Legislature(2015 - 2016)CAPITOL 106
01/22/2015 03:00 PM House HEALTH & SOCIAL SERVICES
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| Overview: Department of Health and Social Services | |
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* first hearing in first committee of referral
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+ teleconferenced
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ALASKA STATE LEGISLATURE
HOUSE HEALTH AND SOCIAL SERVICES STANDING COMMITTEE
January 22, 2015
3:04 p.m.
MEMBERS PRESENT
Representative Paul Seaton, Chair
Representative Liz Vazquez, Vice Chair
Representative Neal Foster
Representative Louise Stutes
Representative David Talerico
Representative Geran Tarr
Representative Adam Wool
MEMBERS ABSENT
All members present
COMMITTEE CALENDAR
OVERVIEW: DEPARTMENT OF HEALTH AND SOCIAL SERVICES
- HEARD
PREVIOUS COMMITTEE ACTION
No previous action to record
WITNESS REGISTER
VALERIE DAVIDSON, Commissioner Designee
Office of the Commissioner
Department of Health and Social Services (DHSS)
Juneau, Alaska
POSITION STATEMENT: Presented a power point overview of the
Department of Health and Social Services.
JAY BUTLER, MD, Chief Medical Officer/Director
Division of Public Health
Central Office
Department of Health and Social Services
Juneau, Alaska
POSITION STATEMENT: Answered questions during the overview of
Department of Health and Social Services.
JON SHERWOOD, Deputy Commissioner
Medicaid and Health Care Policy
Office of the Commissioner
Department of Health and Social Services
Juneau, Alaska
POSITION STATEMENT: Answered questions during the DHSS
overview.
ACTION NARRATIVE
3:04:07 PM
CHAIR PAUL SEATON called the House Health and Social Services
Standing Committee meeting to order at 3:04 p.m.
Representatives Seaton, Vazquez, Tarr, Wool, and Talerico were
present at the call to order. Representatives Foster and Stutes
arrived as the meeting was in progress.
3:05:28 PM
CHAIR SEATON announced that the first order of business would be
for each committee member to introduce themselves and share a
brief account of their interest for participation on the House
Health and Social Services Standing Committee.
REPRESENTATIVE TARR said that she was interested in Vitamin D
and improving health outcomes, as her interests included mental
health, substance abuse treatment, and child sexual abuse
prevention.
REPRESENTATIVE VAZQUEZ explained that she had a "passion for
health care," noting that she had an MBA in health care services
administration. She looked forward to working on improvement of
outcomes, and she expressed her support for prevention.
REPRESENTATIVE WOOL reported that his family were all in the
health industry, and that he was a consumer of health care. He
expressed concern for the difficulty in obtaining health care
and health care insurance.
REPRESENTATIVE FOSTER shared his success with his personal
health since regularly taking Vitamin D. He noted that his
primary interest was for directing attention to the villages
across the state.
REPRESENTATIVE TALERICO reported that, as he had 43 distinct
communities in his district, he had an interest in telemedicine
for the delivery of health care services.
CHAIR SEATON shared his interest for better health outcomes
relative to the expense, and that he wanted to ensure
improvement to the health of Alaskans, with a focus on improving
basic health. He declared that this would have a positive
impact on all budgets. He pointed out that the Department of
Health and Social Services had a myriad of responsibilities. He
stated that he would like to make upstream changes, instead of
waiting until the conditions were downstream and required
expensive treatments. He emphasized that the committee mantra
would be prevention.
REPRESENTATIVE STUTES said that she wanted to learn about ways
to keep Alaskans healthy and to participate in keeping Alaskans
healthy.
^OVERVIEW: DEPARTMENT OF HEALTH AND SOCIAL SERVICES
OVERVIEW: DEPARTMENT OF HEALTH AND SOCIAL SERVICES
3:12:12 PM
CHAIR SEATON announced that the next order of business would be
an overview by the Department of Health and Social Services.
