01/28/2016 03:00 PM House HEALTH & SOCIAL SERVICES
| Audio | Topic |
|---|---|
| Start | |
| HB226 | |
| HB260 | |
| HB262 | |
| HB237 | |
| Adjourn |
+ teleconferenced
= bill was previously heard/scheduled
| *+ | HB 226 | TELECONFERENCED | |
| *+ | HB 260 | TELECONFERENCED | |
| *+ | HB 262 | TELECONFERENCED | |
| + | TELECONFERENCED | ||
| *+ | HB 237 | TELECONFERENCED | |
ALASKA STATE LEGISLATURE
HOUSE HEALTH AND SOCIAL SERVICES STANDING COMMITTEE
January 28, 2016
3:05 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
HOUSE BILL NO. 226
"An Act extending the termination date of the Alaska Commission
on Aging; and providing for an effective date."
- HEARD & HELD
HOUSE BILL NO. 260
"An Act relating to the recovery of overpayments of day care
assistance and child care grants; and providing for an effective
date."
- HEARD & HELD
HOUSE BILL NO. 262
"An Act relating to eligibility requirements of the Alaska
senior benefits payment program; and providing for an effective
date."
- HEARD & HELD
HOUSE BILL NO. 237
"An Act relating to an interstate compact on medical licensure;
amending the duties of the State Medical Board; and relating to
the Department of Public Safety's authority to conduct national
criminal history record checks of physicians."
- HEARD & HELD
PREVIOUS COMMITTEE ACTION
BILL: HB 226
SHORT TITLE: EXTEND ALASKA COMMISSION ON AGING
SPONSOR(s): REPRESENTATIVE(s) HAWKER
01/19/16 (H) PREFILE RELEASED 1/8/16
01/19/16 (H) READ THE FIRST TIME - REFERRALS
01/19/16 (H) HSS, FIN
01/28/16 (H) HSS AT 3:00 PM CAPITOL 106
BILL: HB 260
SHORT TITLE: DAY CARE ASSISTANCE & CHILD CARE GRANTS
SPONSOR(s): RULES BY REQUEST OF THE GOVERNOR
01/19/16 (H) READ THE FIRST TIME - REFERRALS
01/19/16 (H) HSS, FIN
01/28/16 (H) HSS AT 3:00 PM CAPITOL 106
BILL: HB 262
SHORT TITLE: SENIOR BENEFITS PROG. ELIGIBILITY
SPONSOR(s): RULES BY REQUEST OF THE GOVERNOR
01/19/16 (H) READ THE FIRST TIME - REFERRALS
01/19/16 (H) HSS, FIN
01/28/16 (H) HSS AT 3:00 PM CAPITOL 106
BILL: HB 237
SHORT TITLE: INTERSTATE MEDICAL LICENSURE COMPACT
SPONSOR(s): SEATON
01/19/16 (H) PREFILE RELEASED 1/15/16
01/19/16 (H) READ THE FIRST TIME - REFERRALS
01/19/16 (H) HSS, FIN
01/26/16 (H) HSS AT 3:00 PM CAPITOL 106
01/26/16 (H) Scheduled but Not Heard
01/28/16 (H) HSS AT 3:00 PM CAPITOL 106
WITNESS REGISTER
REPRESENTATIVE MIKE HAWKER
Alaska State Legislature
Juneau, Alaska
POSITION STATEMENT: As the sponsor of the bill, presented HB
226.
DENISE DANIELLO, Executive Director
Alaska Commission on Aging
Division of Senior and Disabilities Services
Department of Health and Social Services (DHSS)
Juneau, Alaska
POSITION STATEMENT: Testified in support of HB 226.
KRISTIN CURTIS, Legislative Auditor
Division of Legislative Audit
Alaska State Legislature
Juneau, Alaska
POSITION STATEMENT: Testified during discussion on HB 226.
MARIE DARLIN, Coordinator
AARP Capital City Task Force
Commission on Aging
Juneau, Alaska
POSITION STATEMENT: Testified in support of HB 226.
CHARLES MCKEE
Anchorage, Alaska
POSITION STATEMENT: Testified during discussion of HB 226.
MARY SHIELDS, Chair
Alaska Commission on Aging
Anchorage, Alaska
POSITION STATEMENT: Testified in support of HB 226.
GORDON GLASER
Alaska Commission on Aging
Anchorage, Alaska
POSITION STATEMENT: Testified in support of HB 226.
PETER ZUYUS
Homer, Alaska
POSITION STATEMENT: Testified in support of HB 226.
