Legislature(2023 - 2024)DAVIS 106

04/04/2024 03:00 PM House HEALTH & SOCIAL SERVICES

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Audio Topic
03:11:42 PM Start
03:12:25 PM Confirmation Hearing(s)|| State Medical Board|| Board of Veterinary Examiners|| State Physical Therapy & Occupational Therapy Board|| Board of Marital & Family Therapy
03:20:17 PM HB187
03:26:53 PM Confirmation Hearing(s)|| State Medical Board|| Board of Veterinary Examiners|| State Physical Therapy & Occupational Therapy Board|| Board of Marital & Family Therapy
03:27:57 PM HB366
03:30:33 PM Confirmation Hearing(s)|| State Medical Board|| Board of Veterinary Examiners|| State Physical Therapy & Occupational Therapy Board|| Board of Marital & Family Therapy
03:56:54 PM SB91
04:20:13 PM Adjourn
* first hearing in first committee of referral
+ teleconferenced
= bill was previously heard/scheduled
+ Consideration of Governor’s Appointees: State TELECONFERENCED
Medical Board - David Barnes; Board of Veterinary
Examiners - Denise Albert; State Physical Therapy
and Occupational Therapy Board - Rebecca Dean;
Board of Marital and Family Therapy - Kayla Green
-- Public Testimony --
+ SB 91 TELEHEALTH: MULTIDISCIPLINARY CARE TEAM TELECONFERENCED
Moved CSSB 91(FIN) Out of Committee
-- Invited & Public Testimony --
+ Bills Previously Heard/Scheduled TELECONFERENCED
+= HB 187 PRIOR AUTH EXEMPT FOR HEALTH PROVIDERS TELECONFERENCED
Moved HB 187 Out of Committee
+ HB 366 MINORS & RESIDENT PSYCH TREATMENT CENTERS TELECONFERENCED
Moved HB 366 Out of Committee
**Streamed live on AKL.tv**
                    ALASKA STATE LEGISLATURE                                                                                  
      HOUSE HEALTH AND SOCIAL SERVICES STANDING COMMITTEE                                                                     
                         April 4, 2024                                                                                          
                           3:11 p.m.                                                                                            
                                                                                                                                
                             DRAFT                                                                                            
                                                                                                                                
MEMBERS PRESENT                                                                                                               
                                                                                                                                
Representative Mike Prax, Chair                                                                                                 
Representative Justin Ruffridge, Vice Chair                                                                                     
Representative CJ McCormick                                                                                                     
Representative Jesse Sumner                                                                                                     
Representative Zack Fields                                                                                                      
Representative Genevieve Mina                                                                                                   
                                                                                                                                
MEMBERS ABSENT                                                                                                                
                                                                                                                                
Representative Dan Saddler                                                                                                      
                                                                                                                                
COMMITTEE CALENDAR                                                                                                            
                                                                                                                                
CONFIRMATION HEARING(S)                                                                                                         
                                                                                                                                
State Medical Board                                                                                                           
                                                                                                                                
     David Barnes - Wasilla                                                                                                     
                                                                                                                                
     - CONFIRMATION(S) ADVANCED                                                                                                 
                                                                                                                                
Board of Veterinary Examiners                                                                                                 
                                                                                                                                
     Denise Albert - Denali National Park                                                                                       
                                                                                                                                
     - CONFIRMATION(S) ADVANCED                                                                                                 
                                                                                                                                
State Physical Therapy & Occupational Therapy Board                                                                           
                                                                                                                                
     Rebecca Dean - Fairbanks                                                                                                   
                                                                                                                                
     - CONFIRMATION(S) ADVANCED                                                                                                 
                                                                                                                                
Board of Marital & Family Therapy                                                                                             
                                                                                                                                
     Kayla Green - Eagle River                                                                                                  
                                                                                                                                
     - CONFIRMATION(S) ADVANCED                                                                                                 
                                                                                                                                
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."                                                                                                                          
                                                                                                                                
     - MOVED HB 187 OUT OF COMMITTEE                                                                                            
                                                                                                                                
HOUSE BILL NO. 366                                                                                                              
"An Act relating to residential psychiatric treatment centers;                                                                  
and providing for an effective date."                                                                                           
                                                                                                                                
     - MOVED HB 366 OUT OF COMMITTEE                                                                                            
                                                                                                                                
CS FOR SENATE BILL NO. 91(FIN)                                                                                                  
"An Act relating to telehealth; relating to multidisciplinary                                                                   
care teams; and relating to the practice of medicine."                                                                          
                                                                                                                                
