providers  from  making  preauthorization                                                               
requests  for certain  services; and  providing for  an effective                                                               
date."                                                                                                                          
                                                                                                                                
     - HEARD & HELD                                                                                                             
                                                                                                                                
HOUSE BILL NO. 205                                                                                                              
"An Act interpreting the right to  privacy under art. I, sec. 22,                                                               
Constitution  of  the  State   of  Alaska;  defining  'abortion,'                                                               
'birth,'  'child,' 'conception,'  'natural person,'  and 'preborn                                                               
child'; relating  to civil actions  and liability under  the Act;                                                               
relating  to murder  of a  child; repealing  abortion procedures;                                                               
amending the definition of 'person'  for crimes against a person;                                                               
repealing murder of an unborn  child and penalties and provisions                                                               
related  to that  crime;  relating to  the  powers of  guardians;                                                               
relating  to  powers  of  attorney  for  health  care  decisions;                                                               
relating  to   regulation  of   abortion;  relating   to  medical                                                               
treatment  for  minors;  relating   to  relocation  of  a  child;                                                               
relating  to the  office of  public  advocacy; repealing  medical                                                               
assistance  payment  for abortions;  relating  to  duties of  the                                                               
attorney  general;  relating to  the  limitation  on the  use  of                                                               
assets; and providing for an effective date."                                                                                   
                                                                                                                                
     - HEARD & HELD - ASSIGNED TO SUBCOMMITTEE                                                                                  
                                                                                                                                
PREVIOUS COMMITTEE ACTION                                                                                                     
                                                                                                                                
BILL: HB 363                                                                                                                  
SHORT TITLE: FOSTER CHILDREN PSYCHIATRIC TREATMENT                                                                              
SPONSOR(s): REPRESENTATIVE(s) GRAY                                                                                              
                                                                                                                                
02/20/24       (H)       READ THE FIRST TIME - REFERRALS                                                                        
02/20/24       (H)       HSS                                                                                                    
03/14/24       (H)       HSS AT 3:00 PM DAVIS 106                                                                               
                                                                                                                                
BILL: HB 187                                                                                                                  
SHORT TITLE: PRIOR AUTH EXEMPT FOR HEALTH PROVIDERS                                                                             
SPONSOR(s): REPRESENTATIVE(s) SUMNER                                                                                            
                                                                                                                                
05/03/23       (H)       READ THE FIRST TIME - REFERRALS                                                                        
05/03/23       (H)       HSS, L&C                                                                                               
02/15/24       (H)       HSS AT 3:00 PM DAVIS 106                                                                               
02/15/24       (H)       Heard & Held                                                                                           
02/15/24       (H)       MINUTE(HSS)                                                                                            
03/14/24       (H)       HSS AT 3:00 PM DAVIS 106                                                                               
                                                                                                                                
BILL: HB 205                                                                                                                  
SHORT TITLE: CRIMINALIZE ABORTION; PRIVACY; COURTS                                                                              
SPONSOR(s): REPRESENTATIVE(s) EASTMAN                                                                                           
                                                                                                                                
05/16/23       (H)       READ THE FIRST TIME - REFERRALS                                                                        
05/16/23       (H)       HSS, JUD, FIN                                                                                          
05/16/23       (H)       HSS RPT RECD W/CS AWAIT TRANSMITTAL NXT                                                                
03/14/24       (H)       HSS AT 3:00 PM DAVIS 106                                                                               
                                                                                                                                
WITNESS REGISTER                                                                                                              
                                                                                                                                
BETHEL BELISLE, Appointee                                                                                                       
Board of Certified Direct Entry Midwives                                                                                        
Anchorage, Alaska                                                                                                               
POSITION STATEMENT:   Testified as  an appointee to the  Board of                                                             
Certified Direct Entry Midwives.                                                                                                
                                                                                                                                
REPRESENTATIVE ANDREW GRAY                                                                                                      
Alaska State Legislature                                                                                                        
Juneau, Alaska                                                                                                                  
POSITION  STATEMENT:     As  prime  sponsor,   gave  the  sponsor                                                             
statement for Version S of HB 363.                                                                                              
                                                                                                                                
MATTHEW TURNER, Staff                                                                                                           
Representative Andrew Gray                                                                                                      
Alaska State Legislature                                                                                                        
Juneau, Alaska                                                                                                                  
POSITION  STATEMENT:   On behalf  of  Representative Gray,  prime                                                             
sponsor,  explained the  changes made  in the  proposed committee                                                               
substitute to HB 363.                                                                                                           
                                                                                                                                
MATEO JAMIE                                                                                                                     
Anchorage, Alaska                                                                                                               
POSITION  STATEMENT:    As  a foster  care  child,  gave  invited                                                             
testimony on HB 363, Version S.                                                                                                 
                                                                                                                                
SARAH LEWIS                                                                                                                     
Anchorage, Alaska                                                                                                               
POSITION  STATEMENT:    As  a foster  care  child,  gave  invited                                                             
testimony on HB 363, Version S.                                                                                                 
                                                                                                                                
NANCY MEADE, General Counsel                                                                                                    
Alaska Court System                                                                                                             
Anchorage, Alaska                                                                                                               
POSITION STATEMENT:  Answered committee  questions relating to HB
363, Version S.                                                                                                                 
                                                                                                                                
KIM SWISHER, Deputy Director                                                                                                    
Office of Children's Services                                                                                                   
Department of Family & Community Services                                                                                       
Anchorage, Alaska                                                                                                               
POSITION STATEMENT:   Gave invited  testimony on HB  363, Version                                                             
S.                                                                                                                              
                                                                                                                                
JEANNIE MONK, Senior Vice President                                                                                             
Alaska State Hospital & Healthcare Association                                                                                  
Juneau, Alaska                                                                                                                  
POSITION STATEMENT:  Testified in support of HB 187.                                                                          
                                                                                                                                
REPRESENTATIVE JESSE SUMNER                                                                                                     
Alaska State Legislature                                                                                                        
Juneau, Alaska                                                                                                                  
POSITION STATEMENT:  As prime sponsor, answered committee                                                                     
questions on HB 187.                                                                                                            
                                                                                                                                
TAMMY THIEL, Executive Director                                                                                                 
Denali Oncology Group                                                                                                           
Anchorage, Alaska                                                                                                               
POSITION STATEMENT:  Testified in support of HB 187.                                                                          
                                                                                                                                
PAM VENTGEN, Executive Director                                                                                                 
Alaska State Medical Association                                                                                                
Anchorage, Alaska                                                                                                               
POSITION STATEMENT:  Testified in support of HB 187.                                                                          
                                                                                                                                
MARC REECE, Director of Public Policy                                                                                           
AETNA                                                                                                                           
Denver, Colorado                                                                                                                
POSITION STATEMENT:  Testified in opposition to HB 187.                                                                       
                                                                                                                                
PREET KLAUR, Policy & Legislative Manger                                                                                        
Premera Blue Cross Blue Shield of Alaska                                                                                        
Seattle, Washington                                                                                                             
POSITION STATEMENT:  Testified in opposition to HB 187.                                                                       
                                                                                                                                
STEVE RAMOS, Acting Chief Health Administrator                                                                                  
Division of Retirement & Benefits                                                                                               
Department of Administration                                                                                                    
Juneau, Alaska                                                                                                                  
POSITION STATEMENT:  Answered committee members' questions                                                                    
during the hearing on HB 187.                                                                                                   
                                                                                                                                
REPRESENTATIVE DAVID EASTMAN                                                                                                    
Alaska State Legislature                                                                                                        
Juneau, Alaska                                                                                                                  
POSITION STATEMENT:  As prime sponsor, introduced HB 205.                                                                     
                                                                                                                                
PAT MARTIN, Outreach Director                                                                                                   
Alaska Right to Life                                                                                                            
Anchorage, Alaska                                                                                                               
POSITION STATEMENT:  Gave invited testimony on HB 205.                                                                        
                                                                                                                                
RICHARD CLAYTON TROTTER, General Counsel                                                                                        
Justice Foundation                                                                                                              
Eagle River, Alaska                                                                                                             
POSITION STATEMENT:  Testified in support of HB 205.                                                                          
                                                                                                                                
ROBERT M. BIRD, Past President                                                                                                  
Alaska Right to Life                                                                                                            
Kenai, Alaska                                                                                                                   
POSITION STATEMENT:  Spoke in support of HB 205.                                                                              
                                                                                                                                
ACTION NARRATIVE                                                                                                              
                                                                                                                                
3:03:58 PM                                                                                                                    
                                                                                                                                
CHAIR PRAX called  the House Health and  Social Services Standing                                                               
Committee  meeting  to  order  at   3:03  p.m.    Representatives                                                               
McCormick, Saddler, Fields, Sumner, and  Prax were present at the                                                               
call to  order.   Representatives Ruffridge  and Mina  arrived as                                                               
the meeting was in progress.                                                                                                    
                                                                                                                                
^CONFIRMATION HEARING(S):                                                                                                       
                    CONFIRMATION HEARING(S):                                                                                
                                                                                                                              
^Board of Direct Entry Midwives                                                                                                 
                 Board of Direct Entry Midwives                                                                             
3:06:07 PM                                                                                                                    
                                                                                                                                