3:14:02 PM
VALERIE DAVIDSON, Commissioner Designee, Office of the
Commissioner, Department of Health and Social Services (DHSS),
shared that she had been an early childhood teacher and she
believed strongly in early childhood opportunities. She stated
that the sooner there were good relationships between children
and health care providers, the better the experiences later in
life. She reported that she had worked for the past 15 years in
the Alaska Tribal Health system, including the past 8 years with
the Alaska Native Tribal Health Consortium (ANTHC), which was
statewide. She shared that the Yukon-Kuskokwim Health
Corporation in Bethel was very innovative for providing health
care services. She offered an overview of the department, slide
2, "Alaska Department of Health and Social Services Organization
Chart." She moved on to slides 3 and 4, "Executive Leadership,"
and introduced those in attendance.
COMMISSIONER DAVIDSON, in response to Representative Tarr,
explained that the Division of Behavioral Health was now aligned
with the Division of Public Assistance.
3:22:37 PM
COMMISSIONER DAVIDSON directed attention to slides 5 and 6,
"Health & Social Services," noting that Department of Health and
Social Services had eight divisions. She introduced each
division and its director.
3:25:31 PM
CHAIR SEATON, referencing the Divisions of Public Assistance and
Senior and Disability Services, asked which division was
responsible for public assistance to seniors.
COMMISSIONER DAVIDSON replied that all public assistance
programs were housed under the Division of Public Assistance.
3:26:04 PM
COMMISSIONER DAVIDSON, addressing slide 7, stated that the
vision for the department was to ensure that "Alaska
individuals, families, and communities really are safe and they
are as healthy as possible." She listed the three main
priorities of the department: health and wellness across the
life span; health care access, delivery, and value; and safe and
responsible individuals, families, and communities. She stated
that this focus for priorities included core services, and she
acknowledged that the budget was linked to results based
accountability. She reported that the former commissioner had
done a good job ensuring that the budgets aligned with the
departmental priorities, which she opined was not an easy task.
She stated that data was still incoming and there would be
further alignment.
3:27:29 PM
CHAIR SEATON asked if there were plans for accomplishing the
priorities and the goals, as the committee wanted to ensure
there was a "mechanism to accomplish each one of those goals."
He stated that the current position of health care in Alaska did
not have an enviable ranking in the US.
COMMISSIONER DAVIDSON, in response, directed attention to slides
8 - 11, "Areas of primary focus (4)." She explained that the
first focus was to provide access to health care for Alaskans,
which included a commitment to Medicaid expansion, as there were
more than 40,000 Alaskans who did not have access to health care
and would be eligible. She declared that, in the short term, it
was important to get individuals as healthy as possible during
this period when the federal government offered a 100 percent
match to Medicaid. She explained that the longer term goal
recognized that there were changes necessary to the Medicaid
program, both the current and expanded recipients, in order for
its delivery to be as efficient as possible. She acknowledged
that there were significant systems challenges to enroll
individuals in the Medicaid expansion. She referenced the two
system conversions, which included the eligibility information
system for Medicaid and other public assistance, which was a
year late in coming on line and was experiencing a backlog. She
explained that the other major system change was to the Medicaid
payment system, now called the Medicaid Management Information
System (MMIS). She reported that this system also had
significant challenges for accuracy and timeliness of claims
payments to providers. Noting that, in order to proceed
responsibly, it was necessary to ensure the systems were running
sufficiently, she shared her anticipation for a July start date
to Medicaid expansion, even as this could mean an aggressive
push to meet this goal.
3:33:09 PM
REPRESENTATIVE STUTES asked whether the Department of Health and
Social Services (DHSS) was going to work with the Department of
Corrections (DOC) for mental health evaluation to inmates as,
she opined, there was a disconnect between the two services.
She suggested this could alleviate the burden on the penal
system.