     - MOVED CSSB 91(FIN) OUT OF COMMITTEE                                                                                      
                                                                                                                                
PREVIOUS COMMITTEE ACTION                                                                                                     
                                                                                                                                
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                                                                               
03/14/24       (H)       Heard & Held                                                                                           
03/14/24       (H)       MINUTE(HSS)                                                                                            
03/21/24       (H)       HSS AT 3:00 PM DAVIS 106                                                                               
03/21/24       (H)       <Bill Hearing Canceled>                                                                                
03/26/24       (H)       HSS AT 3:00 PM DAVIS 106                                                                               
03/26/24       (H)       Heard & Held                                                                                           
03/26/24       (H)       MINUTE(HSS)                                                                                            
04/04/24       (H)       HSS AT 3:00 PM DAVIS 106                                                                               
                                                                                                                                
BILL: HB 366                                                                                                                  
SHORT TITLE: MINORS & RESIDENT PSYCH TREATMENT CENTERS                                                                          
SPONSOR(s): REPRESENTATIVE(s) DIBERT                                                                                            
                                                                                                                                
02/20/24       (H)       READ THE FIRST TIME - REFERRALS                                                                        
02/20/24       (H)       HSS, L&C                                                                                               
04/04/24       (H)       HSS AT 3:00 PM DAVIS 106                                                                               
                                                                                                                                
BILL: SB 91                                                                                                                   
SHORT TITLE: TELEHEALTH: MULTIDISCIPLINARY CARE TEAM                                                                            
SPONSOR(s): SENATOR(s) CLAMAN                                                                                                   
                                                                                                                                
03/06/23       (S)       READ THE FIRST TIME - REFERRALS                                                                        
03/06/23       (S)       HSS, FIN                                                                                               
03/21/23       (S)       HSS AT 3:30 PM BUTROVICH 205                                                                           
03/21/23       (S)       Heard & Held                                                                                           
03/21/23       (S)       MINUTE(HSS)                                                                                            
04/11/23       (S)       HSS AT 3:30 PM BUTROVICH 205                                                                           
04/11/23       (S)       Heard & Held                                                                                           
04/11/23       (S)       MINUTE(HSS)                                                                                            
04/13/23       (S)       HSS AT 3:30 PM BUTROVICH 205                                                                           
04/13/23       (S)       Moved CSSB 91(HSS) Out of Committee                                                                    
04/13/23       (S)       MINUTE(HSS)                                                                                            
04/14/23       (S)       HSS RPT CS 1DNP 4NR   SAME TITLE                                                                       
04/14/23       (S)       NR: WILSON, TOBIN, KAUFMAN, DUNBAR                                                                     
04/14/23       (S)       DNP: GIESSEL                                                                                           
02/14/24       (S)       FIN AT 9:30 AM SENATE FINANCE 532                                                                      
02/14/24       (S)       Heard & Held                                                                                           
02/14/24       (S)       MINUTE(FIN)                                                                                            
02/29/24       (S)       FIN AT 1:30 PM SENATE FINANCE 532                                                                      
02/29/24       (S)       Moved CSSB 91(FIN) Out of Committee                                                                    
02/29/24       (S)       MINUTE(FIN)                                                                                            
03/01/24       (S)       FIN RPT CS 2DP 2NR   SAME TITLE                                                                        
03/01/24       (S)       DP: OLSON, BISHOP                                                                                      
03/01/24       (S)       NR: WILSON, MERRICK                                                                                    
03/22/24       (S)       TRANSMITTED TO (H)                                                                                     
03/22/24       (S)       VERSION: CSSB 91(FIN)                                                                                  
03/25/24       (H)       READ THE FIRST TIME - REFERRALS                                                                        
03/25/24       (H)       HSS, FIN                                                                                               
04/04/24       (H)       HSS AT 3:00 PM DAVIS 106                                                                               
                                                                                                                                
WITNESS REGISTER                                                                                                              
                                                                                                                                
DAVID BARNES, DO, Appointee                                                                                                     
State Medical Board                                                                                                             
Wasilla, Alaska                                                                                                                 
POSITION STATEMENT:  Testified as appointee to the State Medical                                                              
Board.                                                                                                                          
                                                                                                                                
DENISE ALBERT, DVM, Appointee                                                                                                   
Board of Veterinary Examiners                                                                                                   
Denali National Park, Alaska                                                                                                    
POSITION STATEMENT:  Testified as appointee to the Board of                                                                   
Veterinary Examiners.                                                                                                           
                                                                                                                                
REBECCA DEAN, Appointee                                                                                                         
State Physical Therapy & Occupational Therapy Board                                                                             
Fairbanks, Alaska                                                                                                               
POSITION STATEMENT:  Testified as appointee to the State                                                                      
Physical Therapy & Occupational Therapy Board.                                                                                  
                                                                                                                                
KAYLA GREEN, Appointee                                                                                                          
Board of Marital & Family Therapy                                                                                               
Eagle River, Alaska                                                                                                             
POSITION STATEMENT:  Testified as appointee to the Board of                                                                   
Marital & Family Therapy.                                                                                                       
                                                                                                                                