DAVID LEVY, Senior Services Coordinator
Anchorage Senior Advisory Commission
Anchorage, Alaska
POSITION STATEMENT: Testified in support of HB 226.
SEAN O'BRIEN, Director
Division of Public Assistance
Department of Health and Social Services (DHSS)
Juneau, Alaska
POSITION STATEMENT: Provided an overview and responded to
questions during discussion of HB 260 and HB 262.
STACIE KRALY, Chief Assistant Attorney General
Statewide Section Supervisor
Human Services Section
Civil Division (Juneau)
Department of Law
Juneau, Alaska
POSITION STATEMENT: Testified and answered questions during
presentation on HB 260.
JANICE BRADEN
Child Care Program Office
Division of Public Assistance
Department of Health and Social Services
Anchorage, Alaska
POSITION STATEMENT: Testified during discussion of HB 260.
MONICA MITCHELL, Chief
Policy and Program Development
Division of Public Assistance
Department of Health and Social Services
Juneau, Alaska
POSITION STATEMENT: Answered questions during discussion of HB
262.
TANEEKA HANSEN, Staff
Representative Paul Seaton
Alaska State Legislature
Juneau, Alaska
POSITION STATEMENT: Introduced HB 237 on behalf of the sponsor,
Representative Seaton.
ACTION NARRATIVE
3:05:15 PM
CHAIR PAUL SEATON called the House Health and Social Services
Standing Committee meeting to order at 3:05 p.m.
Representatives Seaton, Tarr, Wool, and Talerico were present at
the call to order. Representatives Vazquez, Foster, and Stutes
arrived as the meeting was in progress.
HB 226-EXTEND ALASKA COMMISSION ON AGING
3:06:32 PM
CHAIR SEATON announced that the first order of business would be
HOUSE BILL NO. 226, "An Act extending the termination date of
the Alaska Commission on Aging; and providing for an effective
date."
3:06:49 PM
REPRESENTATIVE MIKE HAWKER, Alaska State Legislature, explained
that HB 226 would extend the sunset date of the Alaska
Commission on Aging. He pointed out that these board extensions
were an administerial job of the Alaska State Legislature, as it
offered an opportunity to review and examine the performance of
the board in accordance with the statutes which authorized them
and its relevance and importance to the state. The review of
the boards and commissions is performed by the state auditor and
the state audit group, which produce an audit with
recommendations. Upon completion of its recent sunset review,
April 10, 2015, the state auditors recommended extension of the
Alaska Commission on Aging for eight years, through June 30,
2024, as also requested in proposed HB 226. He stated that the
Alaska Commission on Aging was a bit different than most
commissions, as it was necessitated by the federal Older
Americans Act (OAA). He explained that to receive the federal
funding of $11 million to various programs for the benefit of
seniors, there must be a council in the state, comprised of
older individuals who are eligible to participate in OAA funded
programs. He further defined that this entity must be the
"state agency regarding aging issues and make recommendations to
our state agency that handles these programs," which was the
Department of Health and Social Services in Alaska. He pointed
out that the Commission on Aging developed the state plan for
senior services. He declared that this board "actually does
something," that it had an important mission and it developed
policy. He pointed out that the Commission was necessary in
order to continue to qualify for federal funding to senior
programs. He reported that auditors had noticed two issues that
the commission needed to rectify: better advance noticing of
meetings, of which the commission had agreed and taken steps to
rectify; and to better monitor the legislative watch list, as
there were bills listed that were not relevant. He suggested
that the commission served an important purpose, and that it
leveraged a relatively small amount of state money to bring in
more than $11 million to support programs for senior Alaskans.
3:14:00 PM
DENISE DANIELLO, Executive Director, Alaska Commission on Aging,
Division of Senior and Disabilities Services, Department of
Health and Social Services (DHSS), stated that she supported the
legislative audit to extend the termination date for the
Commission on Aging. She offered a brief overview of the work
by the commission and its role in state government. She
explained that the mission was "to ensure the dignity and
independence of all older Alaskans and to assist them to lead
useful and meaningful lives through planning, advocacy,
education, and inter agency cooperation." She declared that the
State of Alaska was unique, in comparison with other states, as
it constituted a single planning and service area for its
provision of services for seniors; whereas, other states had
numerous area agencies to administer funding, programs, and
services for seniors. In Alaska, the Department of Health and
Social Services was the sole state agency on aging, and the
responsibilities were carried out jointly by the Division of
Senior and Disabilities Services, which administered the
majority of federal and state funding for senior programs, and
the Alaska Commission on Aging, which developed the state plan
for senior services and provided advocacy, outreach, and
education, as specified under the OAA. She reiterated that
Alaska received about $11 million of federal funding annually
for senior programs and services. She noted that this was also
extended to Alaska Native Tribal providers, through the
Department of Labor & Workforce Development. She reported that
the commission had been formed in 1981, and was originally
called the Older Alaskans Commission. She relayed that the
commitment was to ensure that seniors gained access to
appropriate and quality services, and to maintain their health
and independence to allow them to remain in their own community,
living independently, for as long as possible. She stated that
this work was now more important than ever, as the senior
population continued to grow, from its current estimate of
120,444 Alaskans over 60 years of age, at a 4.2 percent annual
increase. She shared that this comprised 16 percent of the
state population, and was the fastest growing age demographic in
Alaska. She added that for the sixth consecutive year Alaska
was the state with the fastest growing senior population per
capita.