BETHEL  BELISLE,  Appointee,  Board  of  Certified  Direct  Entry                                                               
Midwives, reviewed her qualifications  for her appointment to the                                                               
Board of Certified Direct Entry Midwives.                                                                                       
                                                                                                                                
3:07:47 PM                                                                                                                    
                                                                                                                                
MS.  BELISLE,  in  response   to  questions  from  Representative                                                               
Saddler,  said  two   issues  that  need  to   be  addressed  are                                                               
regulatory "clean-up"  to make sure regulations  and statutes are                                                               
in alignment and  staying fiscally responsible so as  to meet the                                                               
terms  of  a   legislative  audit.    She  said   that  the  2022                                                               
legislative audit  highlighted what the  board was missing.   She                                                               
said that concerns  with hiring practices were  brought about and                                                               
stressed that the  board itself does the hiring  for the Division                                                               
of Corporations,  Business, and  Professional Licensing,  not the                                                               
division itself.   Regarding  recruitment, she  said it  has been                                                               
difficult to  fill every spot on  the board.  She  said there are                                                               
several direct-entry  midwives who are  ready to apply  should HB
175 come  up with any  new amendments that require  three direct-                                                               
entry  midwives.   She  said the  Midwife  Association of  Alaska                                                               
(MAA) has  been working  with doctors  and families  to encourage                                                               
more direct-entry midwives to apply to the board.                                                                               
                                                                                                                                
3:12:54 PM                                                                                                                    
                                                                                                                                
MS.  BELISLE,  in  response to  a  question  from  Representative                                                               
Fields regarding  outcomes of regulations,  noted that  there was                                                               
one  particular  outcome with  a  patient  under  the care  of  a                                                               
midwife,  an  obstetrician  gynecologist,  and  a  family  doctor                                                               
regarding a  particularly difficult  delivery. She said  that the                                                               
patient  wouldn't have  delivered if  not for  the presence  of a                                                               
midwife,  whom Ms.  Belisle credited  with  saving the  patient's                                                               
life.                                                                                                                           
                                                                                                                                
MS.  BELISLE gave  her  final statement  on  her appointment  and                                                               
thanked  the  committee  for  the   opportunity  to  present  her                                                               
application to the board.                                                                                                       
                                                                                                                                
3:17:02 PM                                                                                                                    
                                                                                                                                
CHAIR  PRAX opened  public testimony  on the  appointment of  Ms.                                                               
Belisle to the  Board of Certified Direct-Entry  Midwives.  After                                                               
ascertaining  that there  was no  one who  wished to  testify, he                                                               
closed public testimony.                                                                                                        
                                                                                                                                
3:18:06 PM                                                                                                                    
                                                                                                                                
CHAIR  PRAX stated  that  the House  Health  and Social  Services                                                               
Standing  Committee  has  reviewed   the  qualifications  of  the                                                               
governor's appointees  and recommends that the  following name be                                                               
forwarded to a joint session  for consideration:  Bethel Belisle,                                                               
Board of Certified  Direct Entry Midwives.  He  said that signing                                                               
the report  regarding appointments  to boards and  commissions in                                                               
no way  reflects an individual  member's approval  or disapproval                                                               
of the appointee,  and the nomination is merely  forwarded to the                                                               
full legislature for confirmation or rejection.                                                                                 
                                                                                                                                
3:18:34 PM                                                                                                                    
                                                                                                                                
The committee took an at-ease from 3:18 p.m. to 3:21 p.m.                                                                       
                                                                                                                                
          HB 363-FOSTER CHILDREN PSYCHIATRIC TREATMENT                                                                      
                                                                                                                                
3:21:11 PM                                                                                                                    
                                                                                                                                
CHAIR PRAX  announced that  the next order  of business  would be                                                               
HOUSE BILL NO.  363, "An Act relating to the  placement of foster                                                               
children in psychiatric hospitals."                                                                                             
                                                                                                                                
REPRESENTATIVE ANDREW  GRAY, Alaska  State Legislature,  as prime                                                               
sponsor,  introduced HB  363.   He  encouraged  the committee  to                                                               
adopt the proposed committee substitute.                                                                                        
                                                                                                                                
3:23:08 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE RUFFRIDGE  moved to  adopt the  proposed committee                                                               
substitute  (CS)  for  HB  363,  Version  33-LS1049\S,  Bergerud,                                                               
3/13/24, as the working document.                                                                                               
                                                                                                                                
REPRESENTATIVE SADDLER objected for the purpose of discussion.                                                                  
                                                                                                                                
3:23:45 PM                                                                                                                    
                                                                                                                                
MATTHEW TURNER,  Staff, Representative Andrew Gray,  Alaska State                                                               
Legislature, on  behalf of Representative Gray,  prime sponsor of                                                               
HB 363, explained  the summary of changes from  the original bill                                                               
version to  Version S {included  in the committee  packet], which                                                               
read as follows [original punctuation provided]:                                                                                
                                                                                                                                
     Title Change                                                                                                               
     Add: and  amending Rule 12.1(b),  Alaska Child  in Need                                                                    
     of Aid Rules Procedure                                                                                                     
                                                                                                                                
     Eliminate Section                                                                                                          
     Eliminate section 1 from version A.                                                                                        
                                                                                                                                
     Section 1                                                                                                                  
     Amends  AS   47.10.087(b)  to  conform   to  subsequent                                                                    
     changes.                                                                                                                   
                                                                                                                                
     Section 2                                                                                                                  
     Adds   two   definitions   to  this   section:   "acute                                                                    
     psychiatric  hospital"   and  "contemporaneous  two-way                                                                    
     video conference".                                                                                                         
                                                                                                                                
     Section 3                                                                                                                  
     Adds new  rules specifically for how  the Department of                                                                    
     Family and  Youth Services  may place  a child  into an                                                                    
     acute  psychiatric hospital,  how  the Department  must                                                                    
     immediately  begin   search  for  a   less  restrictive                                                                    
     placement  for  when the  child  is  released from  the                                                                    
     acute  psychiatric  hospital,   rules  for  assuring  a                                                                    
     timely initial  court hearing  to review  the placement                                                                    
     of  the child,  and for  establishing regular   ongoing                                                                    
     hearings to  assure the  child does  not remain  in the                                                                    
     acute psychiatric hospital for longer than necessary.                                                                      
                                                                                                                                
3:25:10 PM                                                                                                                    
                                                                                                                                
The committee took a brief at-ease at 3:25 p.m.                                                                                 
                                                                                                                                
3:25:36 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE GRAY gave  the sponsor statement for  Version S of                                                               
HB 363 [included in the committee  packet].  He explained that HB
363 aims  to require  children in  the custody  of the  Office of                                                               
Children's  Services (OCS),  also  known as  foster children,  to                                                               
receive  a hearing  in front  of a  judge in  a timely  manner to                                                               
ensure that  they meet the criteria  to be placed under  the care                                                               
of a psychiatric hospital.   He cited Native Village of Quinhagak                                                             
vs  State of  Alaska,  heard  in the  Alaska  Supreme Court,  and                                                             
highlighted  the judge's  opinion that  "there is  no doubt  that                                                               
children  in  OCS  custody  are  at  substantial  risk  of  being                                                               
hospitalized for  longer than they  need" and the  statement made                                                               
that  "clarifying   the  legal   protections  for   a  vulnerable                                                               
population  of children  in  state custody  is  of utmost  public                                                               
importance."   He said the  Alaska Supreme Court  determined that                                                               
the current  46-day wait  between a  child's first  admission and                                                               
court hearing  is far too  long to satisfy  due process.   When a                                                               
young person  is hospitalized in a  psychiatric institution, that                                                               
person has limitations  placed on their rights  and freedoms that                                                               
are not  placed onto others.   He said  the chance that  a foster                                                               
child's rights could  be restricted are much higher  than that of                                                               
other children.  He said that  often, one of the greatest traumas                                                               
experienced by foster  children is the process of  admission to a                                                               
psychiatric institution; it  is akin to a  form of incarceration.                                                               
He advised that children have  suffered from admissions that were                                                               
too long and unnecessary, which is  what HB 363 Version S aims to                                                               
solve.  He  opined that the priority should not  be on the child,                                                               
not on making the legal  process surrounding foster childcare and                                                               
custody more convenient for the adults involved.                                                                                
                                                                                                                                
3:31:27 PM                                                                                                                    
                                                                                                                                
MR.  TURNER began  the associated  PowerPoint presentation  to HB
363,  Version S  [hardcopy  included in  committee  packet].   He                                                               
started  on slide  1,  which  explained the  purpose  of HB  363,                                                               
Version S, by giving context  with an article of the Constitution                                                               
of the State of Alaska.   He moved through slides 3-4, which gave                                                               
context  to  the   reality  of  the  situation   faced  by  acute                                                               
psychiatric  care  facilities across  Alaska.    He continued  to                                                               
slide 5,  which touched on  the Alaska Supreme Court  ruling that                                                               
OCS children  are at  risk of being  hospitalized longer  than is                                                               
necessary.   He  moved forward  to slide  6, which  explained the                                                               
authority that  OCS has  with regard to  the placement  of foster                                                               
children in  psychiatric care.   He continued  to slide  7, which                                                               
showed a  graph of  OCS youth  placements into  acute psychiatric                                                               
care  from 2017-2022.    Finally, he  moved  through slides  8-9,                                                               
which explained what HB 363, Version  S, would do if put into law                                                               
to solve the issues surrounding OCS childcare in Alaska.                                                                        
                                                                                                                                