SENATOR MATT CLAMAN                                                                                                             
Alaska State Legislature                                                                                                        
Juneau, Alaska                                                                                                                  
POSITION STATEMENT:  As prime sponsor, presented SB 91.                                                                       
                                                                                                                                
CLAIRE LUBKE, Staff                                                                                                             
Senator Matt Claman                                                                                                             
Alaska State Legislature                                                                                                        
Juneau, Alaska                                                                                                                  
POSITION STATEMENT:  Presented the sectional analysis for SB 91                                                               
on behalf of Senator Claman, prime sponsor.                                                                                     
                                                                                                                                
GAIL BRATEN, representing self                                                                                                  
Anchorage, Alaska                                                                                                               
POSITION STATEMENT:  Gave invited testimony in support of SB 91.                                                              
                                                                                                                                
TIM JENNINGS, representing self                                                                                                 
Anchorage, Alaska                                                                                                               
POSITION STATEMENT:  Gave invited testimony in support of SB 91.                                                              
                                                                                                                                
BROOKE LAVENDER, ALS Care Services Manager                                                                                      
Anchorage, Alaska                                                                                                               
POSITION STATEMENT:  Gave invited testimony in support of SB 91.                                                              
                                                                                                                                
HOSANNA HEARTSONG, representing self                                                                                            
Soldotna, Alaska                                                                                                                
POSITION STATEMENT:  Testified in support of SB 91.                                                                           
                                                                                                                                
EMILY NENON, Director                                                                                                           
Alaska Government Relations                                                                                                     
American Cancer Society Cancer Action Network                                                                                   
Anchorage, Alaska                                                                                                               
POSITION STATEMENT:  Testified in support of SB 91.                                                                           
                                                                                                                                
ACTION NARRATIVE                                                                                                              
                                                                                                                                
3:11:42 PM                                                                                                                    
                                                                                                                                
VICE CHAIR RUFFRIDGE called the  House Health and Social Services                                                               
Standing   Committee    meeting   to    order   at    3:11   p.m.                                                               
Representatives  McCormick,  Fields,  Mina,  and  Ruffridge  were                                                               
present at  the call to  order.  Representatives Sumner  and Prax                                                               
arrived as the meeting was in progress.                                                                                         
                                                                                                                                
^CONFIRMATION HEARING(S)                                                                                                        
^State Medical Board                                                                                                            
^Board of Veterinary Examiners                                                                                                  
^State Physical Therapy & Occupational Therapy Board                                                                            
^Board of Marital & Family Therapy                                                                                              
                    CONFIRMATION HEARING(S)                                                                                 
                      State Medical Board                                                                                   
                 Board of Veterinary Examiners                                                                              
      State Physical Therapy & Occupational Therapy Board                                                                   
               Board of Marital & Family Therapy                                                                            
                                                                                                                                
3:12:25 PM                                                                                                                    
                                                                                                                                
VICE CHAIR RUFFRIDGE  announced that the first  order of business                                                               
would be  confirmation hearings on  the governor's  appointees to                                                               
various boards and commissions.                                                                                                 
                                                                                                                                
3:13:14 PM                                                                                                                    
                                                                                                                                
DAVID  BARNES,  DO,  Appointee, State  Medical  Board,  gave  his                                                               
personal,   educational,   and  employment   background   [resume                                                               
included  in  committee packet],  and  he  expressed interest  in                                                               
participating  in  the  regulation  of the  medical  practice  in                                                               
Alaska, focusing  on protection of both  healthcare providers and                                                               
the public.   He talked  about the  unique nature of  Alaska with                                                               
its rural areas.                                                                                                                
                                                                                                                                
3:15:52 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE  MINA asked  Dr.  Barnes to  describe the  biggest                                                               
issues facing physicians.                                                                                                       
                                                                                                                                
DR. BARNES highlighted the issue  of insurance being a barrier to                                                               
care,    listing   difficulties    such   as    obtaining   prior                                                               
authorizations,  previously  accepted procedures  being  refused,                                                               
and  the insurance  industry regulating  what physicians  can do.                                                               
In  response  to a  follow-up  question,  he indicated  that  the                                                               
biggest  issue  addressed  by  the board  is  the  regulation  of                                                               
physicians, with multiple cases per week.                                                                                       
                                                                                                                                
         HB 187-PRIOR AUTH EXEMPT FOR HEALTH PROVIDERS                                                                      
                                                                                                                                
[Although not  announced, the next  order of  business, initiated                                                               
by a  motion by  Representative Sumner, was  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."]                                                                                                                         
                                                                                                                                