COMMISSIONER DAVIDSON in response, expressed her agreement with
early intervention opportunities in order to forego the
construction of another prison. She reported that there was a
recidivism effort which included both departments, as well as
the Alaska Court System and local communities. She stated that
the correction system was filled with people "who wouldn't be
there if we provided adequate alcohol or other substance abuse
treatment," declaring that these were resources that were very
well spent. She compared that this was the same as with
Medicaid expansion, as behavioral health services were covered.
She pointed out that, as the Patient Protection and Affordable
Care Act required behavioral health parity, this was an
opportunity to interrupt that cycle in corrections and child
welfare issues. She opined that too often the focus was too
late and that earlier intervention could stop the cycle. She
reported that there would be savings for DOC as inmates were
eligible under Medicaid expansion for health care costs outside
the facility. She declared that the challenge was for timing,
to ensure that people could be enrolled and receive services.
She pointed out that there were also some short term savings
with Medicaid expansion, including catastrophic coverage, which
was currently paid out of the general fund. For a longer term
strategy, as Medicaid was $1.7 billion of the DHSS budget of
$2.7 billion, she offered her belief that it was necessary to
review the use of Medicaid services in Alaska and design a
program that worked for Alaska.
3:38:12 PM
COMMISSIONER DAVIDSON shared that there were current
opportunities to realize savings, including funding projects for
long term care facilities and skilled nursing facilities, so
care for elders could be provided closer to home. She reported
that there was a 100 percent match for these services, if three
requirements were met: an Indian Health Service (IHS)
beneficiary, an Alaska Native, or a Medicaid beneficiary at an
IHS facility. She clarified that this was already available and
would continue under the Medicaid expansion. She referenced
Senate Bill 61 which looked at the prospects for Alaska to
leverage opportunities and partnerships with the tribal health
system to recognize savings. She listed the long term care
services and behavioral health services for residential, home,
and community, as two of these opportunities. She mentioned the
super utilizer program, which focuses on reducing the use of
emergency departments. Although Medicaid beneficiaries often
made use of emergency departments, DHSS was working with these
recipients to better manage their care through a primary care
provider. She acknowledged that the emergency room had become
the first resort for people without medical coverage, resulting
in a significant bill for uncompensated care. She suggested
that Medicaid expansion could teach people more appropriate ways
to access health care. She allowed that DHSS was open to
suggestions for change, and she was looking at the experiences
of other states for best practice models.
3:44:27 PM
REPRESENTATIVE FOSTER asked whether there were any transitional
costs to the state during the Medicaid expansion and its initial
100 percent payment by the federal government.
COMMISSIONER DAVIDSON explained that Medicaid expansion allowed
states to be reimbursed at 100 percent during 2014, 2015, and
2016. For the next three calendar years, 2017, 2018, and 2019,
the federal match would transition from 95 percent, to 94
percent, and then to 93 percent. In 2020, this would transition
to a 90 percent federal match, where it would remain. Directing
attention to the transition costs for Alaska, she informed the
committee that there was an administrative match for 50 percent
of cost, as well as a 90 percent match for systems improvement
and changes.
COMMISSIONER DAVIDSON, in response to Representative Foster,
said that the budget, including transition costs, would be
provided soon after the governor's budget statement, though she
opined that this would be less than anticipated.
3:47:53 PM
CHAIR SEATON asked for more information regarding the enrollment
system.
COMMISSIONER DAVIDSON said that the first phase of the
enrollment system, the Medicaid determination, had been delayed
a year. She noted that the second phase, including Temporary
Assistance to Needy Families (TANF) and food assistance, would
go live after that. She said that mandatory overtime
requirements were about to be implemented to ensure that
individuals would be enrolled and to diminish some of the
backlogs. She offered that more progress had been made with the
enrollment system than the payment system, noting that
litigation had begun against Xerox by the former administration.