3:36:33 PM                                                                                                                    
                                                                                                                                
MR. TURNER offered  the sectional analysis for HB  363, Version S                                                               
[included in  committee packet], which read  as follows [original                                                               
punctuation provided]:                                                                                                          
                                                                                                                                
     Section 1                                                                                                                  
                                                                                                                                
     AS   47.10.087   Placement    in   secure   residential                                                                    
     psychiatric treatment centers.                                                                                             
                                                                                                                                
     Amends  AS   47.10.087(b)  to  conform   to  subsequent                                                                    
     changes.                                                                                                                   
                                                                                                                                
     Section 2                                                                                                                  
                                                                                                                                
     AS 47.10.087(d) Definitions                                                                                                
                                                                                                                                
     Adds two  definitions to AS 47.10.087(d)  and renumbers                                                                    
     the section to conform to these changes.                                                                                   
                                                                                                                                
     The first defines an "acute  psychiatric hospital" as a                                                                    
     facility that  primarily provides diagnosis  and short-                                                                    
     term  treatment of  mental,  emotional, and  behavioral                                                                    
     disorders.                                                                                                                 
                                                                                                                                
     The  second defines  a  "contemporaneous two-way  video                                                                    
     conference".                                                                                                               
                                                                                                                                
     Section 3                                                                                                                  
                                                                                                                                
     AS 47.10.087 Child in need of aid procedures                                                                               
                                                                                                                                
     Adds  new  subsections  to AS  47.10.087  that  do  the                                                                    
     following:                                                                                                                 
                                                                                                                                
     (e) Allows OCS to place a  child in its custody into an                                                                    
     acute  psychiatric   hospital  if   it  is   the  least                                                                    
     restrictive  placement  available,  and the  person  in                                                                    
     charge of  admittance to the facility  finds that acute                                                                    
     psychiatric care is  the best course of  action for the                                                                    
     child.                                                                                                                     
                                                                                                                                
     (f) Within 24  hours after placing a child  in an acute                                                                    
     psychiatric hospital under OCS  shall notify the court,                                                                    
     the  child's  parents,  and any  other  parties  to  an                                                                    
     ongoing child-in-need-of-aid  case involving  the child                                                                    
     of the placement.                                                                                                          
                                                                                                                                
     (g) A court shall review  a placement made under (e) of                                                                    
     this   section   within   48  hours   after   receiving                                                                    
     notification  of  the  child's placement  in  an  acute                                                                    
     psychiatric  hospital.  The   court  shall  notify  the                                                                    
     child, the  child's attorney, the child's  parents, the                                                                    
     department, and  any parties to a  child-in-need-of aid                                                                    
     case involving the  child of the time and  place of the                                                                    
     hearing once the hearing is scheduled.                                                                                     
                                                                                                                                
     Additional  language  defines  the  48-hour  period  to                                                                    
     allow for  weekends and holidays, and  allows the court                                                                    
     an  additional two  day  continuance  if the  concerned                                                                    
     parties  cannot  meet  earlier.  To  make  the  hearing                                                                    
     easier, it may be held via teleconference.                                                                                 
                                                                                                                                
     The hearing will  determine whether continued placement                                                                    
     in  an  acute  psychiatric  hospital  is  in  the  best                                                                    
     interest  of the  child. If  the child  remains in  the                                                                    
     acute  psychiatric  hospital,   there  will  be  review                                                                    
     hearings held  every 30 days  or at the request  of the                                                                    
     child or another party after showing good cause.                                                                           
                                                                                                                                
3:39:34 PM                                                                                                                    
                                                                                                                                
MATEO  JAMIE, as  a foster  child, gave  invited testimony  on HB
363, Version  S. He  described his experience  being placed  in a                                                               
psychiatric facility  and said when  he was admitted, all  of his                                                               
belongings were taken from him and  he was forced to wear medical                                                               
scrubs, all of which were distressing.   He said he was placed in                                                               
a  psychiatric facility  because there  were no  available foster                                                               
homes, which the  doctor at the facility  acknowledged was common                                                               
practice.    He  said  that  during his  two-month  stay  at  the                                                               
facility, his OCS  worker visited him only twice  to determine if                                                               
the  facility was  the correct  placement or  not.   He described                                                               
situations where  staff physically attacked the  youth staying at                                                               
the facility and police were called  in to maintain order, and he                                                               
cited  these  situations  as  causes  for  post-traumatic  stress                                                               
disorder  (PTSD).    He  said  that if  they  didn't  obey  every                                                               
command,  children at  the psychiatric  facility would  receive a                                                               
chemical  sedative via  injection, which  further contributed  to                                                               
the trauma  and humiliation  of being  admitted to  a psychiatric                                                               
institution.  He  explained that he felt "like a  zombie" for the                                                               
two months  he was  admitted to  the institution  and had  no say                                                               
over anything in  his life.  He emphasized  that psychiatric care                                                               
should not  be used  as a  substitute for  proper placement  in a                                                               
foster  home  and  said  that   foster  youth  deserve  placement                                                               
decisions within three days of admittance to OCS.                                                                               
                                                                                                                                
3:42:48 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE MINA gave her thanks  to Mr. Jamie for sharing his                                                               
experience in the foster care system in Alaska.                                                                                 
                                                                                                                                
REPRESENTATIVE   PRAX  speculated   that   just   being  at   the                                                               
psychiatric facility was enough to cause trauma.                                                                                
                                                                                                                                
MR. JAMIE  confirmed that is  correct; he still has  PTSD attacks                                                               
to this day.                                                                                                                    
                                                                                                                                
3:43:51 PM                                                                                                                    
                                                                                                                                
SARAH LEWIS,  as a foster  care child, gave invited  testimony on                                                               
HB  363, Version  S.   She described  her own  experience in  the                                                               
foster care system,  saying she was in the system  until she aged                                                               
out when she  turned 21.  She said foster  youth are being placed                                                               
in psychiatric  hospitals even  though the  public has  been made                                                               
aware  of the  fact that  these  institutions are  not the  right                                                               
place  for many  of them.    She shared  a story  of her  younger                                                               
brother and  sister's experience  in the  foster care  system, in                                                               
which they  were made to wait  29 days in a  psychiatric facility                                                               
after being removed from a  previous foster home.  She emphasized                                                               
how traumatizing this  process was for both her  and her siblings                                                               
and said that  the child has no say in  their placement of foster                                                               
care.  She  recounted a visit to a psychiatric  hospital that her                                                               
youngest  sister was  placed  in  where a  nurse  was taunting  a                                                               
foster  child  and threatening  them  with  an injected  chemical                                                               
sedative.   She  described her  visit  to her  younger sister  as                                                               
heartbreaking, saying  it was as though  she was a zombie  due to                                                               
the heavy volume  of sedative medication they were  giving her at                                                               
the institution.   She said that OCS has created  this trauma and                                                               
done nothing to remedy it, all  the while the foster child has no                                                               
say in their placements in the system.                                                                                          
                                                                                                                                
3:49:37 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE RUFFRIDGE  asked Ms. Lewis  to expound on  why her                                                               
role as  a placement caregiver  in the foster care  system wasn't                                                               
the first option in a foster youth's journey.                                                                                   
                                                                                                                                
MS. LEWIS  said she did  not know why OCS  chose not to  give her                                                               
immediate custody of  her younger siblings; she  only won custody                                                               
after she obtained an attorney.                                                                                                 
                                                                                                                                
3:52:09 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE  FIELDS  said he  was  baffled  by the  accusation                                                               
pertaining   to  NorthStar   Psychiatry  and   asked  how   those                                                               
grievances could have occurred.                                                                                                 
                                                                                                                                
NANCY  MEADE,  General  Counsel, Alaska  Court  System,  answered                                                               
committee questions relating  to HB 363, Version  S, deferred the                                                               
question to OCS.                                                                                                                
                                                                                                                                
REPRESENTATIVE  FIELDS  asked  what mechanism  beside  making  an                                                               
appeal would  be available if  OCS doesn't  help in regard  to an                                                               
alleged abuse at NorthStar Psychiatry.                                                                                          
                                                                                                                                
MS.  MEADE  answered   that  she  is  not   aware  of  litigation                                                               
surrounding NorthStar Psychiatry but would investigate it.                                                                      
                                                                                                                                
3:53:51 PM                                                                                                                    
                                                                                                                                
KIM  SWISHER, Deputy  Director,  Office  of Children's  Services,                                                               
Department  of   Family  &   Community  Services,   gave  invited                                                               
testimony  on HB  363, Version  S.   She said  she isn't  able to                                                               
speak  to ongoing  litigation relating  to NorthStar  Psychiatry,                                                               
but she said  that there are very few  acute psychiatric hospital                                                               
settings  in Alaska  where OCS  is able  to give  urgent care  to                                                               
foster youth experiencing urgent mental health needs.                                                                           
                                                                                                                                
REPRESENTATIVE FIELDS  asked what it  would take for OCS  to find                                                               
an alternative to NorthStar Psychiatry  after years of documented                                                               
abuse.                                                                                                                          
                                                                                                                                
