04/08/2014 03:00 PM House HEALTH & SOCIAL SERVICES
| Audio | Topic |
|---|---|
| Start | |
| SB169 | |
| HB90 | |
| Adjourn |
+ teleconferenced
= bill was previously heard/scheduled
| += | SB 169 | TELECONFERENCED | |
| += | HB 90 | TELECONFERENCED | |
| + | TELECONFERENCED |
ALASKA STATE LEGISLATURE
HOUSE HEALTH AND SOCIAL SERVICES STANDING COMMITTEE
April 8, 2014
3:03 p.m.
MEMBERS PRESENT
Representative Pete Higgins, Chair
Representative Wes Keller, Vice Chair
Representative Lance Pruitt
Representative Lora Reinbold
Representative Paul Seaton
Representative Geran Tarr
MEMBERS ABSENT
Representative Benjamin Nageak
COMMITTEE CALENDAR
COMMITTEE SUBSTITUTE FOR SENATE BILL NO. 169(FIN)
"An Act establishing in the Department of Health and Social
Services a statewide immunization program and the State Vaccine
Assessment Council; creating a vaccine assessment account;
requiring a vaccine assessment from assessable entities and
other program participants for statewide immunization purchases;
repealing the temporary child and adult immunization program;
and providing for an effective date."
- MOVED HCS CSSB 169(HSS) OUT OF COMMITTEE
HOUSE BILL NO. 90
"An Act establishing a temporary program in the Department of
Health and Social Services for testing newborns for baseline
vitamin D levels."
- MOVED CSHB 90(HSS) OUT OF COMMITTEE
PREVIOUS COMMITTEE ACTION
BILL: SB 169
SHORT TITLE: IMMUNIZATION PROGRAM; VACCINE ASSESSMENTS
SPONSOR(s): SENATOR(s) GIESSEL
02/10/14 (S) READ THE FIRST TIME - REFERRALS
02/10/14 (S) HSS
02/21/14 (S) HSS AT 1:30 PM BUTROVICH 205
02/21/14 (S) Heard & Held
02/21/14 (S) MINUTE(HSS)
02/24/14 (S) HSS RPT CS 4DP NEW TITLE
02/24/14 (S) DP: STEDMAN, MICCICHE, MEYER, ELLIS
02/24/14 (S) FIN REFERRAL ADDED AFTER HSS
02/24/14 (S) HSS AT 1:30 PM BUTROVICH 205
02/24/14 (S) Moved CSSB 169(HSS) Out of Committee
02/24/14 (S) MINUTE(HSS)
03/03/14 (S) FIN AT 5:00 PM SENATE FINANCE 532
03/03/14 (S) Scheduled But Not Heard
03/05/14 (S) FIN AT 5:00 PM SENATE FINANCE 532
03/05/14 (S) Moved CSSB 169(FIN) Out of Committee
03/05/14 (S) MINUTE(FIN)
03/07/14 (S) FIN RPT CS 5DP NEW TITLE
03/07/14 (S) DP: MEYER, KELLY, BISHOP, DUNLEAVY,
OLSON
03/21/14 (S) TRANSMITTED TO (H)
03/21/14 (S) VERSION: CSSB 169(FIN)
03/24/14 (H) READ THE FIRST TIME - REFERRALS
03/24/14 (H) HSS, FIN
03/25/14 (H) HSS AT 3:00 PM CAPITOL 106
03/25/14 (H) Heard & Held
03/25/14 (H) MINUTE(HSS)
03/27/14 (H) HSS AT 3:00 PM CAPITOL 106
03/27/14 (H) Heard & Held
03/27/14 (H) MINUTE(HSS)
04/03/14 (H) HSS AT 3:00 PM CAPITOL 106
04/03/14 (H) Heard & Held
04/03/14 (H) MINUTE(HSS)
04/08/14 (H) HSS AT 3:00 PM CAPITOL 106
BILL: HB 90
SHORT TITLE: TESTING NEWBORNS FOR VITAMIN D
SPONSOR(s): REPRESENTATIVE(s) SEATON
01/30/13 (H) READ THE FIRST TIME - REFERRALS
01/30/13 (H) HSS, FIN
02/21/13 (H) HSS AT 3:00 PM CAPITOL 106
02/21/13 (H) Heard & Held
02/21/13 (H) MINUTE(HSS)
02/06/14 (H) HSS AT 3:00 PM CAPITOL 106
02/06/14 (H) Heard & Held
02/06/14 (H) MINUTE(HSS)
04/08/14 (H) HSS AT 3:00 PM CAPITOL 106
WITNESS REGISTER
TOM STUDLER, Staff
Representative Pete Higgins
Alaska State Legislature
Juneau, Alaska
POSITION STATEMENT: Presented the committee substitute (CS) for
SB 169.