She reported that the contract with Xerox required an
administrative hearing, which would be heard by an
administrative law judge in February. She reported that the
state had hired an independent consultant to review the work by
Xerox and write an independent assessment for the program. She
noted that Xerox had submitted a performance improvement plan,
which was being reviewed. She offered her belief that the
situation was direr than she had realized, and that Department
of Health and Social Services would be more transparent
regarding the problems with these systems. She opined that the
public deserved to be more aware of the backlog and the
situation, and that the department should be accountable for
fixing the systems. She reported that the providers were
working with the health care services to ensure that workarounds
were in place to guarantee payment.
CHAIR SEATON expressed his disappointment in the rollout for the
program, and for the lack of dual accounting. He said that his
office had contacted the State of Massachusetts when researching
the problems with Xerox, as that state had incorporated the same
system. He reported that Massachusetts had the same problems.
He asked if the problems in Massachusetts had been resolved.
COMMISSIONER DAVIDSON acknowledged that other states had
contracts with Xerox, although, she opined, as other states were
managed care states, it was not necessary to have the capability
to process as many claims as Alaska. She stated that other
states were also in litigation with Xerox. She pointed out that
the systems in other states were designed to do very different
things.
3:54:35 PM
COMMISSIONER DAVIDSON, directing attention back to the areas of
primary focus, slide 9, "Child welfare/keeping our children
safe," and reported that more than 2400 Alaskan children were in
out of home placements, more than at any previous time. She
expressed concern for the resources and the programs to prevent
this.
COMMISSIONER DAVIDSON moved on to the third area of primary
focus, slide 10, "Tribal and Federal Partnerships." She stated
that it was necessary to have this out front and center to
enhance the State of Alaska's relationships and partnerships
with tribal organizations and the federal government, including
the federal Departments of Interior and Health and Human
Services, to make sure that barriers which are standing in the
way of progress are removed. She pointed out that Alaska Native
children comprised between 17 - 20 percent of the state
population, but comprised 60 percent of the children in out of
home placements. She declared that, as neither the state nor
the federal agencies could solve this problem alone, it was time
for the focus to change from who was providing the service to
what was being done for the children, and who could do what to
help get there. She acknowledged the work between Office of
Children's Services and the tribal organizations, but opined
that it was necessary to be more aggressive for leveraging these
partnerships and opportunities. She declared that tribal
organizations had been ready for this for a long time. She
offered her belief that the commitment to the children should be
the focus beyond those ideas for the right solution, noting that
trust building only happened over time.
3:59:28 PM
CHAIR SEATON asked whether there were particular barriers to the
legislature or to the administration in working on this
partnership.
COMMISSIONER DAVIDSON replied that although there were some
agreements with the Tanana Chiefs Conference for better tribal -
state partnership, there were challenges for getting them
information, especially about child welfare cases. She allowed
that there would be some administrative discretion although the
governor had agreed to work across departments to address these
issues. She suggested that it was necessary for clarity in the
statutes to help remove any of the barriers. She offered to
relay more in-depth information. She concluded with slide 11,
"Improving the health status of Alaskans," and declared that
this was the focus.
4:01:43 PM
JAY BUTLER, MD, Chief Medical Officer/Director, Division of
Public Health, Central Office, Department of Health and Social
Services, shared his background in public health care, noting
that he had worked for the past five years with the Alaska
Native Tribal Health Consortium. Directing attention back to
slide 11, "Improving the health status of Alaskans," he reported
that 28 percent of Alaskan adults and 17 percent of children
were obese, defined as having a body mass index (BMI) over 30.
He pointed out that obesity was most likely a primary driver for
the increased rates of Type 2 diabetes, which affected almost 5
percent of Alaskans. He noted that the teenagers were the age
group with the biggest increase in obesity in the past 15 years.
He shared that diabetes could be managed, as well as prevented,
through healthy behaviors such as weight control and healthy
diet. He suggested that healthy behaviors could be influenced
by making the healthy choice the easy choice. He pointed out
that preventive maintenance was very necessary. He stated that
education was also an important influence on behaviors, and that
the power of education was profound. He noted that the only
eradication of a disease had been for small pox, through
vaccination, and he offered an anecdote of a current educational
campaign to eradicate another disease.
