Legislature(2011 - 2012)CAPITOL 106
02/08/2011 03:00 PM House HEALTH & SOCIAL SERVICES
| Audio | Topic |
|---|---|
| Start | |
| Presentation(s): Children's Justice Act Task Force | |
| Alaska Health Care Commission | |
| Adjourn |
* first hearing in first committee of referral
+ teleconferenced
= bill was previously heard/scheduled
+ teleconferenced
= bill was previously heard/scheduled
| + | TELECONFERENCED | ||
ALASKA STATE LEGISLATURE
HOUSE HEALTH AND SOCIAL SERVICES STANDING COMMITTEE
February 8, 2011
3:04 p.m.
MEMBERS PRESENT
Representative Wes Keller, Chair
Representative Alan Dick, Vice Chair
Representative Bob Herron
Representative Paul Seaton
Representative Sharon Cissna
Representative Bob Miller
Representative Charisse Millett
MEMBERS ABSENT
All members present
COMMITTEE CALENDAR
PRESENTATION(S): CHILDREN'S JUSTICE ACT TASK FORCE
- HEARD
ALASKA HEALTH CARE COMMISSION
- HEARD
PREVIOUS COMMITTEE ACTION
No previous action to record
WITNESS REGISTER
DR. CATHY BALDWIN-JOHNSON, Chair
Alaska Children's Justice Act Task Force
Anchorage, Alaska
POSITION STATEMENT: Presented a PowerPoint, "Alaska Children's
Justice Act Task Force."
JARED PARRISH, Director
Alaska Surveillance of Child Abuse & Neglect (SCAN)
Division of Public Health
Department of Health and Social Services
Juneau, Alaska
POSITION STATEMENT: Testified and answered questions during the
PowerPoint, "Alaska Children's Justice Act Task Force."
DEBORAH ERICKSON, Executive Director
Alaska Health Care Commission
Office of the Commissioner
Department of Health and Social Services
Anchorage, Alaska
POSITION STATEMENT: Presented a PowerPoint, "Alaska Health Care
Commission's 2010 Report."
DR. WARD HURLBURT, Chief Medical Officer/Director
Division of Public Health
Central Office
Department of Health and Social Services
Anchorage, Alaska
POSITION STATEMENT: Testified and answered questions during the
overview of the Alaska Health Care Commission's 2010 Report.
ACTION NARRATIVE
3:04:40 PM
CHAIR WES KELLER called the House Health and Social Services
Standing Committee meeting to order at 3:04 p.m.
Representatives Keller, Millett, Miller, Cissna, and Dick were
present at the call to order. Representatives Seaton and Herron
arrived as the meeting was in progress.
^PRESENTATION(S): Children's Justice Act Task Force
PRESENTATION(S): Children's Justice Act Task Force
3:05:19 PM
CHAIR KELLER announced that the first order of business would be
a presentation by the Children's Justice Act Task Force.
3:05:48 PM
DR. CATHY BALDWIN-JOHNSON, Chair, Alaska Children's Justice Act
Task Force, presented a PowerPoint, "Alaska Children's Justice
Act Task Force." [Included in members' packets.] Pointing to
slide 1, "Introduction," she reported that the Task Force had
been founded in 1999 to "evaluate how our system responds when
there are concerns for child abuse and neglect." She stated
that the Task Force mandate was to make recommendations for
improvements to the system, and to provide an annual update to
the legislature. She declared that the Commission received
population based federal funding.
DR. BALDWIN-JOHNSON moved on to slide 2, "Update," and indicated
that the update included: child maltreatment data in Alaska,
gaps in our laws, costs to our state, and the 2010 Task Force
projects.
3:07:55 PM
DR. BALDWIN-JOHNSON explained slide 3, "Some Issues Identified."
She emphasized the rising concerns: an ongoing need for
education, the wide variation to interpretation of laws and
policies across Alaska, the gaps in our laws, sexual
exploitation of children via the Internet, and child sex
trafficking in Alaska.
3:08:23 PM
REPRESENTATIVE DICK asked her to elaborate on child sex
trafficking in Alaska.
DR. BALDWIN-JOHNSON replied that minors were being lured into
prostitution and sexual activity.