MS. SWISHER  responded that she  has seen the number  of children                                                               
who need to  use NorthStar decline and added that  OCS is working                                                               
with NorthStar to remedy complaints that are put forward.                                                                       
                                                                                                                                
REPRESENTATIVE FIELDS asked  if OCS has worked  with nonprofit or                                                               
tribal  health providers  to establish  other options  for foster                                                               
care placement.                                                                                                                 
                                                                                                                                
MS.  SWISHER  replied  that  she   would  have  to  get  back  to                                                               
Representative Fields later.                                                                                                    
                                                                                                                                
3:56:50 PM                                                                                                                    
                                                                                                                                
CHAIR PRAX asked  how OCS makes the choice  for which psychiatric                                                               
facility  to  use  and  how  OCS verifies  that  the  care  being                                                               
provided is adequate.                                                                                                           
                                                                                                                                
MS. SWISHER answered  that often, acute care  settings are chosen                                                               
when OCS is  awaiting evaluation of a  foster child's evaluation,                                                               
which she  emphasized is performed  by a qualified  mental health                                                               
professional.                                                                                                                   
                                                                                                                                
3:58:58 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE RUFFRIDGE asked if there  is a potential to have a                                                               
position  within  OCS  whose  sole  job  is  to  evaluate  foster                                                               
children for placement options.                                                                                                 
                                                                                                                                
MS. SWISHER answered  that OCS utilizes acute  care settings when                                                               
a foster child  meets the criteria for that need.   She said that                                                               
OCS  doesn't  have  an in-house  mental  health  professional  to                                                               
evaluate   foster  children   but  does   partner  with   outside                                                               
providers,  and   she  said  she   would  follow  up   with  more                                                               
information later.                                                                                                              
                                                                                                                                
4:01:20 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE  MINA  asked Ms.  Meade  to  compare the  standard                                                               
timelines  for court  hearings  of  an adult  and  a child  being                                                               
considered for psychiatric facility.                                                                                            
                                                                                                                                
MS.  MEADE  responded that  in  the  comparable scenario  for  an                                                               
adult,  a  court  hearing  is  required  within  72  hours  of  a                                                               
placement in a  psychiatric facility.  She said  that with regard                                                               
to children's  psychiatric placement, there is  no timeline under                                                               
current  statute,  which is  what  HB  363,  Version S,  aims  to                                                               
address.   She said if  a court determines  that an adult  who is                                                               
being considered  during the  72-hour hearing  does not  meet the                                                               
criteria of  acute care, the  adult is released; whereas  a child                                                               
isn't  just  let  go  and must  be  sent  somewhere,  psychiatric                                                               
institutions often being  the only least-restricting alternative.                                                               
She acknowledged  that it does take  longer for a child  to get a                                                               
hearing  than  an adult  because  of  the  number of  people  and                                                               
entities involved in the process.   She said that 3 days might be                                                               
too short  but agreed  that anything  over 14  days is  too long.                                                               
She advised that it is up  to the legislature to set the adequate                                                               
timeline that the courts must follow.                                                                                           
                                                                                                                                
4:07:15 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE  MINA  echoed  her  understanding  that  there  is                                                               
currently no  requirement to  have a court  hearing unless  it is                                                               
requested by someone.                                                                                                           
                                                                                                                                
MS.  MEADE answered  that the  current statute  that governs  OCS                                                               
childcare says a court hearing must  be granted within 30 days of                                                               
the child being  taken into care, and said that  statute would be                                                               
amended by HB 363, Version S.                                                                                                   
                                                                                                                                
4:09:07 PM                                                                                                                    
                                                                                                                                
CHAIR PRAX  asked whether a  foster child has an  advocate beside                                                               
OCS.    He clarified  the  timeline  of  a foster  child's  court                                                               
hearing and  gave a  hypothetical scenario of  a child  under OCS                                                               
care  to  clarify his  understanding  of  how the  OCS  childcare                                                               
system currently functions.                                                                                                     
                                                                                                                                
MS. MEADE responded  that the intent of HB 363,  Version S, is to                                                               
shorten  the   timelines  of  court  case   hearings  for  foster                                                               
children.   She clarified that  HB 363, Version S,  would address                                                               
foster children  who are already  in state custody,  not children                                                               
who are in need of emergency assistance by OCS.                                                                                 
                                                                                                                                
CHAIR  PRAX gave  another hypothetical  scenario  to clarify  his                                                               
understanding of the OCS childcare system.                                                                                      
                                                                                                                                
MS. SWISHER confirmed that Chair  Prax' understanding is correct:                                                               
a qualified mental health professional  evaluates a foster child,                                                               
and  then OCS  works  with a  care provider  to  find the  least-                                                               
restrictive option  for the child.   In  response to a  series of                                                               
follow-up   questions  from   Representative   Prax,  said   that                                                               
sometimes  foster children  are  evaluated  and immediately  sent                                                               
back  to lower  levels of  care but  the challenge  in Alaska  is                                                               
locating safe,  appropriate step-down  care services.   She added                                                               
that OCS has  recently been doing safety checks  and takes direct                                                               
consultation with foster children.                                                                                              
                                                                                                                                
4:18:09 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE GRAY  gave context to the  proposed 72-hour figure                                                               
as  written  in  HB  363,  Version  S.   He  said  he  asked  the                                                               
Department of Law  and spoke with OCS about  the proposed 72-hour                                                               
figure and acknowledged  that the Native Village  of Quinhagak vs                                                             
State of  Alaska, Office of  Children's Services  case recognizes                                                             
that the  72-hour figure might  be too  tight of a  timeline, but                                                               
said it is incumbent upon  the legislature to select the absolute                                                               
[maximum time in which foster child must be placed].                                                                            
                                                                                                                                
4:19:49 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE   MINA  asked   how  many   court  hearings   have                                                               
teleconference or hybrid hearing capabilities.                                                                                  
                                                                                                                                
MS.  MEADE answered  that OCS  has  a robust  video presence  and                                                               
hybrid court  options are viable  for most  who can't make  it to                                                               
the hearing.                                                                                                                    
                                                                                                                                
4:22:05 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE RUFFRIDGE  gave his thanks to  Representative Gray                                                               
for putting HB  363, Version S, forward and  suggested that there                                                               
be  language added  to include  an  obligation to  a child  being                                                               
released should they not meet  the criteria for acute psychiatric                                                               
care.  He asked Ms. Meade to speak  to the burden of proof of the                                                               
state, and asked  Ms. Swisher whether OCS had noticed  any of the                                                               
complaints brought forward or taken any action to remedy them.                                                                  
                                                                                                                                
4:25:57 PM                                                                                                                    
                                                                                                                                
MS. SWISHER,  responding to  Representative Ruffridge,  said that                                                               
she has  seen changes with  NorthStar Psychiatry in  working with                                                               
its personnel, and OCS takes  these complaints seriously and will                                                               
continue to investigate them.                                                                                                   
                                                                                                                                
MS. MEADE explained  that the standard of  evidence for admitting                                                               
a  foster  child   to  acute  psychiatric  care   is  "clear  and                                                               
convincing" evidence  that the child  is suffering from  a mental                                                               
illness.  She  cited page 3, line  9 of HB 363,  Version S, which                                                               
clarifies  that  the court  can  authorize  OCS to  continue  the                                                               
placement into  acute psychiatric care, but  said the presumption                                                               
is to  not place them  into care if not  necessary.  She  said in                                                               
child  cases, an  individual's will  is  not as  important as  in                                                               
adult  cases.    She  said  the   decision  is  based  off  of  a                                                               
consideration of  all of  the evidence  presented by  all parties                                                               
involved in  the case  and emphasized that  there is  a statewide                                                               
problem with  quality mental health  facilities and  treatment in                                                               
Alaska.                                                                                                                         
                                                                                                                                
4:29:28 PM                                                                                                                    
                                                                                                                                
CHAIR PRAX  expressed interest  in how  a decision  is considered                                                               
between adults and children.                                                                                                    
                                                                                                                                
REPRESENTATIVE  GRAY, in  response  to Representative  Ruffridge,                                                               
said  that he  believes  OCS  is doing  its  best  to get  foster                                                               
children the placements and care they  need but is inhibited by a                                                               
lack of resources.  He emphasized  that the moment a foster child                                                               
says  the words,  "I'm going  to kill  myself," a  child must  be                                                               
taken away from their current  placement and reevaluated.  Making                                                               
a  statement  is sometimes  a  method  used  by children  in  OCS                                                               
custody to escape an unhappy placement, whether true or not.                                                                    
                                                                                                                                
4:31:59 PM                                                                                                                    
                                                                                                                                
MS. LEWIS  added to  Representative Gray's  testimony, clarifying                                                               
that she was referencing her  brother, Jeremy Redmond, who passed                                                               
away in  October 2020 due  to a  lack of care  by OCS.   She said                                                               
that  the job  of OCS  is to  take care  of the  children in  its                                                               
custody, but  it didn't  follow through with  that promise.   She                                                               
said that OCS chose to wait until  there was a crisis in her home                                                               
with  her  brother.   She  recalled  going  to court  to  testify                                                               
against her  brother's foster home  placement and said  her calls                                                               
had been ignored.   She said that after placement  in this foster                                                               
home, her brother was staying with  an adult still under OCS care                                                               
that she  pleaded with the  OCS to be removed  but was not.   She                                                               
said  this  adult under  OCS  care  provided her  little  brother                                                               
drugs,  and it  was  OCS who  notified Ms.  Lewis  of her  little                                                               
brother's  overdose  death, even  after  her  pleas to  have  the                                                               
person removed.                                                                                                                 
                                                                                                                                