3:20:17 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE SUMNER  moved to  report HB  187 out  of committee                                                               
with  individual  recommendations  and  the  accompanying  fiscal                                                               
notes,  and  to  authorize  Legislative Legal  Services  to  make                                                               
technical and conforming  changes.  There being  no objection, HB
187  was reported  out of  the House  Health and  Social Services                                                               
Standing Committee.                                                                                                             
                                                                                                                                
3:21:25 PM                                                                                                                    
                                                                                                                                
The committee took an at-ease from 3:21 p.m. to 3:26 p.m.                                                                       
                                                                                                                                
^CONFIRMATION HEARING(S)                                                                                                        
^State Medical Board                                                                                                            
^Board of Veterinary Examiners                                                                                                  
^State Physical Therapy & Occupational Therapy Board                                                                            
^Board of Marital & Family Therapy                                                                                              
                    CONFIRMATION HEARING(S)                                                                                 
                      State Medical Board                                                                                   
                 Board of Veterinary Examiners                                                                              
      State Physical Therapy & Occupational Therapy Board                                                                   
               Board of Marital & Family Therapy                                                                            
                                                                                                                                
3:26:53 PM                                                                                                                    
                                                                                                                                
VICE CHAIR  RUFFRIDGE announced that  the next order  of business                                                               
would be a return to  the confirmation hearings on the governor's                                                               
appointees to various boards and commissions.                                                                                   
                                                                                                                                
VICE CHAIR RUFFRIDGE opened public  testimony on the confirmation                                                               
hearing for Dr. Barnes.  After  ascertaining there was on one who                                                               
wished to testify, he closed public testimony.                                                                                  
                                                                                                                                
        HB 366-MINORS & RESIDENT PSYCH TREATMENT CENTERS                                                                    
                                                                                                                                
3:27:57 PM                                                                                                                    
                                                                                                                                
VICE CHAIR RUFFRIDGE  announced the next order  of business would                                                               
be  HOUSE  BILL   NO.  366,  "An  Act   relating  to  residential                                                               
psychiatric  treatment centers;  and providing  for an  effective                                                               
date."                                                                                                                          
                                                                                                                                
3:28:08 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE SUMNER  moved to  report HB  366 out  of committee                                                               
with  individual  recommendations  and  the  accompanying  fiscal                                                               
notes.  There being no objection,  HB 366 was reported out of the                                                               
House Health and Social Services Standing Committee.                                                                            
                                                                                                                                
3:28:44 PM                                                                                                                    
                                                                                                                                
The committee took an at-ease from 3:28 p.m. to 3:30 p.m.                                                                       
                                                                                                                                
^CONFIRMATION HEARING(S)                                                                                                        
^State Medical Board                                                                                                            
^Board of Veterinary Examiners                                                                                                  
^State Physical Therapy & Occupational Therapy Board                                                                            
^Board of Marital & Family Therapy                                                                                              
                    CONFIRMATION HEARING(S)                                                                                 
                      State Medical Board                                                                                   
                 Board of Veterinary Examiners                                                                              
      State Physical Therapy & Occupational Therapy Board                                                                   
               Board of Marital & Family Therapy                                                                            
                                                                                                                                
3:30:33 PM                                                                                                                    
                                                                                                                                
VICE CHAIR  RUFFRIDGE announced that  the next order  of business                                                               
would  be the  completion  of the  confirmation  hearings on  the                                                               
governor's appointees to various boards and commissions.                                                                        
                                                                                                                                
3:30:48 PM                                                                                                                    
                                                                                                                                
DENISE  ALBERT, DVM,  Appointee, Board  of Veterinary  Examiners,                                                               
gave  her   personal,  educational,  and   employment  background                                                               
[resume  included  in  committee   packet],  including  her  vast                                                               
experience  working with  sled dogs.   She  said she  has learned                                                               
about regulatory medicine as an active member of the board.                                                                     
                                                                                                                                
3:33:39 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE MINA asked  Dr. Albert to describe  the big issues                                                               
that the board has been addressing.                                                                                             
                                                                                                                                
DR. ALBERT  mentioned eight  years of board  work to  correct the                                                               
prescription  drug  monitoring  program   laws,  which  had  been                                                               
created without input from the  veterinary medical profession and                                                               
had  been problematic.   She  also  talked about  the arrival  of                                                               
telehealth since 2020 and ensuring  a standard quality of care by                                                               
addressing antiquated  regulations on  the books.   She discussed                                                               
the makeup  of the board and  its work to ensure  the eligibility                                                               
of applicants for licensure.                                                                                                    
                                                                                                                                
3:37:36 PM                                                                                                                    
                                                                                                                                
VICE CHAIR  RUFFRIDGE opened public testimony  on the appointment                                                               
of Dr.  Albert.  After ascertaining  there was no one  who wished                                                               
to testify, he closed public testimony.                                                                                         
                                                                                                                                
