Legislature(2023 - 2024)DAVIS 106
04/04/2024 03:00 PM House HEALTH & SOCIAL SERVICES
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Confirmation Hearing(s)|| State Medical Board|| Board of Veterinary Examiners|| State Physical Therapy & Occupational Therapy Board|| Board of Marital & Family Therapy | |
HB187 | |
Confirmation Hearing(s)|| State Medical Board|| Board of Veterinary Examiners|| State Physical Therapy & Occupational Therapy Board|| Board of Marital & Family Therapy | |
HB366 | |
Confirmation Hearing(s)|| State Medical Board|| Board of Veterinary Examiners|| State Physical Therapy & Occupational Therapy Board|| Board of Marital & Family Therapy | |
SB91 | |
Adjourn |
* first hearing in first committee of referral
+ teleconferenced
= bill was previously heard/scheduled
+ teleconferenced
= bill was previously heard/scheduled
+ | TELECONFERENCED | ||
+ | SB 91 | TELECONFERENCED | |
+ | TELECONFERENCED | ||
+= | HB 187 | TELECONFERENCED | |
+ | HB 366 | TELECONFERENCED | |
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.