CHAIR PRAX asked  why Ms. Lewis was disqualified  from custody of                                                               
her little brother.                                                                                                             
                                                                                                                                
MS. LEWIS said  that she was disqualified  from foster parenthood                                                               
because  she  could  not  provide her  little  brother  with  the                                                               
behavioral health services  that he was required  to be receiving                                                               
under OCS care.                                                                                                                 
                                                                                                                                
4:37:48 PM                                                                                                                    
                                                                                                                                
A   roll  call   vote  was   taken.  Representatives   McCormick,                                                               
Ruffridge,  Sumner, Fields,  Mina,  and Prax  voted  in favor  of                                                               
adopting  the  proposed  CS  for  HB  363,  Version  33-LS1049\S,                                                               
Bergarud,  3/13/24,  as  a  working  document.    [Representative                                                               
Saddler was absent.]  Therefore, by  a vote of 6-0, Version S was                                                               
before the committee.                                                                                                           
                                                                                                                                
4:39:14 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE  FIELDS   commented  that   one  of   the  reasons                                                               
institutions with histories  of abuse can still  exist is because                                                               
of  the for-profit  motive of  psychiatric care  facilities.   He                                                               
urged  committee members  to guide  OCS further  because what  is                                                               
happening currently is outrageous.                                                                                              
                                                                                                                                
REPRESENTATIVE  MINA added  that the  Department of  Health (DOH)                                                               
and the Department  of Family and Community  Services (DFCS) have                                                               
a draft of  a youth behavioral health plan that  seeks to address                                                               
downstream  services  of the  departments.    There is  a  public                                                               
comment period open until March 17.                                                                                             
                                                                                                                                
4:41:02 PM                                                                                                                    
                                                                                                                                
CHAIR PRAX announced that HB 363, Version S, was held over.                                                                     
                                                                                                                                
4:41:14 PM                                                                                                                    
                                                                                                                                
The committee took an at-ease from 4:41 p.m. to 4:42 p.m.                                                                       
                                                                                                                                
         HB 187-PRIOR AUTH EXEMPT FOR HEALTH PROVIDERS                                                                      
                                                                                                                                
4:42:43 PM                                                                                                                    
                                                                                                                                
CHAIR PRAX  announced that  the next order  of business  would be                                                               
HOUSE  BILL  NO. 187,  "An  Act  relating to  utilization  review                                                               
entities;  exempting certain  health care  providers from  making                                                               
preauthorization  requests for  certain  services; and  providing                                                               
for an effective date."                                                                                                         
                                                                                                                                
4:44:22 PM                                                                                                                    
                                                                                                                                
CHAIR PRAX opened public testimony on HB 187.                                                                                   
                                                                                                                                
JEANNIE  MONK, Senior  Vice President,  Alaska  State Hospital  &                                                               
Healthcare Association,  testified in  support of HB  187, saying                                                               
it would reduce the wait  time for certain healthcare services by                                                               
exempting   healthcare   providers  from   the   preauthorization                                                               
process.   She  said that  HB 187  represents a  step forward  in                                                               
ensuring timely access to essential  medical care.  She said that                                                               
prior authorization  can be  extremely frustrating  and stressful                                                               
for patients  and said the  last thing  a patient wants  to worry                                                               
about is whether or not  their insurance company will cover their                                                               
medical bills.   She said for patients in rural  areas, the issue                                                               
of prior  authorization is  exacerbated by  the remote  nature of                                                               
rural medical care.  She  emphasized that the prior authorization                                                               
process  is extremely  time consuming  for  medical providers  as                                                               
well.  Often a healthcare provider  will hire teams of staff just                                                               
to manage insurance  and prior authorization requests.   She said                                                               
the proposed legislation would strike  a good balance between all                                                               
aspects of  the prior  authorization process,  and she  urged the                                                               
committee to pass HB 187.                                                                                                       
                                                                                                                                
4:48:00 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE  FIELDS asked  how many  medical conditions  exist                                                               
where the treatment might be longer than 12 months.                                                                             
                                                                                                                                
MS. MONK said she would follow up with an answer later.                                                                         
                                                                                                                                
4:48:37 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE RUFFRIDGE  asked Representative Fields  to clarify                                                               
his question as to how it relates to prior authorization.                                                                       
                                                                                                                                
REPRESENTATIVE FIELDS  asked if  a hypothetical  treatment regime                                                               
that  would need  to be  executed for  longer than  12 months  is                                                               
addressed in HB 187.                                                                                                            
                                                                                                                                
4:49:36 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE JESSE  SUMNER, Alaska State Legislature,  as prime                                                               
sponsor, in  response to  Representative Fields,  cited psoriasis                                                               
medication  as an  ongoing  treatment regime  and  said that  the                                                               
exemption for prior authorization, as  addressed under HB 187, is                                                               
for the healthcare provider, not the patient.                                                                                   
                                                                                                                                
CHAIR PRAX asked Ms. Monk  how often prior authorization requests                                                               
are denied  and how  long payment  would take  if a  request were                                                               
approved.                                                                                                                       
                                                                                                                                
MS. MONK  replied that it  varies greatly,  but there is  no data                                                               
set on  it.  She said  there are hundreds of  procedures all over                                                               
Alaska that have to be authorized every day.                                                                                    
                                                                                                                                
4:52:05 PM                                                                                                                    
                                                                                                                                
TAMMY   THIEL,  Executive   Director,   Denali  Oncology   Group,                                                               
testified in support of HB 187.   She gave context to the primary                                                               
role of  the Denali  Oncology Group (DOG)  and explained  how the                                                               
current  prior  authorization  process  is  negatively  affecting                                                               
medical care  in Alaska.  She  said HB 187 prescribes  a solution                                                               
for  these issues  by introducing  the concept  of a  "gold card"                                                               
that grants  exemption to  healthcare providers  who consistently                                                               
follow  evidence-based   medicine  and  achieve  an   80  percent                                                               
approval rating on  prior authorization requests.   She said this                                                               
could greatly  streamline the process of  prior authorization and                                                               
urged the committee's support for HB 187.                                                                                       
                                                                                                                                
4:55:11 PM                                                                                                                    
                                                                                                                                
PAM   VENTGEN,   Executive   Director,   Alaska   State   Medical                                                               
Association,  testified in  support of  HB  187.   She said  that                                                               
prior authorization  is a process  that serves a purpose  but can                                                               
often inhibit timely  and quality healthcare. She  said the "gold                                                               
card" provision of HB 187 is  sensical and would make the process                                                               
of prior  authorization smoother for  all parties involved.   She                                                               
gave  a  note  on   statistics  surrounding  prior  authorization                                                               
approval/disapproval   rates,   along   with   patient   outcomes                                                               
depending   on  the   approval  or   disapproval  of   the  prior                                                               
authorization.   She  cited a  survey from  the American  Medical                                                               
Association   (AMA)   that   found   that   prior   authorization                                                               
requirements delay necessary treatment and  care in 94 percent of                                                               
cases.   She said the  physical, emotional, and  financial impact                                                               
to  patients  from  delays  caused  by  prior  authorization  are                                                               
significant  and devastating,  and change  should be  made.   She                                                               
said  that  HB 187  makes  sound  and  logical changes  to  these                                                               
problems and urged the committee's support of HB 187.                                                                           
                                                                                                                                
4:59:48 PM                                                                                                                    
                                                                                                                                
MARC  REECE,  Director  of Public  Policy,  AETNA,  testified  in                                                               
opposition  to HB  187.   He  said  that  HB 187  is  not a  good                                                               
solution  to  the ailments  that  currently  exist in  the  prior                                                               
authorization system.   He  explained that  the purpose  of prior                                                               
authorization  is  to ensure  that  healthcare  is paid  for  and                                                               
administered as  soon as  possible and said  that HB  187 doesn't                                                               
help with  that purpose.  He  said that the bill  sponsor doesn't                                                               
recognize  the  impact  of the  proposed  legislations'  proposed                                                               
"gold card" exemption  program.  The 80 percent  threshold is far                                                               
lower  than every  other state  that  has tried  to implement  an                                                               
exemption program.                                                                                                              
                                                                                                                                
5:03:06 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE MINA asked what mechanisms  are currently in place                                                               
that insurance companies  can pursue to reduce the  wait time for                                                               
prior authorization.                                                                                                            
                                                                                                                                
MR. REECE responded  that AETNA is actively trying  to reduce the                                                               
prior   authorization  approval   process  by   removing  certain                                                               
services from prior authorization  and by automating the approval                                                               
process through clinical standards that must be met.                                                                            
                                                                                                                                