3:38:22 PM                                                                                                                    
                                                                                                                                
REBECCA DEAN,  Appointee, State  Physical Therapy  & Occupational                                                               
Therapy  Board, gave  her personal,  educational, and  employment                                                               
background, including  her work  in the area  of licensing.   She                                                               
said  she  brings regulatory  board  competency  and health  care                                                               
delivery expertise  to the board.   She talked about  the balance                                                               
between  board  and  consumer  and   having  a  strong  sense  of                                                               
professionalism and ability to collaborate.                                                                                     
                                                                                                                                
3:43:50 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE MINA  asked Ms. Dean  to discuss the  major issues                                                               
the board faces.                                                                                                                
                                                                                                                                
MS.   DEAN,  in   response,   outlined   the  board's   strategic                                                               
initiatives,  including  the  support  of  the  physical  therapy                                                               
compact  and  related  bills.     She  talked  about  safety  and                                                               
protection  of patients,  as well  as flexibility  for interstate                                                               
licensing.  She  said clinicians need to  understand business and                                                               
leadership in  clinical roles in  order to expand access  to care                                                               
in Alaska.   She said the board is  revising continuing education                                                               
requirements and is  committed to continue its  focus on national                                                               
best  practice  systems  to  bring  to  Alaska.    She  mentioned                                                               
recruitment and  retention; a fair and  standardized disciplinary                                                               
metric; requirements  for licensing that streamline  the process;                                                               
and  the clarification  of  statutory  and regulatory  guidelines                                                               
aimed  at improving  communication  pathways and  access to  full                                                               
information for licensees.                                                                                                      
                                                                                                                                
3:48:36 PM                                                                                                                    
                                                                                                                                
VICE CHAIR RUFFRIDGE opened public  testimony on the confirmation                                                               
for Ms. Dean.  After ascertaining  there was no one who wished to                                                               
testify, he closed public testimony.                                                                                            
                                                                                                                                
3:49:15 PM                                                                                                                    
                                                                                                                                
KAYLA  GREEN,  Appointee,  Board  of Marital  &  Family  Therapy,                                                               
shared  her   personal  background,  education,   and  employment                                                               
history  [resume included  in committee  packet]  and pointed  to                                                               
goals of the  board in helping people get licensed  and take part                                                               
in  continued education.   She  mentioned telehealth  efforts and                                                               
legislation.  She said her  education and understanding of health                                                               
care is an asset on the board.                                                                                                  
                                                                                                                                
REPRESENTATIVE  MINA asked  Ms. Green  to talk  about key  issues                                                               
related to the board and therapists.                                                                                            
                                                                                                                                
MS. GREEN replied that the board  is looking at ways to lower its                                                               
high   fees,  make   continued  education   accessible,  maintain                                                               
telehealth, and support license transferability.                                                                                
                                                                                                                                
3:54:18 PM                                                                                                                    
                                                                                                                                
VICE CHAIR RUFFRIDGE opened public  testimony on the confirmation                                                               
for Ms.  Green.  After ascertaining  there was no one  who wished                                                               
to testify, he close public testimony.                                                                                          
                                                                                                                                
3:54:53 PM                                                                                                                    
                                                                                                                                
VICE  CHAIR RUFFRIDGE  stated that  the House  Health and  Social                                                               
Services Standing  Committee has  reviewed the  qualifications of                                                               
the  governor's  appointees  and recommends  that  the  following                                                               
names be forwarded  to a joint session for  consideration:  David                                                               
Barnes, State  Medical Board; Denise Albert,  Board of Veterinary                                                               
Examiners; Rebecca  Dean, State  Physical Therapy  & Occupational                                                               
Therapy  Board;  and  Kayla  Green, Board  of  Marital  &  Family                                                               
Therapy.  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.                                                                                                      
                                                                                                                                
3:55:26 PM                                                                                                                    
                                                                                                                                
The committee took an at-ease from 3:55 p.m. to 3:56 p.m.                                                                       
                                                                                                                                
         SB 91-TELEHEALTH: MULTIDISCIPLINARY CARE TEAM                                                                      
                                                                                                                                
3:56:54 PM                                                                                                                    
                                                                                                                                
VICE CHAIR RUFFRIDGE  announced that the final  order of business                                                               
would be  CS FOR  SENATE BILL  NO. 91(FIN),  "An Act  relating to                                                               
telehealth;  relating   to  multidisciplinary  care   teams;  and                                                               
relating to the practice of medicine."                                                                                          
                                                                                                                                
3:57:24 PM                                                                                                                    
                                                                                                                                
The committee took an at-ease from 3:57 p.m. to 3:58 p.m.                                                                       
                                                                                                                                