REPRESENTATIVE MILLETT asked if there were any statistics.
DR. BALDWIN-JOHNSON replied that this was being studied to
better understand how large a problem it had become.
REPRESENTATIVE MILLETT asked to clarify if these children were
runaways, or had a lack of supervision, and how did this happen
without parental knowledge.
DR. BALDWIN-JOHNSON, in response, indicated there were a number
of factors, which included runaways, difficult family
situations, and not enough adult supervision. She acknowledged
that there was a need to gather much more information.
REPRESENTATIVE MILLETT asked if the task force was working in
concert with the Office of Children's Services (OCS).
3:10:57 PM
DR. BALDWIN-JOHNSON confirmed that a small task force had been
established to address the issue, and would be invited to
address the legislature.
REPRESENTATIVE CISSNA pointed to the growing problems of
homeless youth and outmigration from rural Alaska.
CHAIR KELLER asked who had identified child trafficking as an
issue.
DR. BALDWIN-JOHNSON stated that it was identified by people
working with Anchorage Police Department and the FBI.
3:13:56 PM
REPRESENTATIVE CISSNA opined that the problem was with "not
looking after our kids" and she suggested that this be addressed
in the "big picture."
DR. BALDWIN-JOHNSON, furnishing slide 4, "2010 Projects," listed
ongoing distribution of the mandated reporter CD, sponsorship in
collaboration with the Alaska Children's Alliance to the 2010
Alaska Child Maltreatment Conference, and scholarships for
Alaskans working in the field as ways to address the need for
further education. She referenced the link to NETSMARTZ on the
task force website, which was an educational site about
preventing child sexual exploitation via the internet. She
affirmed that the Multidisciplinary Team Guidelines, on the task
force website, addressed the wide variation for interpretation
on laws and policies.
3:16:37 PM
JARED PARRISH, Director, Alaska Surveillance of Child Abuse &
Neglect (SCAN), Division of Public Health, Department of Health
and Social Services, established that the data was collected by
the SCAN program. He directed attention to slide 6, "Public
Health Surveillance," and said that this was an important issue
for Centers for Disease Control and Prevention (CDC). He noted
that, as no single agency had jurisdictional responsibility for
all child maltreatment, the public health surveillance was an
ongoing collection and unification of the existing data sources.
This more comprehensive picture of child maltreatment in Alaska
would lead to a standardized public health definition,
accounting for areas not covered by jurisdictional regulations,
and allowing for measurement of the true magnitude and impact.
It would also identify risk and protective factors, and offer
recommendations based on the comprehensive data. He shared
slide 7, "Case Designation," which defined the tiers of abuse:
confirmed, suspected, or potential and the definition for each.
3:19:29 PM
MR. PARRISH moved on to slide 9, "Maltreatment-related child
deaths," and stated that, from 2000 - 2008, approximately 20
percent of child deaths, 0-9 years of age, were maltreatment
related; among Alaska Native children, this increased to 25
percent. He declared that the rates for maltreatment related
child deaths were almost 4 times higher for Alaska Native than
for non-native.
MR. PARRISH supplied slide 11, "Research in Alaska Indicates:"
He identified the seven factors statistically related to
maltreatment, and noted that 80 percent of maltreated children
had two or more of the risk factors. He reported that these
risk factors provided targets for prevention funding.
3:21:13 PM
MR. PARRISH indicated slide 12, "Maltreatment-Any Type," and
clarified that this was sexual abuse, physical abuse, and
neglect. He reported:
In 2008, approximately 12,400 children were the
potential victims of at least one incident of
maltreatment. Among the children experiencing
maltreatment, 24 percent had at least one incident
confirmed.
3:21:47 PM
REPRESENTATIVE SEATON requested to return attention to slide 11,
and asked for clarification that a family receiving public aid
was a greater risk factor than maternal domestic violence or
sexual assault.
MR. PARRISH replied that these were associative, not causal,
indicators.
REPRESENTATIVE MILLER asked for an explanation to the headings
"aOR" and "95%CI."
MR. PARRISH explained that "aOR" was the "adjusted odds ratio"
and that "CI" was confidence interval, which reflected the
percentage range of confidence for the adjusted odds ratio.