SENATOR CATHY GIESSEL
Alaska State Legislature
Juneau, Alaska
POSITION STATEMENT: Testified as the sponsor of SB 169.
STEPHANIE WRIGHTSMAN-BIRCH, Chief
Women, Children & Family Health
Division of Public Health
Department of Health and Social Services
Anchorage, Alaska
POSITION STATEMENT: Testified during discussion of HB 90.
ACTION NARRATIVE
3:03:07 PM
CHAIR PETE HIGGINS called the House Health and Social Services
Standing Committee meeting to order at 3:03 p.m.
Representatives Higgins, Keller, Seaton, Reinbold, and Pruitt
were present at the call to order. Representative Tarr arrived
as the meeting was in progress.
SB 169-IMMUNIZATION PROGRAM; VACCINE ASSESSMENTS
3:04:10 PM
CHAIR HIGGINS announced that the first order of business would
be CS FOR SENATE BILL NO. 169(FIN), "An Act establishing in the
Department of Health and Social Services a statewide
immunization program and the State Vaccine Assessment Council;
creating a vaccine assessment account; requiring a vaccine
assessment from assessable entities and other program
participants for statewide immunization purchases; repealing the
temporary child and adult immunization program; and providing
for an effective date."
3:04:23 PM
REPRESENTATIVE KELLER moved to adopt the House committee
substitute (HCS) for CSSB 169, labeled 28-LS1219\D, Mischel,
4/7/14. There being no objection, it was so ordered.
3:04:46 PM
TOM STUDLER, Staff, Representative Pete Higgins, Alaska State
Legislature, paraphrased from the Sectional Analysis for the
house committee substitute for CSSB 169, Version D [Included in
members' packets], which read:
Section 1. Establishes a Statewide Immunization
Program with a State Vaccine Assessment Council; sets
requirements for vaccine assessments, reporting and
penalties for assessable entities and other program
participants; and creates a vaccine assessment
account.
Section 2. Definitions.
Section 3. Amends Title 21 (Insurance) to require
assessable entities to provide information and pay
assessments.
Section 4. Adds the vaccine assessment account to the
list of program receipts authorized in the budget.
Section 5. Repeals this act on January 1, 2021.
Section 6. Repeals Ch. 24 SLA 2012.
Section 7. Redirects the unobligated funds from Ch. 24
SLA 2012 to be deposited into the vaccine assessment
account.
Section 8. Makes the effective date January 1, 2015.
CHAIR HIGGINS asked for clarification that the January 1 date, a
calendar year, was for accounting purposes for the assessable
entities.
MR. STUDLER explained that the effective date would allow this
to coincide with the assessable entities and providers fiscal
year. It would also allow Department of Health and Social
Services the opportunity to use the existing funds in the House
Bill 301 account before this effective date.
3:07:38 PM
MR. STUDLER paraphrased from the Explanation of changes for the
House CS for CS SB 169\D [Included in members' packets], which
read:
Section 1. Adds Article 1A Statewide Immunization
Program to AS 18.09.
Sec. 18.09.200(a). Establishes a statewide
immunization program in the Department for the purpose
of monitoring, purchasing, and distributing vaccines
to providers.
Sec. 18.09.200(b). The Department of Health and Social
Services shall maintain a list of recommended vaccines
for inclusion in the program; establish the 1st year's
assessment & thereafter make annual assessments based
on commission determinations; notify insurers and
other program participants of the assessment amount;
devise a method for crediting overpayments; coordinate
the bulk purchase of vaccine; set procedures for
distributing vaccines; and review appeals for errors.