3:58:23 PM                                                                                                                    
                                                                                                                                
SENATOR MATT CLAMAN, Alaska State  Legislature, as prime sponsor,                                                               
presented  CSSB 91(FIN).    He informed  the  committee that  the                                                               
incentive  for  the  proposed  legislation was  a  visit  from  a                                                               
constituent   with  amyotrophic   lateral   sclerosis  (ALS),   a                                                               
degenerative  disease that  leads to  paralysis and  death within                                                               
two  to  five years,  but  for  which  medical care  can  improve                                                               
quality of life.   This constituent flew to Seattle  and was told                                                               
she  could   continue  her  treatment  with   her  physician  via                                                               
telehealth but  would have to  fly to  Seattle to meet  in person                                                               
with the other seven members  of her multidisciplinary team.  She                                                               
travels four times  a year to visit these caregivers,  but in the                                                               
future, she will  be unable to do so.   Senator Claman encouraged                                                               
committee members to  read the letter from  Ms. Swanson [included                                                               
in the committee packet].   He explained there are 30 individuals                                                               
with ALS  in Alaska and  treatment for  them is not  available in                                                               
the state.  As a practical  matter, this type of specialized care                                                               
is available  in large  cities with major  medical centers  and a                                                               
higher volume of patients.                                                                                                      
                                                                                                                                
SENATOR CLAMAN noted  that in 2022, the  legislature passed House                                                               
Bill  265,  which  created  a   framework  for  telehealth.    He                                                               
explained that  CSSB 91(FIN)  would amend  the language  of House                                                               
Bill 265 by adding members  of out-of-state and multidisciplinary                                                               
care  teams  as  an  option  of telehealth  when  an  Alaskan  is                                                               
suffering   with    a   life-threatening   condition    and   the                                                               
multidisciplinary care is  not readily available in  Alaska.  The                                                               
proposed  legislation  would  ensure  that "all  members  of  the                                                               
multidisciplinary care  team are  subject to  Alaska's regulatory                                                               
authority"  and would  "align multidisciplinary  care teams  with                                                               
the  current   registration  process  of   Alaska's  telemedicine                                                               
business  registry."   The bill  would expand  telehealth options                                                               
"so that  Alaskans with  life-threatening conditions  can receive                                                               
the specialized  care they  need while  remaining in  their local                                                               
support network whenever possible."                                                                                             
                                                                                                                                
4:01:36 PM                                                                                                                    
                                                                                                                                
CLAIRE   LUBKE,  Staff,   Senator  Matt   Claman,  Alaska   State                                                               
Legislature,  on   behalf  of  Senator  Claman,   prime  sponsor,                                                               
presented  the  sectional  analysis  for SB  91,  which  read  as                                                               
follows [original punctuation provided]:                                                                                        
                                                                                                                                
     Senate Bill 91 Sectional Analysis  Version S                                                                               
                                                                                                                                
     Section 1                                                                                                                  
     AS 08.02.130. Telehealth                                                                                                   
     Amends subsection (b) to expand  who may provide health care                                                               
     services through telehealth to  include out of state members                                                               
     of  the physician's  multidisciplinary  care  team when  the                                                               
     health care  service provided by the  multidisciplinary care                                                               
     team is not  reasonably available in Alaska and  is "for on-                                                               
     going treatment  or follow-up care regarding  a suspected or                                                               
     diagnosed life-threatening condition," as  stated in the new                                                               
     subsection (C).                                                                                                            
                                                                                                                                
     Section 2                                                                                                                  
     AS 08.02.130. Telehealth                                                                                                   
     Amends the  definition of "health  care provider"  in (j)(1)                                                               
     by   adding  section   (C)  to   include  a   member  of   a                                                               
     multidisciplinary  care  team  who is  licensed  in  another                                                               
     state.                                                                                                                     
                                                                                                                                
     Section 3                                                                                                                  
     AS 08.02.130. Telehealth                                                                                                   
     Creates  a definition  for  "member  of a  multidisciplinary                                                               
     care team" in  (5) of this section to  mean "an audiologist,                                                               
     speech-language pathologist,  behavior analyst, professional                                                               
     counselor, dietitian, nutritionist,  naturopath, marital and                                                               
     family    therapist,   podiatrist,    osteopath,   physician                                                               
     assistant,    nurse,    pharmacist,   physical    therapist,                                                               
     occupational   therapist,   psychologist  or   psychological                                                               
     associate, advanced  nurse practitioner, or a  social worker                                                               
     who  is  a  member  of  a team  that  includes  a  physician                                                               
     licensed  in another  state who  meets  the requirements  of                                                               
     (b)(1) of this section."                                                                                                   
                                                                                                                                