3:23:16 PM
MR. PARRISH returned to slide 12, stating that as many as 34
children a day were maltreated in Alaska.
MR. PARRISH continued with slide 13, "Maltreatment-Neglect," and
stated that, in 2008, "almost 9000 children were the potential
victims of at least one incident of neglect. Among the children
experiencing neglect, 25 percent had at least one incident
confirmed." He emphasized that 25 percent was the "tip of the
iceberg." He pointed out that this was as many as 25 children
each day.
3:24:55 PM
MR. PARRISH provided slide 14, "Maltreatment-Physical Abuse,"
and stated that "2700 children were the potential victims of at
least one incident of physical abuse in 2008. Among the
children experiencing physical abuse, 22 percent had at least
one incident confirmed."
3:25:17 PM
MR. PARRISH, in response to Representative Cissna, said that he
would supply a matrix defining maltreatment and neglect. He
replied that each agency had a separate definition for neglect.
DR. BALDWIN-JOHNSON added that neglect meant a failure to meet a
child's basic needs, such as nutritional, medical, emotional,
and educational neglect. She noted that neglect did not include
abuse, but that maltreatment included both abuse and neglect.
3:27:14 PM
MR. PARRISH, returning attention to slide 14, stated that
physical abuse could affect as many as seven children each day.
MR. PARRISH concluded with slide 15, "Maltreatment-Sexual
Abuse," stating:
In 2008, almost 2000 children were the potential
victims of at least one incident of sexual abuse.
Among the children experiencing sexual abuse, 16
percent had at least one incident confirmed.
REPRESENTATIVE DICK asked how to define a potential victim.
MR. PARRISH defined a potential victim as having at least one
incident of sexual abuse. He pointed out that a child could
have multiple incidences of sexual abuse each year.
3:28:40 PM
DR. BALDWIN-JOHNSON said that confirmed instances were much
lower as many times there was not the corroborating evidence to
prosecute.
3:29:17 PM
REPRESENTATIVE DICK asked for further clarification.
DR. BALDWIN-JOHNSON explained that a valid OCS report, or a
medical code that identified sexual abuse, defined a potential
victim. She shared that a confirmed incident had to go to
court.
3:29:52 PM
MR. PARRISH stated that potentially five children a day were
sexually abused in Alaska.
3:30:21 PM
DR. BALDWIN-JOHNSON, indicating slide 16, "Gaps in our laws
Abusive Head Trauma," spoke about abusive head trauma and stated
that if the child did not die, the highest criminal charge was
Assault 1, which had limited penalties. She said that children
were included with adults under the physical assault laws.
DR. BALDWIN-JOHNSON offered slide 17, "Gaps in our laws
Torture," pointing out the difficulty to find charges for the
torture of children.
DR. BALDWIN-JOHNSON referred to slide 18, "Gaps in our laws,"
and pointed out that multiple forms of physical abuse to
children only result in a charge of Assault 1.
DR. BALDWIN-JOHNSON directed attention to slide 19 and slide 20,
"Gaps in our laws: sexual abuse," and reported that sexual abuse
of a five year old carried the same charge as a 19 year old
having consensual sex with a 14 year old. She announced that
foster siblings could not be charged with incest or sexual abuse
of a minor if there was less than a four year age difference.
3:33:46 PM
CHAIR KELLER confirmed that the committee members would
deliberate the legislation proposals.
3:34:29 PM
DR. BALDWIN-JOHNSON brought attention to slide 21, "What does
this cost?" and observed that there were both short and long
term costs for medical and mental health care, as well as for
the child protection and criminal justice systems.
3:35:05 PM
DR. BALDWIN-JOHNSON explained that the Adverse Childhood
Experiences Studies, slide 22, "Turning Gold Into Lead,"
recognized the link between "bad things happening to children
and the adults that they become..." She directed attention to
the chart on slide 23 which graphed the rising costs in health
care.
3:36:04 PM
DR. BALDWIN-JOHNSON stated that slide 24, "Direct Annual Costs
of Child Abuse & Neglect in the US," revealed costs totaled more
than $33 billion. Slide 25, "Indirect Annual Costs," showed
that costs for juvenile delinquency and adult criminality
exceeded $70 billion.