4:09:50 PM
DR. BUTLER discussed the reduction of tobacco use, noting that
use was down to 20 percent in Alaska, with huge progress for the
prevention of smoking. He suggested that this change was a
result of both education and a change of the social norms.
REPRESENTATIVE TARR asked about any focus on e-cigarette use.
DR. BUTLER replied that there was great interest, although there
was a lot that was still not known. He noted that tobacco use
overlapped with e-cigarette and marijuana use. He reported that
e-cigarettes had been touted as nicotine prevention tools,
although they were not currently FDA approved for overcoming
nicotine addiction. He expressed his concerns with the flavors
and the marketing of e-cigarettes, comparing it to the smokeless
products.
CHAIR SEATON asked if the Department of Health and Social
Services was letting it be known that the sale of nicotine
delivery products to minors was illegal.
DR. BUTLER replied that the legislation was an important
deterrent, although he was not aware of the enforcement. He
reported that the illegal sale of tobacco products was an
educational issue. In response to Chair Seaton, he agreed that
the illegal sale of nicotine delivery systems to minors should
also be part of the educational curriculum.
4:16:07 PM
DR. BUTLER announced that the department desired to reduce the
abuse of alcohol and other drugs, as 25 percent of Alaskan
adults reported binge drinking. He declared that it was
important to realize that this was not just a personal health
decision, but that impairment also affected the health of
others. He offered examples of injuries from motor vehicles, as
well as injuries to the fetus from fetal alcohol spectrum
disorder. He moved on to address opioid drug abuse with the
increase of opioid prescriptions, possibly due to a lack of
understanding for pain management. He declared that this would
be a priority for the Alaska Health Care Commission during the
upcoming year.
REPRESENTATIVE WOOL asked about a centralized data base for
opioid prescriptions.
DR. BUTLER replied that that was a recognized best practice, and
it was used in Alaska.
REPRESENTATIVE TARR offered her belief that the funding was
scheduled to cease last year, and there had not been any
legislation to extend the funding.
COMMISSIONER DAVIDSON expressed agreement that funding had been
discontinued but that, as the department had felt it was
"sufficiently important for the health of Alaska, it was being
continued through an agreement with another department.
REPRESENTATIVE VAZQUEZ asked if this data base was different
than the data base for the over-utilization of prescription
drugs.
4:20:41 PM
JON SHERWOOD, Deputy Commissioner, Medicaid and Health Care
Policy, Office of the Commissioner, Department of Health and
Social Services, in response to Representative Vazquez, said
that this was a different program, was available to all health
care providers and pharmacies, and was not limited to Medicaid.
REPRESENTATIVE TARR asked for clarification that the provider
had to access the information from the data base, and whether
any of the program management had changed, especially as it was
not on a real time basis.
MR. SHERWOOD explained that the program was now under the
Department of Commerce, Community & Economic Development. As
administration of the data base was not in the DHSS
responsibility, he was not aware of the specifics.
REPRESENTATIVE VAZQUEZ asked if the prescription data base was
used by DHSS.
MR. SHERWOOD opined that DHSS did not have access to the data
base, although he was not absolutely certain. He relayed that
it was intended for use by providers when prescribing.
REPRESENTATIVE VAZQUEZ asked if this lack of access was because
of statutory restraints.
MR. SHERWOOD offered his belief that the statute did not
identify DHSS as a user of the data base, although he would like
to confirm this.
CHAIR SEATON asked that Mr. Sherwood provide that answer to the
committee.
REPRESENTATIVE VAZQUEZ asked how many individuals were in the
Lock-In program, and how its use had constrained expenses over
the past five years. She asked whether the settlement with
legal services regarding the Lock-In program was still in
effect.
MR. SHERWOOD replied that he would research that and send the
information to the committee.
CHAIR SEATON asked for a status update, specifically to how the
system was working.
REPRESENTATIVE VAZQUEZ requested a copy of the legal settlement.