Sec. 18.09.210. Establishes the State Vaccine
Assessment Council within HSS for the purpose of
determining the assessment amount. The council has 8
members appointed by the Commissioner: the state's
Chief Medical Officer (chair); Director of Division
Insurance; 3 health care insurers, one of whom must be
a plan administrator; 2 health care providers, one of
which must be a pediatrician; and 1 representing a
tribal or public health insurance plan who serve
without compensation or reimbursement of expenses.
Terms are 3 years with a 2- term limit. HSS will
provide staff and other assistance to the council. The
commission establishes and implements a plan of
operation, submits an annual financial report to HSS
each July 1st, and monitors compliance with the
program.
Sec. 18.09.210(b)(1) the department's chief medical
officer for public health or the chief medical
officer's designee, who shall serve as the chair;
Sec. 18.09.210(f)(2). Requires an annual financial
report to the commissioner and legislature.
Sec. 18.09.220(a) Establishes the vaccine assessment
and reporting requirements after being phased into the
program by the commissioner.
Sec.18.09.220(e). An assessable entity may opt out of
the program during the three year phase-in period.
Sec. 18.09.225(a). Allows health care providers to opt
into the program to purchase vaccine.
Sec. 18.09.225(b) a health care provider who did not
opt into the program may not be denied a claim from an
assessable entity.
Sec. 18.09.225(c) a health care provider cannot bill a
payer or resell a vaccine distributed under the
program.
Sec. 18.09.230. Creates a special account in the
general fund for the purpose of purchasing vaccines.
The legislature may appropriate program receipts from
vaccine assessments, money from other sources, and
interest earned. Appropriations do not lapse.
Sec. 18.09.240. Allows the commissioner to determine a
monetary penalty for noncompliance.
Section 2. 18.09.990. Defines the terms assessable
entity, commissioner (Health & Social Services),
council, covered individual, other program
participant, program, provider, recommended vaccine,
and vaccine.
Section 3. Requires assessable entities to provide
information to the department under (AS 21.09.242)
Section 4. Adds the vaccine assessment account to the
list of special accounts for program receipts in (AS
37.05.146(c)
Section 5. repeals this act on January 1, 2021
Section6. Repeals Ch. 24, SLA 2012 (HB310), a
temporary statewide immunization program.
Section 7. Redirects the remaining HB310 funds to be
deposited to the vaccine account.
Section 8. Makes the act effective January 1, 2015.
3:09:17 PM
CHAIR HIGGINS referred to an earlier discussion regarding the
window of opportunity for an assessable entity to opt out of the
program, pointing out that the opt out was no longer voluntary,
but would now be up to the discretion of the commissioner for
determination of the time period.
3:10:18 PM
[Chair Higgins closed public testimony.]
SENATOR CATHY GIESSEL, Alaska State Legislature, said that this
was a small but important step in reducing the health care costs
for Alaskans, as well as a step toward fulfillment of the goals
of the Alaska Health Care Commission.
3:11:40 PM
REPRESENTATIVE KELLER moved to report HCS CSSB 169, Version 28-
LS1219\D, Mischel, 4/7/14, out of committee with individual
recommendations and the accompanying fiscal notes. There being
no objection HCS CSSB 169(HSS) was moved from the House Health
and Social Services Standing Committee.
The committee took an at-ease from 3:12 p.m. to 3:16 p.m.
HB 90-TESTING NEWBORNS FOR VITAMIN D
3:16:43 PM
CHAIR HIGGINS announced that the next order of business would be
HOUSE BILL NO. 90, "An Act establishing a temporary program in
the Department of Health and Social Services for testing
newborns for baseline vitamin D levels." [In front of the
committee was the proposed committee substitute (CS) for HB 90,
labeled 28-LS0376\O, Mischel, 2/4/14, adopted as the working
draft on February 6, 2014.]
REPRESENTATIVE KELLER moved to adopt the proposed committee
substitute (CS) for HB 90, labeled 28-LS0376\Y, Mischel,
3/31/14, as the working draft. There being no objection, it was
so ordered.
REPRESENTATIVE SEATON, as the sponsor of the bill, explained the
changes to Version Y, reporting that these changes were made in
response to suggestions from the House Health and Social
Services Standing Committee. He noted that the original
proposal had been for statewide universal testing for one year
with an opt out option, and that the research did not direct any
immediate benefit for the newborns or the mothers. He explained
that Version Y would make this a two year pilot project for 500
volunteer pregnant women. He was discussing involvement with
various providers to become the coordinating local entity and to
provide program analysis and data for the participants benefit.