3:37:01 PM
DR. BALDWIN-JOHNSON emphasized this total cost of more than $103
billion, as shown on slide 26, "Total Annual Cost of Child Abuse
and Neglect in the US," and shared that the annual cost in
Alaska was more than $500 million, as shown on slide 27.
DR. BALDWIN-JOHNSON turned to slide 28, "What are we willing to
pay to keep kids safe?" She reported on a child maltreatment
survey in the state of Georgia which had shown a willingness by
each citizen to pay $150 to help reduce the number of deaths
from child maltreatment. She asked what Alaskans were willing
to pay to keep kids safe.
DR. BALDWIN-JOHNSON summarized slide 30, "In Juneau:" and asked
for ongoing support for the governor's initiative, "Choose
Respect," and to ensure that the related data and program
development include children. She summarized slide 31, "In your
community," and asked for support to the local Child Advocacy
Centers and for support to any child maltreatment prevention
programs.
3:38:47 PM
DR. BALDWIN-JOHNSON asked the committee for assistance, slide
32, "2011 Alaska CJATF Projects," with legislative support to
the Task Force, and with passing laws which hold offenders
accountable and prevent future victimization. She endorsed the
search for more information on child trafficking and child on-
line sexual exploitation.
DR. BALDWIN-JOHNSON shared slide 33, "Remember:" and asked that
legislators remember:
During this legislative session, here in Alaska, about
3000 children are likely going to be maltreated, 450
sexually abused, 630 physically abused, 2200
neglected, and the price tag to our state during this
90 days exceeds $123 million.
3:39:54 PM
REPRESENTATIVE DICK asked where to look for a definition of
neglect. He asked if this definition could become intrusive
into people's private lives, with respect to government imposed
immunizations.
DR. BALDWIN-JOHNSON replied that refusing immunizations was not
a form of neglect in Alaska. She emphasized that the conditions
under which some children live in Alaska were appalling.
3:41:07 PM
DR. BALDWIN-JOHNSON, in response to Chair Keller, explained that
the mandated reporter training CD was developed for statewide
distribution, and was also available on the website.
REPRESENTATIVE SEATON clarified that the neglect statute was a
statewide standard and was not the community standard for a
village.
3:43:01 PM
REPRESENTATIVE CISSNA reflected that this was now a generational
problem, and that kids were not being taken care of. She opined
that foster care could not replace the family.
3:45:38 PM
DR. BALDWIN-JOHNSON replied that this had been a topic of
discussion. She offered her belief that the Office of
Children's Services (OCS) was making efforts to keep children
safer in their own homes. She agreed that foster care was not
usually the first choice, but there may be no other alternative.
She opined that the solutions were complicated, as they involved
a cultural shift for the value of children, which would be
multi-tiered. She confirmed that as more data was uncovered,
the risk factors could be better identified, and prevention
solutions could be developed. She advocated for better laws to
hold people accountable, and to prevent further victimization.
3:48:13 PM
REPRESENTATIVE HERRON asked if the Task Force had contacted the
administration about proposed legislation.
DR. BALDWIN-JOHNSON replied that they had not yet spoken with
the administration.
3:48:46 PM
CHAIR KELLER declared that the role of government was to take
care of the most vulnerable. He challenged the task force to
contact HHSS and ask for children's advocates. He requested
more information and updates about the child advocacy centers.
3:50:15 PM
The committee took a brief at-ease.
^Alaska Health Care Commission
Alaska Health Care Commission
3:52:54 PM
CHAIR KELLER announced that the final order of business would be
a presentation by the Alaska Health Care Commission.
DEBORAH ERICKSON, Executive Director, Alaska Health Care
Commission, Office of the Commissioner, Department of Health and
Social Services, presented a PowerPoint, "Alaska Health Care
Commission's 2010 Report." [Included in members' packets] She
directed attention to slide 2, "A Brief History of Health Reform
Attempts in Alaska," and listed the groups and organizations
which addressed these issues. She stated that each had provided
findings and recommendations.