She opined that Lock-In was a good cost containment measure as
it prevented over utilization by recipients.
CHAIR SEATON asked for an outline of the Lock-In program.
REPRESENTATIVE WOOL asked if the data base tracked the physician
or provider as well as the recipient.
MR. SHERWOOD replied that he was unsure and agreed to get the
information back to the committee.
CHAIR SEATON asked for a more comprehensive description of the
prescription data base program, as well.
4:27:43 PM
DR. BUTLER directed attention back to slide 11, and discussed
the now legal use of marijuana. He stated that the Division of
Public Health wanted to reduce any adverse health effects from
this legalization, and do what was best for Alaska. He stated
that DHSS would learn lessons from legalization in other states.
He listed some of the short term effects from marijuana
legalization to include an increase in Colorado for emergency
room visits by children from THC ingestion, and an increase in
burns during extraction of THC. He expressed concern with the
medical literature on long term effects, particularly for heavy
use in adolescents. He shared that the department was reviewing
regulations with marijuana. He allowed that the bigger question
for all drug use was why people needed to self-medicate. He
mentioned the data on adverse childhood experiences and those
effects on health in later life. He reported that research was
working to reduce these later health effects. He said that
almost 25 percent of hospitalization injuries were alcohol
based.
DR. BUTLER relayed that injuries were the leading cause of
premature death in Alaska, and the outcome could be influenced
during the golden hour of field management and transport to a
certified trauma center. He reported that there were now two
Level 2 trauma centers in Alaska, as well as 15-16 Level 4
centers.
4:33:47 PM
CHAIR SEATON asked about other strategies for prevention of
injuries.
DR. BUTLER, in response, mentioned the "Kids Don't Float"
program, which encouraged the use of personal floatation
devices. He pointed to the white flotation coats program, which
were made to look like a traditional whaler's coat, as the
whalers were the traditional leaders in a community. He cited
education and regulations for the use of seat belts and helmets.
He spoke of the tragic injuries from domestic violence, and,
although not a traditional part of public health, he deemed it
was necessary for DHSS to recognize and address this problem.
4:35:57 PM
DR. BUTLER stated that immunizations had made a big difference
in the health of Alaskan children and that Alaska was doing well
for ensuring vaccinations for school age children. However, he
noted that some vaccination rates lagged, especially for the
immunizations of two year olds. He shared that access to
vaccines was often a challenge. He noted that Alaska was
looking at models for a return to the universal vaccine program,
and he mentioned the Alaska vaccine assessment program. This
program would allow the purchase of vaccines at wholesale prices
for substantial savings to providers and third party payers. He
offered his belief that Alaska would be the tenth state to use
this model for vaccine purchases.
CHAIR SEATON asked whether the state program for purchasing,
warehousing, and distributing vaccines was currently in place.
DR. BUTLER replied that the remaining funding allowed to forward
fund the first year purchases, and then continue to buy in bulk.
He explained that much of the country had direct to provider
distribution, but that the state had convinced the federal
government that Alaska had a better understanding for
distribution logistics in an Arctic environment.
4:39:10 PM
DR. BUTLER discussed the prevention and control of infectious
diseases, noting that this health threat would continue as it
dealt with another biologic system that was able to continuously
change. He offered his belief that there was not a high risk
for Ebola in Alaska, as the department monitored the return of
the very small volume of travelers from affected areas. He
noted that DHSS continued its work with hospitals in Alaska and
Washington State for management planning in case of Ebola. He
mused that Ebola brought back the conversation about readiness
for serious infectious diseases.
4:41:33 PM
REPRESENTATIVE FOSTER asked about inadequate sewage and water
quality and its role with infectious diseases, and whether
Department of Health and Social Services would have any role
with this.
COMMISSIONER DAVIDSON replied that the Centers for Disease
Control and the ANTHC had reviewed the impact on infants and
communities without adequate sanitation facilities. These
findings indicated that there were 11 times greater likelihood
for hospitalization from respiratory infections and 5 times more
likely from skin infections. She clarified that these infants
required a medivac from the rural community to the hospitals.