5:05:14 PM                                                                                                                    
                                                                                                                                
PREET  KLAUR, Policy  & Legislative  Manger,  Premera Blue  Cross                                                               
Blue Shield  of Alaska, testified in  opposition to HB 187.   She                                                               
said  the  proposed  bill  would  be  costly  and  confusing  for                                                               
insurance companies  and their members.   She warned that  HB 187                                                               
would increase  the risk  for adverse  medical events,  citing an                                                               
unnamed study  that found that  over 10 percent  of authorization                                                               
reviews prevented  adverse drug events  and medical errors.   She                                                               
emphasized  that  prior  authorization  is  a  critical  tool  in                                                               
ensuring that  healthcare is cost-effective  and safe,  and added                                                               
that  all  prior authorization  requests  are  resolved within  5                                                               
days, or  within 24  hours if  it is an  emergency request.   She                                                               
explained  an existing  support structure  for medical  providers                                                               
that allows  for a  reevaluation process  if there  were wrongful                                                               
disapproval of a prior authorization request.                                                                                   
                                                                                                                                
REPRESENTATIVE  MINA asked  what  mechanisms  Premera Blue  Cross                                                               
Blue Shield of Alaska was  pursuing to reduce prior authorization                                                               
approval times.                                                                                                                 
                                                                                                                                
MS. KLAUR answered that Premera  Blue Cross Blue Shield of Alaska                                                               
has  created a  reevaluation process  for a  denied approval  and                                                               
implemented  an electronic  portal  online for  easier access  to                                                               
information regarding its prior authorization approval.                                                                         
                                                                                                                                
5:10:18 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE  MINA   asked  whether  HB  187   applies  to  the                                                               
healthcare plans utilized by the State of Alaska.                                                                               
                                                                                                                                
STEVE  RAMOS,  Acting  Chief Health  Administrator,  Division  of                                                               
Retirement  & Benefits,  Department  of Administration,  answered                                                               
that HB  187 is housed under  Title 21 under Alaska  Statute, and                                                               
the  Alaska  Care  plans  as  administered  by  the  Division  of                                                               
Retirement  and Benefits  are not  insurance plans,  so they  are                                                               
subject to Title 39 under Alaska Statute.                                                                                       
                                                                                                                                
REPRESENTATIVE MINA asked Representative  Sumner, "Is your intent                                                               
to  also cover  the state  plan and  [Employee Retirement  Income                                                               
Security Act]  (ERISA) plans  or are you  only sticking  to Title                                                               
21?"                                                                                                                            
                                                                                                                                
REPRESENTATIVE SUMNER answered that is correct.                                                                                 
                                                                                                                                
5:11:56 PM                                                                                                                    
                                                                                                                                
CHAIR PRAX, after  ascertaining there was no one  else who wished                                                               
to testify, closed public testimony on HB 187.                                                                                  
                                                                                                                                
CHAIR PRAX announced that HB 187 was held over.                                                                                 
                                                                                                                                
          HB 205-CRIMINALIZE ABORTION; PRIVACY; COURTS                                                                      
                                                                                                                                
5:12:35 PM                                                                                                                    
                                                                                                                                
CHAIR PRAX  announced that the  final order of business  would be                                                               
HOUSE BILL  NO. 205,  "An Act interpreting  the right  to privacy                                                               
under  art. I,  sec. 22,  Constitution  of the  State of  Alaska;                                                               
defining  'abortion,'  'birth,' 'child,'  'conception,'  'natural                                                               
person,'  and  'preborn child';  relating  to  civil actions  and                                                               
liability  under  the  Act;  relating   to  murder  of  a  child;                                                               
repealing  abortion   procedures;  amending  the   definition  of                                                               
'person'  for crimes  against a  person; repealing  murder of  an                                                               
unborn child and penalties and  provisions related to that crime;                                                               
relating  to  the powers  of  guardians;  relating to  powers  of                                                               
attorney  for health  care decisions;  relating to  regulation of                                                               
abortion; relating  to medical treatment for  minors; relating to                                                               
relocation  of  a  child;  relating   to  the  office  of  public                                                               
advocacy;  repealing medical  assistance  payment for  abortions;                                                               
relating  to duties  of  the attorney  general;  relating to  the                                                               
limitation on the  use of assets; and providing  for an effective                                                               
date."                                                                                                                          
                                                                                                                                
5:13:10 PM                                                                                                                    
                                                                                                                                
The committee took an at-ease from 5:13 p.m. to 5:16 p.m.                                                                       
                                                                                                                                
5:16:09 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE DAVID EASTMAN, Alaska  State Legislature, as prime                                                               
sponsor, introduced HB  205.  He explained that the  bill is also                                                               
referred to  as the "Life  at Conception Act" and  "Preborn Child                                                               
Equality Act  of 2024" and  deals with the  constitutional rights                                                               
of children.                                                                                                                    
                                                                                                                                
5:17:10 PM                                                                                                                    
                                                                                                                                
PAT  MARTIN,  Outreach  Director,  Alaska  Right  to  Life,  gave                                                               
invited testimony in  support of HB 205.  He  began his testimony                                                               
by  drawing attention  to  an article  in a  1965  issue of  Life                                                             
Magazine  and  proffering  that the  article  anticipated  Alaska                                                             
Right  to   Life's  overarching   theory  that  life   begins  at                                                               
conception.  He  explained the article was  published seven years                                                               
before  Roe  v.  Wade,  and  in the  magazine  issue  "there  are                                                             
articles which  were very publicly published,  and these indicate                                                               
that in 1965 we had the  scientific knowledge that life begins at                                                               
conception and, in fact, we had  not just the knowledge that life                                                               
begins at conception, but we  had actual imagery that life begins                                                               
at conception."                                                                                                                 
                                                                                                                                
MR. MARTIN referred to the  committee's previous consideration of                                                               
a healthcare  bill, using that to  bolster his major points.   He                                                               
purported the following [bullet-pointed for clarity]:                                                                           
   • Performing an abortion is murder.                                                                                          
   • The  act  of performing  an  abortion  falls under  the                                                                    
     heading of healthcare.                                                                                                     
   • When an egg and a sperm meet, life begins.                                                                                 
   • An  individual human  being in  the womb  is alive  but                                                                    
     separate from the mother.                                                                                                  
   • An  individual   human  being   is  killed   during  an                                                                    
     abortion, no matter what the stage of gestation.                                                                           
   • Whether the fetus  is eight days or six weeks  it is an                                                                    
     individual human being that is alive.                                                                                      
   • The constitution  gives an  inherent right  to equality                                                                    
     and equal protection under the law.                                                                                        
   • Equal right  to protection under  the law applies  to a                                                                    
     fetus.                                                                                                                     
   • The Alaska constitution and  Alaska judicial system are                                                                    
      in conflict regarding the right to life of an unborn                                                                      
     child.                                                                                                                     
   • Children  in  the womb  deserve  to  be protected  from                                                                    
     violence.                                                                                                                  
   • We make it  legal for doctors to murder a  child in the                                                                    
     womb and pay them to do so.                                                                                                
   • We pay  for abortions because  our tax dollars  pay for                                                                    
     half of the abortions performed in Alaska.                                                                                 
   • In 1969 Senator Rayder  moved to Alaska from California                                                                    
       and introduced bills legalizing abortion until one                                                                       
     finally passed and became law after a 2/3 vote by the                                                                      
     legislature to override the governor's veto.                                                                               
   • It has been known for 800 years that abortions kill.                                                                       
   • We ignore science and  wantonly legalize killing babies                                                                    
     in the womb.                                                                                                               
   • Alaska's supreme court has a  duty and the authority to                                                                    
     create new constitutional rights.                                                                                          
   • Our constitutions are designed  to recognize the rights                                                                    
     that are given to us from God.                                                                                             
   • The legislature  and the people  can change  the Alaska                                                                    
     constitution to recognize the rights of the unborn.                                                                        
   • Alaska's supreme court has  determined that abortion is                                                                    
      a fundamental right, but the court does not have the                                                                      
     authority to make that determination.                                                                                      
   • The  Alaska courts  have said  reproductive rights  are                                                                    
     unamenable, but they technically lack the authority to                                                                     
     make that determination.                                                                                                   
   • A  child's   health  is  not  a   concern  in  abortion                                                                    
     jurisprudence in the state of Alaska.                                                                                      
   • We deny the  health of the life of a  child when we say                                                                    
     a woman can kill him [sic].                                                                                                
   • A  brutal gruesome  brutal death  is not  good for  the                                                                    
     health of a child.                                                                                                         
   • Anyone advocating  for abortion in Alaska  does so with                                                                    
     total disregard for the health of the child as well as                                                                     
     disregard for the existence of the child.                                                                                  
   • The  statute that  governs abortion  in Alaska  doesn't                                                                    
          mention the child; it says the process is a                                                                           
     termination of pregnancy.                                                                                                  
   • One  of  the results  of  the  Dobbs decision  is  that                                                                    
     states can determine abortion policy.                                                                                      
                                                                                                                                
MR. MARTIN, as  part of his discourse, proffered as  proof that a                                                               
being   in  the   womb  is   alive  by   purporting  that   blood                                                               
transfusions,  open heart  surgery, and  spinal bifida  surgeries                                                               
have been  performed on children  in the  womb.  He  also alleged                                                               
that there were  active murder cases in Alaska in  which men were                                                               
being prosecuted  for killing babies  in the womb.   He described                                                               
several of these cases, explaining  that in one instance the baby                                                               
in the  womb was murdered  by another man  when it was  36 weeks.                                                               
He  added, "In  some  of these  cases, the  mothers  died in  the                                                               
process as well."  He also  drew the committee's attention to the                                                               
phrase  "reproductive  rights,"  characterizing  it  as  abortion                                                               
activism.    He  claimed  that in  1997  abortion  advocates  and                                                               
activists "created out  of whole cloth, out of thin  air, a right                                                               
for a woman to kill her  child in total violation of that child's                                                               
constitutional  rights to  life, to  equality among  persons, and                                                               
equal protections under the law."                                                                                               
                                                                                                                                