MS. ERICKSON offered slide 3, a graph of the 1993 legislative
task force projections of health care expenditures. She opined
that these cost concerns had lead to the establishment of the
current Alaska Health Care Commission. She said that 2005
health care expenditures were more than $5.5 billion, and that
Institute of Social and Economic Research (ISER) consultants had
projected 2010 expenditures to be more than $7 billion.
MS. ERICKSON referring to slide 4, "Significance of Health Care
to SOA," listed Medicaid expenses to be about $1.4 billion of
the $7.3 billion in the state operating budget. The Medicaid
expenses were comparable to the entire operating budget of the
Department of Education and Early Development, and twice that of
the Department of Transportation & Public Facilities. She
pointed out that these Medicaid operating expenses did not
include other health care expenses incurred by state government.
3:59:19 PM
CHAIR KELLER asked about the level of detail in the ISER study.
MS. ERICKSON replied that it would show spending for health care
by major payers in 2010, and the factors driving the increases
in costs.
3:59:47 PM
REPRESENTATIVE CISSNA asked if social disparity had been
considered.
4:01:01 PM
MS. ERICKSON replied that social factors to health care costs
would be discussed later.
4:01:35 PM
MS. ERICKSON provided slide 5, "Alaska Health Care Commission."
She said that the Alaska Health Care Commission was convened
under a 2009 administrative order by Governor Palin, and was
established in statute in 2010. The bill added four additional
voting members to the Commission, and included a transition
clause to provide for continuity by retaining the former
members.
4:03:42 PM
MS. ERICKSON stated, as shown on slide 6, "Alaska Health Care
Commission," that the purpose of the Commission was: "to foster
the development of a statewide plan to address quality,
accessibility and availability of health care for all citizens
of the state." The main duties listed in the statute were "for
the commission to serve as the state's health planning
coordinating body and to foster the development of both the
comprehensive state wide health care policy and also a strategy
for improving the health of all Alaskans."
MS. ERICKSON discussed slide 7, "Membership," and stated that
there were 11 voting members designated from the health care
industry, the Division of Veterans' Affairs (VA), and consumers.
She pointed out that the Chair was the Chief Medical Officer of
Department of Health and Social Services.
4:05:11 PM
MS. ERICKSON moved on to slide 8, "5-Year Strategic Planning
Process," and listed the five parts of the process: develop
vision, describe current state, build foundation, design
transformation policies, and measure progress. Once the vision
was developed, each of the other four parts had an annual goal.
4:06:14 PM
MS. ERICKSON, summarizing slide 9, "Develop Vision," stated the
vision:
Alaska's health care system produces improved health
status, provides value for Alaskans health care
dollar, delivers consumer and provider satisfaction,
and is sustainable.
She listed the goals: increase access, control costs, improve
quality, and make the system more prevention-based.
MS. ERICKSON provided slide 10, "Describe Current State," and
explained that the 2009 report had an appendix with a
description of the current system, an explanation of service
finance, and an overview of the impact on Alaska from the
Patient Protection Affordable Care Act (PPACA). She added that,
in 2011, the Commission was planning an analysis of the current
conditions.
4:10:22 PM
DR. WARD HURLBURT, Chief Medical Officer/Director, Division of
Public Health, Central Office, Division of Public Health,
Department of Health and Social Services, offered three reasons
for a Health Care Commission, cost, cost, and cost. He said
that the costs of health care now exceeded 18 percent of gross
domestic product. He compared this cost in the United States to
the other 37 industrialized countries in the world, which each
spent between 8 - 12 percent of its gross domestic product for
health care. He reported that, from 1991 - 2005, the cost of
living in Alaska increased 38 percent, while health care costs
increased 100 percent. He stated that health care expenditure
was $7.1 billion in Alaska, about 23 percent of the state gross
domestic product.
DR. HURLBURT directed attention to slide 12, "Describe Current
State" and discussed that Medicaid would cost Alaska about $1.5
billion in the upcoming fiscal year, an average of $13,000 for
each of the 110,000 enrollees. He pointed out that, although
the majority of enrollees were young women and children, the
high costs were for those individuals with "life issues, like
drug use."