She relayed that this equated to hospitalization for one in
three infants from the community in any year. She explained
that the challenge was for some public health benefit programs
to continue in other state departments during times of
significant budget contractions. She offered a personal
anecdote of her daughter's bouts with respiratory disease. She
pointed out that adequate sanitation facilities programs were
matched by federal funding. She declared that there was a link
between adequate sanitation facilities and public health and the
health status of communities.
DR. BUTLER declared that it was necessary to consider what could
realistically be accomplished for the 25 percent of the state
population who did not have the proper sanitation facilities.
He emphasized that it was important to use engineering models to
look for ways to provide these services. He referenced the
diseases associated with a lack of running water, pointing out
that these were not waterborne diseases. He noted the challenge
to supply adequate wash water for personal hygiene, comparing
this to the absolute minimum World Health Organization standard
for refugee camps. He declared the need for opportunities for
people to wash in rural Alaska.
4:48:27 PM
DR. BUTLER moved on to discuss the prevention of infant deaths,
reporting that today's death rates were about tenfold lower due
to immunization, improved standards of living, and increased
protection in the first year of life. He discussed
implementation of the Healthy Alaskans 2020 action plan. He
said that it was necessary to programmatically address these
health challenges in order to make a difference. He explained
that the Healthy Alaskans program was a collaboration between
the State of Alaska and the Alaska Native Tribal Health
Consortium to connect with communities, identify some of the
priorities for improving health, determine what could be done to
make those improvements, and then measure the impact. He
relayed that the plan's outcome was for 25 measures with useable
goals and included specific outcomes such as reducing cancer
mortality, reducing the proportion of Alaskans living below the
poverty line, and improving the high school graduation rate.
4:51:33 PM
DR. BUTLER expressed his pleasure in hearing of the interest in
prevention, stating that health care had really been disease
care. He enthused that prevention was an emphasis of the Alaska
Health Care Commission in defining how health care was provided.
He offered his thoughts on Vitamin D, citing thousands of
studies for its health outcomes which included the prevention of
falls and fractures in the elderly, as well as prevention of
colon, breast, and prostate cancer, cardio vascular disease,
stroke, diabetes, and depression. He allowed that there were
still a lot of questions for the public health opportunities,
and that association did not necessarily prove causation. He
pointed out that there were more than 1500 clinical trials
assessing Vitamin D, and, as he was a pragmatist, he asked what
this would mean for Alaska. He shared that the vital trial,
involving more than 25,000 Americans, was very well conducted
and, because of its size, offered many analyses. He lauded the
potential for flu prevention with an over the counter
supplement.
CHAIR SEATON reflected on some of the earlier trials which only
offered once a week or once a month Vitamin D dosage, noting
that recent research showed that daily dosage was necessary to
affect soft tissue. Other studies examining the effect on
cancer and other disease had shown that Vitamin D may prove
ineffective if dosages were only taken a few times each month.
4:58:57 PM
COMMISSIONER DAVIDSON acknowledged the work of the HSS
transition team which brought together more than 250 Alaskan
volunteers to offer ideas for improvement to the delivery of
services, slide 12, "Looking to the future." She directed
attention to the five recommendations listed on the slide and
said that these would all be evaluated for possible
implementation.
CHAIR SEATON stated that the committee would review Medicaid
expansion, including reviews of the Arizona criteria and the
Tennessee model for cost sharing with the health care providers
to implement the program.
5:01:55 PM
ADJOURNMENT
There being no further business before the committee, the House
Health and Social Services Standing Committee meeting was
adjourned at 5:01 p.m.
| Document Name | Date/Time | Subjects |
|---|---|---|
| DHSS House_HSS Committee Powerpoint Intro_2015.01.22.pptx |
HHSS 1/22/2015 3:00:00 PM |
HSS presentation |