He reported that this would become a project based on the
application of medical science to collect the information on
pregnancies in Alaska and to provide medical benefits for
mothers and newborns. He pointed out that a similar project in
South Carolina had reduced the pre-term births to 7 percent,
which would equate to a reduction of 25 pre-term births in
Alaska and a savings of $1.3 million. He shared that the state
would have a maximum match with the partners of 20 percent,
about $100,000. He referred to the Protect Our Children Now
program description and cost schedule. [Included in members'
packets] He stated that this would move the population forward
in prevention of unintended pregnancy outcomes. He asked that
the committee move the bill forward.
3:23:08 PM
CHAIR HIGGINS asked for clarification that the end goal for the
program was for documentation proving that Vitamin D does what
Representative Seaton had presented, and to encourage its use.
REPRESENTATIVE SEATON expressed his agreement, reiterating that
this was a voluntary demonstration project and that, should the
results support it, the medical community would encourage the
use of Vitamin D.
CHAIR HIGGINS asked about the study in Australia.
REPRESENTATIVE SEATON clarified that the proposed program,
Protect Our Children Now, was based on a South Carolina study.
He opined that the program could lower pre-term births in
Alaska.
3:25:37 PM
REPRESENTATIVE SEATON, in response to Chair Higgins, said that
the South Carolina study had been conducted since 2004, and had
begun as a research project. He said that the proposed program
for Alaska was an outgrowth of this project.
CHAIR HIGGINS reflected on a recent seminar he had attended
which discussed studies and research. He offered an anecdote
claiming that a two year study was useless and needed to be
drawn out over a much longer period, and that the performance of
the studies often made the research useless. He pointed out
that the proposed bill was for a two-year study, yet he opined
that it was necessary for a longer research project to fully
understand the data.
REPRESENTATIVE SEATON expressed his agreement. He pointed out
that the aforementioned had been a research study, while this
was a project based on that research. He noted that pregnancy
outcomes were recognized in 9 months, and it would require about
500 pregnancies for enough data to review the pre-term birth
rate. He declared that the proposed bill was for a project
based on scientific research, and although it would offer more
data, was not a research project.
3:30:17 PM
REPRESENTATIVE SEATON pointed out that the fiscal note from
Department of Health and Social Services was higher than
permitted by the proposed bill, and he relayed that there was a
search for a different partner to do this more economically. He
mentioned partners in other states performing this program for
much less than the attached fiscal note proposed. He shared
that the proposed bill would show a willingness by the State of
Alaska to participate in the improvement of the health of
pregnant women and infants. He reiterated that this was a pilot
project, implementing earlier research findings from other
studies.
3:31:19 PM
REPRESENTATIVE TARR referred to other screenings, and asked if
any of them would be willing to incorporate questions about
Vitamin D use.
REPRESENTATIVE SEATON replied that this would be part of the
nutritional and screening information compiled from those who
volunteered to be in the program. He clarified that the project
was not designed for a questionnaire, but would focus on better
outcomes and healthier mothers and newborns. The proposed bill
would show that the state would be willing to participate as a
minor partner.
3:33:37 PM
CHAIR HIGGINS stated that public testimony was still open.
3:33:55 PM
STEPHANIE WRIGHTSMAN-BIRCH, Chief, Women, Children & Family
Health, Division of Public Health, Department of Health and
Social Services, stated appreciation for the changes to Version
Y, especially as it included treatment and public information
after the data had been collected. She expressed concerns with
the content of the bill as it pointed toward conducting an
experimentally designed research study which would be the
responsibility of the Division of Public Health to carry
forward. She stated that this was not a core function of
Division of Public Health. She acknowledged that participation
was voluntary, although she opined that all research was
voluntary. She stated that a longer time was necessary to
collect the data. She declared that DHSS was very sensitive to
requiring Institutional Review Board (IRB) approvals. She noted
that there were rigorous study design elements and national
standards that needed to be adhered. She noted that the
proposed fiscal note included state personnel time for
administration, and even if the intent was for a contractor and
a grantee, it was the responsibility of the Division of Public
Health to oversee the study design and protocol, and to conduct
a secondary review of the data. She declared that there were
costs included for this. Once the data was collected and
analyzed, it had to be compared with prior research and
recommendations. She declared a challenge to be the lack of
acceptable standard recommendations or guidelines for Vitamin D
levels on newborns or pregnant women. She acknowledged a
difference of opinion between the Vitamin D literature and the
recommendations for its use by organizations to which public
health officials were bound to follow.