     Section 4                                                                                                                  
     AS 08.02. Miscellaneous Provisions                                                                                         
     Adds new  sections AS 08.02.135:  Grounds for  imposition of                                                               
     disciplinary  sanctions of  out  of state  multidisciplinary                                                               
     care team  members and AS 08.02.140:  Disciplinary sanctions                                                               
     for out of state multidisciplinary care team member.                                                                       
                                                                                                                                
     Section 5                                                                                                                  
     AS 44.33.381. Telemedicine business registry                                                                               
     Amends subsection  (b) of  this section  by adding  that the                                                               
     department may "renew every two  years the registration of a                                                               
     business that meets all  renewal requirements established by                                                               
     regulation and pays a renewal fee every two years."                                                                        
                                                                                                                                
     Section 6                                                                                                                  
     AS 44.33.381. Telemedicine business registry                                                                               
     Adds new  subsection (d) which  includes the  following fees                                                               
     that  the  department  shall  charge  businesses  performing                                                               
     telemedicine   services   in    the   state:   (1)   initial                                                               
     registration fee,  $100, adjusted for inflation  in a manner                                                               
     determined  by   the  department;  (2)  renewal   fee  $100,                                                               
     adjusted  for  inflation  in  a  manner  determined  by  the                                                               
     department; and (3) fee to  report changes in the business's                                                               
     registration information, $50.                                                                                             
                                                                                                                                
4:04:51 PM                                                                                                                    
                                                                                                                                
VICE CHAIR RUFFRIDGE opened invited testimony on CSSB 91(FIN).                                                                  
                                                                                                                                
4:05:05 PM                                                                                                                    
                                                                                                                                
GAIL  BRATEN,  representing  self,   gave  invited  testimony  in                                                               
support of  CSSB 91(FIN).   She briefly described  her background                                                               
and explained that  health care for ALS  patients is challenging.                                                               
In order for her and her husband  to stay in Alaska at least part                                                               
of the time, they must be  able to use telehealth.  She described                                                               
the progress  of the science  for ALS.   For her husband  to have                                                               
the best  outcomes, he  needed to  meet with  a multidisciplinary                                                               
team of experts.  With telehealth,  he can meet with team members                                                               
who are specialized  and bring the latest research in  ALS to the                                                               
team.   Through telehealth care  team collaboration,  her husband                                                               
can  receive the  best care.   Alaska  does not  have specialized                                                               
multidisciplinary healthcare  teams for ALS.   She  described the                                                               
Mayo Clinic team her husband met  with in Minnesota who asked him                                                               
to return  every 3  months.  With  telehealth, her  husband could                                                               
meet with the Mayo multidisciplinary  team without the stress and                                                               
expense  of  travel.    She  urged the  committee  to  pass  CSSB
91(FIN).                                                                                                                        
                                                                                                                                
4:08:15 PM                                                                                                                    
                                                                                                                                
TIM  JENNINGS,  representing  self,  gave  invited  testimony  in                                                               
support of  SB 91.   He told  the committee that  he has  ALS and                                                               
briefly explained  the importance of  being able to meet  with an                                                               
interdisciplinary  care  team  via  telehealth.    He  urged  the                                                               
committee to pass CSSB 91(FIN).                                                                                                 
                                                                                                                                
4:09:15 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE FIELDS  discussed one of his  constituents who has                                                               
cancer  and would  benefit from  telehealth medicine.   He  asked                                                               
whether the bill could be moved at that time.                                                                                   
                                                                                                                                
4:09:50 PM                                                                                                                    
                                                                                                                                
VICE  CHAIR  RUFFRIDGE  pointed out  that  there  was  additional                                                               
testimony.                                                                                                                      
                                                                                                                                
4:10:02 PM                                                                                                                    
                                                                                                                                
BROOKE  LAVENDER,   ALS  Care  Services  Manager,   gave  invited                                                               
testimony  in  support  of  CSSB  91(FIN).    She  described  the                                                               
proposed legislation as a crucial  element of care across Alaska.                                                               
Telehealth would  particularly benefit  those with  ALS, multiple                                                               
sclerosis (MS),  and cancer.   She provided examples  of patients                                                               
in Alaska who have great difficulty  traveling to the Lower 48 to                                                               
receive appropriate  care.   Individuals with  challenging health                                                               
conditions  would  greatly  benefit from  the  multi-disciplinary                                                               
approach telehealth  could provide.   She urged the  committee to                                                               
pass CSSB 91(FIN).                                                                                                              
                                                                                                                                
4:13:28 PM                                                                                                                    
                                                                                                                                
VICE CHAIR RUFFRIDGE opened public testimony on SB 91.                                                                          
                                                                                                                                
4:13:45 PM                                                                                                                    
                                                                                                                                
HOSANNA HEARTSONG, representing self,  testified in support of SB
91.   She has MS  and shared her personal  story.  She  urged the                                                               
committee to pass SB 91.                                                                                                        
                                                                                                                                