4:15:50 PM
DR. HURLBURT pointed to slide 13, "Differences in Medicaid Fees,
2009," and explained that the comparative costs of Alaska
Medicaid fee schedules were more than 2.5 to 3 times those of
Washington and Oregon. He referenced the comparative workers'
comp fee schedules for Alaska, Washington, and Hawaii, which
also reflected the much higher costs in Alaska. He reported
that an actuarial firm and the VA were both reviewing the
reasons for the high medical costs in Alaska.
4:18:18 PM
DR. HURLBURT referred to slide 14, "Determinants of Health" and
slide 15, "Chronic Disease accounts for," and said that the
leading cause of death for ages 1 - 44 years was unintentional
injuries. He noted that infectious disease had been a high
cause of death, but that "diseases of choice" were now higher.
He shared that although Alaska ranked first in education against
smoking, a much bigger problem was now obesity. CDC had
estimated the direct medical cost related to the complications
of obesity to be $300 billion each year, which he extrapolated
to a cost for Alaska of $800 million each year. He pointed to
diabetes as the most notable complication of obesity, and that,
in 2003, CDC estimated that children born in this decade had a
33 percent risk of developing diabetes, while almost 8 percent
of the population had diabetes. He reported that 33 percent of
Americans were overweight, which lead to a 13 percent increase
for expectation of premature mortality; another 33 percent were
obese, which lead to an increase of 40 - 80 percent. He listed
the complications of diabetes to include blindness, loss of
kidney function, dialysis, loss of limbs, and heart attack, and
he stressed the huge economic. He opined that the challenge to
overcome obesity would be greater than that of smoking. He
applauded the efforts of the Anchorage schools to combat obesity
rates. He summarized that chronic diseases accounted for the
majority of health care costs and that the economic impact could
be devastating.
4:24:48 PM
DR. HURLBURT, in response to Chair Keller, said that Milliman, a
large national actuarial firm, would be a good choice for
studying the reasons for the increased health rates.
4:25:58 PM
CHAIR KELLER asked when this would be available.
MS. ERICKSON replied that the VA would release the report later
in the year.
CHAIR KELLER asked if the report would specify the fee
differences between workers' comp and Medicaid.
MS. ERICKSON replied that the request was for an analysis and
comparison of the methodologies of the health care payers in
Alaska, which she assumed would include Medicaid, Workers' Comp,
private insurance, and TRICARE fee schedules.
REPRESENTATIVE HERRON asked about the three contracts to be
proposed: actuarial, Medicare, and health status.
MS. ERICKSON agreed that the three contracts would be in place,
although ISER was just finishing up a study on the economic
impact of the PPACA on Alaska. She reported that there was a
contract with ISER for an analysis on health care spending in
Alaska, and a contract with a health care actuarial firm for a
comparison of pricing, the cost of providing Medicare in Alaska,
and any inequities with reimbursement for Medicare versus
primary care.
4:28:52 PM
REPRESENTATIVE CISSNA reiterated her earlier question about
social disparities.
DR. HURLBURT replied that social disparities had not been a
major focus of the Health Care Commission, though it was a focus
of the federal government. He noted that Alaska Natives were
the largest non-white population and he confirmed that standards
for Alaska Natives were not yet to the US all races standards.
He noted that the Alaska Tribal Health System was doing a better
job on child immunizations than the rest of state. He stated
his aspiration to be in the top 90 percentile for child health
care. He referenced studies which indicated that the Alaska
Tribal Health System was about 33 percent underfunded. He
pointed out the collaboration between the health care systems in
Alaska.
4:34:07 PM
REPRESENTATIVE CISSNA stated that her visitations around Alaska
had revealed an out migration from its rural areas. She
expressed that it's the "whole well-being picture that's got to
be looked at." She stressed the need for immediate work on
this.
4:36:38 PM
MS. ERICKSON, indicating slide 16, "Analysis of Current
Conditions (planned for 2011)," pointed to the formula for costs
to health care, and explained that the cost for total
expenditures was equal to the price for the process multiplied
by the utilization. She confirmed that the analysis would
include a cost analysis, a price comparison study, and a health
status assessment. In response to Representative Cissna, she
noted that underlying health status and utilization would be
reviewed in accord with social determinants.