5:32:03 PM                                                                                                                    
                                                                                                                                
CHAIR PRAX  responded by commenting  on the  Roe v. Wade  and the                                                               
Dobbs decision and stated that these were huge matters.                                                                         
                                                                                                                                
MR. MARTIN asked Chair Prax to  enter a set of petitions into the                                                               
record, specifying that there were 4,822 signed petitions.                                                                      
                                                                                                                                
5:36:04 PM                                                                                                                    
                                                                                                                                
RICHARD  CLAYTON TROTTER,  General  Counsel, Justice  Foundation,                                                               
gave invited  testimony in support of  HB 205.  He  described his                                                               
background  and how  it relates  to HB  205, explaining  that the                                                               
Justice Foundation  filed four briefs  in the Dobbs  decision and                                                               
that the  foundation has approximately  5,000 related cases.   He                                                               
explained  that he  has  copies of  testimony  from Alaska  post-                                                               
aborted women and women from all  over the United States which he                                                               
would be happy  to provide to the committee.   He noted that some                                                               
of the stories would bring a  person to tears, relating one story                                                               
about  a woman  who  terminated  a pregnancy  and  has spent  the                                                               
subsequent  years "lamenting  and  grieving over"  the child  she                                                               
thought she murdered in her own womb.                                                                                           
                                                                                                                                
MR.  TROTTER continued  his testimony  by describing  one of  his                                                               
briefs which said  that a person is a person  no matter how small                                                               
and quoted Dr.  Suess.  He described the  continuum of conception                                                               
to birth,  explaining that barring unforeseen  circumstances such                                                               
as being  shot or killed, the  child will be born  into the world                                                               
and become  a human being.   He  went on to  tell the story  of a                                                               
person known  as Hannah S,  who never occupied her  mother's womb                                                               
as a  baby but instead  started life as an  egg that came  out of                                                               
her mother's womb  and was placed in a petri  dish and frozen for                                                               
2 1/2 years and then the  egg was fertilized.  The fertilized egg                                                               
was subsequently stored for 2 1/2  years; thawed out and put in a                                                               
woman's  womb; and  was born  "in  the regular  way" nine  months                                                               
later.   She  is  now  a graduate  of  Baylor  University in  the                                                               
graduate school  of Social Studies, and  her goal is to  stand up                                                               
for  in  vitro  babies.    He explained  that  during  the  Dobbs                                                               
deliberations, she was  waving her hands in  the air figuratively                                                               
saying,  "I'm alive!   I'm  alive!   I  was alive  for two  years                                                               
frozen."                                                                                                                        
                                                                                                                                
MR. TROTTER  opined that modern  technology is proving,  beyond a                                                               
reasonable doubt, that  life begins at conception  and that every                                                               
time an  embryo in a  petri dish is  destroyed, a human  being is                                                               
murdered or man slaughtered.   He touched upon the recent Alabama                                                               
statute  regarding in  vitro fertilization  and again  emphasized                                                               
that life begins at conception.   The Dobbs case said that Roe v.                                                             
Wade and the Casey decision  must be overturned and that abortion                                                             
is not  a constitutional  right.   He went on  to say  the people                                                               
elected  as representatives  of  each state  must  be allowed  to                                                               
determine  their  laws  on  the  issue.   He  emphasized  to  the                                                               
committee that it was up to  citizens to persuade one another and                                                               
then go vote.  It therefore  becomes the purview of the committee                                                               
and the legislature to make  decisions protecting the life of the                                                               
unborn.   He  then  reviewed findings  of the  Dobbs  case as  it                                                               
related to  the Alaska court  system and the  Alaska legislature,                                                               
discussing  who, in  his view,  had  the authority  to make  such                                                               
judgments.                                                                                                                      
                                                                                                                                
MR. TROTTER commented  that the state recently  voted down having                                                               
a constitutional convention saying he  understood there was a lot                                                               
of outside  money influencing  Alaska voters.   He  described the                                                               
Alaska Supreme Court and the  [1997] Valley Hospital case and how                                                               
rational basis review was not  the standard that should have been                                                               
applied.  He expressed appreciation  to the committee for hearing                                                               
his  testimony,  closing  with  a final  comment  about  how  the                                                               
aforementioned  Hannah   S  stands   as  proof  of   his  primary                                                               
hypothesis.                                                                                                                     
                                                                                                                                
5:51:13 PM                                                                                                                    
                                                                                                                                
ROBERT  M.  BIRD, Past  President,  Alaska  Right to  Life,  gave                                                               
invited  testimony  in support  of  HB  205.   He  described  his                                                               
background  as a  political candidate,  a retired  schoolteacher,                                                               
and  a  radio  talk  show  host.    He  began  his  testimony  by                                                               
describing the Alaska Constitution  and the Alaska Supreme Court.                                                               
He posited that the Supreme  Court could make decisions regarding                                                               
Alaska cases relevant  to the constitution.  The  courts can then                                                               
reverse those decisions regarding the  constitution in such a way                                                               
that they  can say whatever they  want about what it  means which                                                               
basically results in  there being no Alaska  Constitution at all.                                                               
He  pointed out  that people  say  the constitution  is a  living                                                               
document, but it is not alive.   It is dead.  He that the Supreme                                                               
Court can do unconstitutional things  and opined that the idea of                                                               
three co-equal branches  of government is nonsense.   He referred                                                               
to a  section of Federalist No.  45, [an essay in  the Federalist                                                           
Papers series  written by James  Madison and published  in 1788],                                                             
which  he  interpreted as  saying  the  US  Supreme Court  is  of                                                               
absolutely  no use  and  their decisions  depend  entirely on  an                                                               
executive enforcing its opinion.                                                                                                
                                                                                                                                
MR. BIRD continued by saying  that there was a "blatant, obvious,                                                               
impeachable offense"  that goes  way back  to Article  1, Section                                                               
22,  the  Right  to  Privacy,   which  was  added  to  the  state                                                               
constitution in 1972.  He pointed  out the language that gave the                                                               
legislature  the  right  to  implement or  define  the  right  to                                                               
privacy.   He  questioned the  limits  of the  right to  privacy,                                                               
purporting  that the  courts "absconded  their duty  to intercept                                                               
the definition of where the  right to privacy should be limited,"                                                               
and  so abortion  came to  be defined  as a  privacy right.   "As                                                               
such, any ability of the  legislature to restrict abortion has to                                                               
go according to the whims of the judiciary."                                                                                    
                                                                                                                                
5:55:33 PM                                                                                                                    
                                                                                                                                
CHAIR PRAX  reminded Mr.  Bird that the  House Health  and Social                                                               
Services Standing  Committee was  focusing on the  health aspects                                                               
of  the issue  and that  the House  Judiciary Standing  Committee                                                               
would consider the legal aspects.                                                                                               
                                                                                                                                
MR.  BIRD responded  that he  did not  think he  was going  to be                                                               
asked about the health aspects.  He  went on to point out that if                                                               
HB 205 did  not have some sort  of rider on it  saying that "this                                                               
statute  shall not  be  reviewable by  the  judiciary," then  the                                                               
judiciary  would simply  fall back  on its  own established  case                                                               
law.   He quoted  Article 4,  Section 1,  which states  that "the                                                               
jurisdiction of  the courts  shall be  proscribed by  law," which                                                               
means that the legislature does, in  fact, have the right and the                                                               
ability  to  keep  the judiciary's  hands  off  whatever  statute                                                               
emerges.                                                                                                                        
                                                                                                                                
5:57:07 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE SUMNER asked whether  it would prevent enforcement                                                               
of the law  by the courts if  a section was added  which said the                                                               
law should not be reviewed by the judiciary.                                                                                    
                                                                                                                                
MR.  BIRD  responded  that  courts   do  not  enforce  laws;  the                                                               
executives do.   He referred  again to the Valley  Hospital case,                                                               
using  that  to advance  his  theories  concerning the  right  to                                                               
enforce laws pertaining  to abortion and how that  is the purview                                                               
of the executive branch not the courts.                                                                                         
                                                                                                                                
REPRESENTATIVE SUMNER  asked for clarification  regarding whether                                                               
such a  section would prevent  courts from adjudicating  a murder                                                               
charge subsequent to the passage of HB 205.                                                                                     
                                                                                                                                
MR. BIRD responded  that the courts could adjudicate  and pass on                                                               
the  opinions, but  enforcement  is  up to  the  executives.   He                                                               
referred  to Abe  Lincoln's  inaugural address  of  1861 when  he                                                               
spoke  out against  the Dredd  Scott decision  having the  courts                                                               
strike down laws  as being unconstitutional.  He  posited that it                                                               
is a false tradition that all court decisions have to be obeyed.                                                                
                                                                                                                                
5:59:23 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE RUFFRIDGE asked whether  Mr. Bird had read through                                                               
HB  205, particularly  the language  in Sections  5 and  6, which                                                               
states that "this chapter is not subject to judicial review".                                                                   
                                                                                                                                