3:39:09 PM
CHAIR HIGGINS closed public testimony and took a brief at-ease.
3:39:45 PM
REPRESENTATIVE KELLER moved to report the proposed committee
substitute (CS) for HB 90, labeled 28-LS0376\Y, Mischel,
3/31/14, out of committee with individual recommendations and
the attached fiscal notes. There being no objection, CSHB
90(HSS) was moved from the House Health and Social Services
Standing Committee.
3:39:58 PM
The committee took a brief at-ease.
3:42:11 PM
ADJOURNMENT
There being no further business before the committee, the House
Health and Social Services Standing Committee meeting was
adjourned at 3:42 p.m.
| Document Name | Date/Time | Subjects |
|---|---|---|
| HB090 sponsor statement- 2014.pdf |
HHSS 4/8/2014 3:00:00 PM |
HB 90 |
| HB090 draft proposed CS Ver 28-LS0376Y.pdf |
HHSS 4/8/2014 3:00:00 PM |
HB 90 |
| HB090 changes-ver O to ver Y.pdf |
HHSS 4/8/2014 3:00:00 PM |
HB 90 |
| Alaska Vaccine Letter Medicaid FINAL 4-7-14.pdf |
HHSS 4/8/2014 3:00:00 PM |
|
| HB090 Support Document-study-Wagner-2013.pdf |
HHSS 2/6/2014 3:00:00 PM HHSS 4/8/2014 3:00:00 PM |
HB 90 |
| HB090 Support Document-Protect our Children Now-booklet 2-3-14_grassroots.pdf |
HHSS 2/6/2014 3:00:00 PM HHSS 4/8/2014 3:00:00 PM |
HB 90 |
| HCS for CSSB 169 ver T Section Analysis.pdf |
HHSS 4/3/2014 3:00:00 PM HHSS 4/8/2014 3:00:00 PM |
SB 169 |
| HCS for CSSB 169 ver T Explanation of Changes.pdf |
HHSS 4/3/2014 3:00:00 PM HHSS 4/8/2014 3:00:00 PM |
SB 169 |
| CS SB 169 Version T.pdf |
HHSS 4/3/2014 3:00:00 PM HHSS 4/8/2014 3:00:00 PM |
SB 169 |
| SB169 WhoPaysFor VaccineInAK.pdf |
HHSS 4/8/2014 3:00:00 PM SHSS 2/21/2014 1:30:00 PM |
SB 169 |
| SB 169 DCCED fiscal note.pdf |
HHSS 4/8/2014 3:00:00 PM SHSS 2/21/2014 1:30:00 PM |
SB 169 |
| SB 169 DHSS fiscal note #2.pdf |
HHSS 4/8/2014 3:00:00 PM SHSS 2/21/2014 1:30:00 PM |
SB 169 |
| SB 169 DHSS fiscal note.pdf |
HHSS 4/8/2014 3:00:00 PM SHSS 2/21/2014 1:30:00 PM |
SB 169 |
| SB 169 DOA fiscal note.pdf |
HHSS 4/8/2014 3:00:00 PM SHSS 2/21/2014 1:30:00 PM |
SB 169 |
| SB 169 Fund Transfers fiscal note.pdf |
HHSS 4/8/2014 3:00:00 PM SHSS 2/21/2014 1:30:00 PM |
SB 169 |
| SB169 Sponsor Statement Immunization Program.pdf |
HHSS 4/8/2014 3:00:00 PM SHSS 2/21/2014 1:30:00 PM |
SB 169 |
| House CSSB 169 Version D.pdf |
HHSS 4/8/2014 3:00:00 PM |
SB 169 |
| HCS for CSSB 169 ver D Section Analysis.pdf |
HHSS 4/8/2014 3:00:00 PM |
SB 169 |
| HCS for CSSB 169 ver D Explanation of Changes.pdf |
HHSS 4/8/2014 3:00:00 PM |
SB 169 |