4:38:00 PM
MS. ERICKSON presented slide 17, "Health Care Transformation
Strategy," and explained the strategies for transforming Alaska
health care. She explained the need to build the foundation by
ensuring a strong health care workforce, deploying health
information technology, and maintaining strong statewide
leadership. The health care strategies were built around this
foundation. Referring to slide 18, she relayed that in 2009,
the focus was on primary care intervention and patient centered
medical home models; in 2010, the focus was on evidence based
medicine; and for 2011, the strategic study would be for price
and quality transparency, and value driven purchasing.
REPRESENTATIVE DICK asked about the relative cost of malpractice
insurance to the cost of health care.
MS. ERICKSON replied that malpractice reform was one of the
strategies for increasing value, which the commission was going
to study in the future. She pointed to the Alaska Health Care
Commission's 2009 report, which included a national estimate for
the effect of malpractice on health care costs and an
explanation of Alaska laws regarding malpractice. She confirmed
that there had been a malpractice reform effort in 2005.
4:42:58 PM
CHAIR KELLER opined that Alaska liability laws were in good
shape.
REPRESENTATIVE SEATON remarked that even with malpractice
reform, there had not been any lowering of Alaska insurance
rates. He pointed out that the malpractice premium which
doctors paid had remained the same, but that they received a
rebate at the end of the year, the value of which was not passed
on to the consumer. He asked for a further review. He referred
to slide 20, "Potential System Design Policies for Enhanced
Prevention," asked if any of the policies had been implemented,
and questioned why prevention was not more of a focus.
4:45:38 PM
MS. ERICKSON, in response to Representative Seaton, said that a
duty of the Alaska Health Care Commission was to develop a
strategy for improving the health of Alaskans. She shared that
a 2009 recommendation from the Commission was to explore
opportunities for support of healthy lifestyles. She directed
attention to slide 27, "Status of 2009 Recommendations." She
clarified that the recommendations from the Commission were
standing recommendations for the future, and that it would
report each year on the full body of recommendations relative to
what had happened in the state. Returning attention to slide
27, she indicated that the governor's "Choose Respect"
initiative, the Childhood Obesity Collaborative, and the Alaska
Food Policy Council were 2010 activities which supported healthy
lifestyles. She stated that the report included major policies
and organizational activities undertaken in the health care
industry during the year.
4:50:21 PM
REPRESENTATIVE MILLETT asked why substance and alcohol abuse was
not addressed by either the 2009 recommendations or the
governor's initiative.
4:51:19 PM
MS. ERICKSON, in response to Representative Millett, said that
the 2009 prevention recommendation was a very generic policy
suggestion. She said there were no new initiatives, but that
behavioral health would be addressed in the 2011 health status
report. She noted that the StopSuicideAlaska web portal was a
new behavioral health initiative.
REPRESENTATIVE SEATON, referring to the use of checklists in
hospitals, asked if the Alaska Health Care Commission had
focused on procedures as a means to improving health.
DR. HURLBURT replied that the Commission was trying to deal with
broader scope issues, not with specifics of clinical practice.
4:55:17 PM
REPRESENTATIVE SEATON asked to see that the recommendations,
even though not specific, were followed.
4:55:48 PM
DR. HURLBURT referred to slide 33, "New 2010 Recommendations,"
and declared that these recommendations dealt primarily with the
use of evidence-based medicine. He announced that this dealt
with quality and cost savings, and he embraced the suggestions
for follow up.
4:57:03 PM
CHAIR KELLER asked Representative Seaton for more information on
his statement about malpractice rates.
REPRESENTATIVE SEATON asked Dr. Hurlburt if that information was
available.
CHAIR KELLER offered for his staff to contact the Director of
the Division of Insurance for this information.
4:58:29 PM
REPRESENTATIVE DICK offered his belief that high health care
costs were a direct result of what the health care providers
thought they could charge.
4:58:59 PM
ADJOURNMENT
There being no further business before the committee, the House
Health and Social Services Standing Committee meeting was
adjourned at 4:59 p.m.
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