MR. BIRD said he supports that part  of the bill.  He then stated                                                               
that the  Alaska Pipeline would  never have been built  unless in                                                               
1972, Congress had placed the  construction of the pipeline under                                                               
such an override.                                                                                                               
                                                                                                                                
6:00:39 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE SUMNER  asked for further  clarification regarding                                                               
whether such  a section  would prevent the  court from  taking up                                                               
the previously mentioned murder prosecutions.                                                                                   
                                                                                                                                
MR. BIRD suggested  that such a section in statute  would make it                                                               
non-reviewable.  He cautioned that  an executive could choose not                                                               
to  enforce  certain  elements  of   any  law  he  doesn't  like;                                                               
therefore, it is an imperfect section.                                                                                          
                                                                                                                                
6:02:20 PM                                                                                                                    
                                                                                                                                
MR. MARTIN  brought up Representative Sumner's  previous question                                                               
and  explained that  the section  in  HB 205  on judicial  review                                                               
would not hinder  criminal prosecution.  Rather,  the language is                                                               
to protect against judicial activism,  but in the case of someone                                                               
who performs an illegal abortion,  the prosecution of that person                                                               
would be protected.                                                                                                             
                                                                                                                                
REPRESENTATIVE SUMNER said that answered his question.                                                                          
                                                                                                                                
6:03:43 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE  EASTMAN   summarized  the  points  made   by  the                                                               
witnesses  and   commented  that  "we  have   the  science,  it's                                                               
established, and there  is very little question about  that."  He                                                               
concluded that the  questions from decades ago  are now resolved,                                                               
thus, he opined,  it is time for "our statutes"  to catch up with                                                               
"our science."                                                                                                                  
                                                                                                                                
6:04:50 PM                                                                                                                    
                                                                                                                                
CHAIR PRAX announced that HB 205 was held over.                                                                                 
                                                                                                                                
6:05:03 PM                                                                                                                    
                                                                                                                                
ADJOURNMENT                                                                                                                   
                                                                                                                                
There being no  further business before the  committee, the House                                                               
Health  and  Social  Services   Standing  Committee  meeting  was                                                               
adjourned at 6:05 p.m.                                                                                                          

Document Name Date/Time Subjects
Bethel Belisle Midwives Resume_Redacted.pdf HHSS 3/14/2024 3:00:00 PM
Governor's Appointee
HB 363 Sectional Analysis.pdf HHSS 3/14/2024 3:00:00 PM
HB 363
HB 363 Sponsor Statement.pdf HHSS 3/14/2024 3:00:00 PM
HB 363
HB 363 Version A.pdf HHSS 3/14/2024 3:00:00 PM
HB 363
HB 205 Version A.pdf HHSS 3/14/2024 3:00:00 PM
HB 205
HB 187 Providence Supports.pdf HHSS 3/14/2024 3:00:00 PM
HB 187
HB 363 Fiscal Note FCS-CSM.pdf HHSS 3/14/2024 3:00:00 PM
HB 363
Fiscal Note LAW-CS.pdf HHSS 3/14/2024 3:00:00 PM
HB 205
Fiscal Note DOH-HFLC.pdf HHSS 3/14/2024 3:00:00 PM
HB 205
Fiscal Note DOH-MAA.pdf HHSS 3/14/2024 3:00:00 PM
HB 205
Fiscal Note LAW-CJL.pdf HHSS 3/14/2024 3:00:00 PM
HB 205
Fiscal Note DOH-MS.pdf HHSS 3/14/2024 3:00:00 PM
HB 205
HB 363 CS Version S.pdf HHSS 3/14/2024 3:00:00 PM
HB 363
HB 363 Sponsor Statement Ver. S.pdf HHSS 3/14/2024 3:00:00 PM
HB 363
HB 363 Sectional Analysis Verion S.pdf HHSS 3/14/2024 3:00:00 PM
HB 363
HB 363 Summary of Changes Ver A to S.pdf HHSS 3/14/2024 3:00:00 PM
HB 363
HB 205 Article-Alabama Supreme Court Decision Protecting Embryonic Children-3.13.24.pdf HHSS 3/14/2024 3:00:00 PM
HB 205
HB 205 Article-Personhood and After-Birth Abortion-3.13.24.pdf HHSS 3/14/2024 3:00:00 PM
HB 205
HB 205 Article-Does the Fourteenth Amendment Prohibit Abortion-3.13.24.pdf HHSS 3/14/2024 3:00:00 PM
HB 205
HB 205 Article-Science is Clear-Each new human life begins at Fertilization-3.13.24.pdf HHSS 3/14/2024 3:00:00 PM
HB 205
HB 205 Leg Legal Memo.pdf HHSS 3/14/2024 3:00:00 PM
HB 205
HB 205 Legal Brief -Amicus Brief AHA and AKRTL- Dobbs v Jackson.pdf HHSS 3/14/2024 3:00:00 PM
HB 205
HB 205 Legal Brief-Amicus Brief for Texas and Alaska - Dobbs v Jackson.pdf HHSS 3/14/2024 3:00:00 PM
HB 205
HB 205 Legal Opinion-Dobbs_v_Jackson_Opinion-3.13.24.pdf HHSS 3/14/2024 3:00:00 PM
HB 205
HB 205 Sectional Analysis version A.pdf HHSS 3/14/2024 3:00:00 PM
HB 205
HB 363 Fiscal Note JUD-ACS.pdf HHSS 3/14/2024 3:00:00 PM
HB 363
HB 187 Links to Resources.pdf HHSS 3/14/2024 3:00:00 PM
HB 187
HB 187 AMA Prior Authorization Reform.pdf HHSS 3/14/2024 3:00:00 PM
HB 187
HB 187 Delayed Care article.pdf HHSS 3/14/2024 3:00:00 PM
HB 187
HB 187 Oncology Alliance Supports.pdf HHSS 3/14/2024 3:00:00 PM
HB 187
HB 363 Presentation.pdf HHSS 3/14/2024 3:00:00 PM
HB 363
HB 205 Testimony Gualberto Jones Esq..pdf HHSS 3/14/2024 3:00:00 PM
HB 205
HB 205 Support Letters.pdf HHSS 3/14/2024 3:00:00 PM
HB 205
HB 187 CPH Letter of Support -.pdf HHSS 3/14/2024 3:00:00 PM
HB 187
HB 205 Sponsor Statement version A v.2.pdf HHSS 3/14/2024 3:00:00 PM
HB 205
Bethel Belisle Opposition Testimony.pdf HHSS 3/14/2024 3:00:00 PM
Governor's Appointee
HB 363 Germain Support.pdf HHSS 3/14/2024 3:00:00 PM
HB 363
HB 205 LCA Petition 2023_Redacted #9-compressed.pdf HHSS 3/14/2024 3:00:00 PM
HB 205
HB 205 LCA Petition 2023_Redacted #10-compressed.pdf HHSS 3/14/2024 3:00:00 PM
HB 205
HB 205 LCA Petition 2023_Redacted #11-compressed.pdf HHSS 3/14/2024 3:00:00 PM
HB 205
HB 205 LCA Petition 2023_Redacted #12-compressed.pdf HHSS 3/14/2024 3:00:00 PM
HB 205
HB 205 LCA Petition 2023_Redacted #13-compressed.pdf HHSS 3/14/2024 3:00:00 PM
HB 205
HB 205 LCA Petition 2023_Redacted #14-compressed.pdf HHSS 3/14/2024 3:00:00 PM
HB 205
HB 205 LCA Petition 2023_Redacted #15-compressed.pdf HHSS 3/14/2024 3:00:00 PM
HB 205
HB 205 LCA Petition 2023_Redacted #16-compressed.pdf HHSS 3/14/2024 3:00:00 PM
HB 205
HB 205 LCA Petition 2023_Redacted #18-compressed.pdf HHSS 3/14/2024 3:00:00 PM
HB 205
HB 205 LCA Petition 2023_Redacted #19-compressed.pdf HHSS 3/14/2024 3:00:00 PM
HB 205
HB 205 LCA Petition 2023_Redacted #20-compressed.pdf HHSS 3/14/2024 3:00:00 PM
HB 205
HB 205 LCA Petition 2023_Redacted #21-compressed.pdf HHSS 3/14/2024 3:00:00 PM
HB 205
HB 205 LCA Petition 2023_Redacted #22-compressed.pdf HHSS 3/14/2024 3:00:00 PM
HB 205
HB 205 LCA Petition 2023_Redacted #23-compressed.pdf HHSS 3/14/2024 3:00:00 PM
HB 205
HB 205 LCA Petition 2023_Redacted #24-compressed.pdf HHSS 3/14/2024 3:00:00 PM
HB 205
HB 205 LCA Petition 2023_Redacted #25-compressed.pdf HHSS 3/14/2024 3:00:00 PM
HB 205
HB 205 LCA Petition 2023_Redacted #26-compressed.pdf HHSS 3/14/2024 3:00:00 PM
HB 205
HB 205 LCA Petition 2023_Redacted #17-compressed.pdf HHSS 3/14/2024 3:00:00 PM
HB 205
HHSS Committee HB 363 DFCS Follow Up.pdf HHSS 3/14/2024 3:00:00 PM
HB 363