4:15:09 PM                                                                                                                    
                                                                                                                                
EMILY  NENON,  Director,  Alaska Government  Relations,  American                                                               
Cancer Society Cancer Action Network,  testified in support of SB
91.   She  referred  to the  network she  worked  with who  would                                                               
become part  of a  multidisciplinary approach  to cancer  care in                                                               
Alaska.   She  explained that  most cancer  patients can  receive                                                               
appropriate care in Alaska.   However, with complex cases, people                                                               
often go out of town to  receive care.  Multidisciplinary care is                                                               
the  leading model  for  complex cancer  cases,  but without  the                                                               
ability to  travel or participate in  telehealth, Alaska patients                                                               
lack access  to this  type of  care.   In addition,  patients who                                                               
have to move or travel out of  state to receive the level of care                                                               
they  need are  cut  off  from their  support  networks and  home                                                               
health care teams.  She urged the committee to pass SB 91.                                                                      
                                                                                                                                
4:18:31 PM                                                                                                                    
                                                                                                                                
VICE CHAIR  RUFFRIDGE, after ascertaining  there was no  one else                                                               
who wished to testify, closed public testimony on SB 91.                                                                        
                                                                                                                                
4:18:50 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE MINA expressed her support for CSSB 91(FIN).                                                                     
                                                                                                                                
4:19:12 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE  SUMNER  moved  to  report  CSSB  91(FIN)  out  of                                                               
committee  with individual  recommendations and  the accompanying                                                               
fiscal  notes.    There  being no  objection,  CSSB  91(FIN)  was                                                               
reported out  of the  House Health  and Social  Services Standing                                                               
Committee.                                                                                                                      
                                                                                                                                
VICE  CHAIR RUFFRIDGE  noted that  Chair Prax  had returned  just                                                               
prior to adjournment.                                                                                                           
                                                                                                                                
4:20:13 PM                                                                                                                    
                                                                                                                                
ADJOURNMENT                                                                                                                   
                                                                                                                                
There being no further business before the committee, the House                                                                 
Health and Social Services Standing Committee meeting was                                                                       
adjourned at 4:20 p.m.                                                                                                          

Document Name Date/Time Subjects
SB 91 FN DCCED-CPBL 3.1.2024.pdf HHSS 4/4/2024 3:00:00 PM
SB 91
SB 91 Research ALS Association Multidisciplinary Care Team.pdf HHSS 4/4/2024 3:00:00 PM
SB 91
SB 91 Research Murkowski multidisciplinary care PR 11.02.2023.pdf HHSS 4/4/2024 3:00:00 PM
SB 91
SB 91 Research Murkowski sponsor ALS multidisciplinary care.pdf HHSS 4/4/2024 3:00:00 PM
SB 91
SB 91 Sectional Analysis Version S.pdf HHSS 4/4/2024 3:00:00 PM
SB 91
SB 91 Sponsor Statement Version S.pdf HHSS 4/4/2024 3:00:00 PM
SB 91
SB 91 Summary of Changes Version B to Version S.pdf HHSS 4/4/2024 3:00:00 PM
SB 91
SB 91 Testimony- Received as of 2.27.2024.pdf HHSS 4/4/2024 3:00:00 PM
SB 91
SB 91 Version S- CS SFIN.pdf HHSS 4/4/2024 3:00:00 PM
SB 91
Rebecca Dean PTOT Resume_Redacted.pdf HHSS 4/4/2024 3:00:00 PM
Governor's Appointee
David Barnes Medical Board App_Redacted.pdf HHSS 4/4/2024 3:00:00 PM
Governor's Appointee
David Barnes Medical Board Resume_Redacted.pdf HHSS 4/4/2024 3:00:00 PM
Governor's Appointee
Denise Albert Veterinarian Examiners CV_Redacted.pdf HHSS 4/4/2024 3:00:00 PM
Governor's Appointee
Kayla Green Marital & Family Therapy Resume_Redacted.pdf HHSS 4/4/2024 3:00:00 PM
Governor's Appointee
Rebecca Dean Physical Therapy Occupational Therapy App_Redacted.pdf HHSS 4/4/2024 3:00:00 PM
Governor's Appointee
SB 91 Fiscal Note DCCED-CBPL 3.29.24.pdf HHSS 4/4/2024 3:00:00 PM
SB 91
SB 91 Amendment S.1 #1.pdf HHSS 4/4/2024 3:00:00 PM
SB 91
SB 91 Legal Memo on Amendment #1.pdf HHSS 4/4/2024 3:00:00 PM
SB 91
SB 91 American Cancer Society Support.pdf HHSS 4/4/2024 3:00:00 PM
SB 91
SB 91 Wooley Support.pdf HHSS 4/4/2024 3:00:00 PM
SB 91