3:19:18 PM
MS. DANIELLO shared that the commission was charged with
formulating a four year comprehensive Alaska state plan for
senior services for approval by the Department of Health and
Social Services in order to satisfy the federal requirement for
all states to have a state plan when receiving funding through
the OAA. She relayed that, since FY08, the commission, working
collaboratively with many agencies as well as seniors, had
developed three state plans for senior services. The current
state plan for FY16 - FY19 included 6 goals, with 28 strategic
objectives, and 48 performance measures, as well as a formula
that directed the distribution of federal and state funding for
senior programs and services: the nutrition and transportation
support services program, and the senior in home services
program. She reported that the commission also provided the
senior snapshot published in the annual report, which is an
annual statistical analysis of senior demographics, use of
programs and services, and reports on indicators related to
senior health, senior safety, senior housing, and economic
security. The commission also provided annual budget and policy
recommendations to the Alaska Mental Health Trust Authority
concerning the needs of older Alaskans living with Alzheimer's
and related dementia. She offered a conservative estimate that
there were 6,600 Alaskans aged 65 years or older with
Alzheimer's, which did not include early onset or related
dementias. She pointed out that the commission provided
information quarterly to the Trust and collaboratively published
Alaska's roadmap to address Alzheimer's and related dementia,
which was the first state plan to address the challenges and
complexity of issues for these diseases. She noted that the
commission also made recommendations to the governor and the
legislature with respect to legislation, regulations, and
appropriations for programs and services that benefit older
Alaskans, including the Medicaid adult dental program, the
Alaska senior benefits program, and the statewide alert system
for vulnerable adults, the silver alert. She pointed out that
the commission actively encouraged public participation for
policy and budget recommendations, and conducted regular
community forums and bi-weekly statewide legislative
teleconferences for discussion on legislation relevant to
seniors.
3:24:32 PM
MS. DANIELLO reported that, in recent years, the commission had
made efforts to recognize the many issues facing Alaskan
seniors, by coordinating the power of aging symposium, and
encouraging seniors to participate in civic engagement. She
relayed that the commission had collaborated in the coordination
of the senior housing summit, and the senior fall prevention
coalition, as falls were the number one cause of hospitalization
and death for seniors aged 75 and older. She mentioned the
Healthy Body, Healthy Brain campaign, which raised awareness of
risk factors and protective factors promoting cognitive health.
The commission had called attention to the fact that seniors
were a $3 billion industry in Alaska, which did not include the
countless hours of volunteer and care giving work. She declared
that seniors appreciated the programs and services to strengthen
their health and ability to live independently in their
communities. She referenced the audit findings, which required
public online postings for all the commission board and
committee meetings, as well as review and approval of the
legislative watch list by the commission chair prior to its
distribution. She expressed the commission's approval for these
findings, noting the updated policies and procedures, and
reported that the new practices had been implemented. She
declared support for HB 226.
3:27:03 PM
REPRESENTATIVE TARR asked how the issue for the shortage of
affordable housing was being addressed outside urban areas.
MS. DANIELLO replied that the commission had participated in the
governor's housing summit in January, which included eight
breakout sessions, one of which was a session for senior
housing. During this session, a problem statement was defined
which declared that Alaska had a shortage of accessible,
affordable housing for people to age in place, and a list of
recommendations was provided. These recommendations included
the implementation of strategies identified in the Alaska road
map for addressing Alzheimer's disease. She expressed a desire
to read the report from this housing summit, and "a large need
to continue this conversation with these recommendations from
the senior housing breakout session to provide the platform for
continuing that discussion and further work." She expressed her
desire to create a partnership with the Alaska Housing Finance
Corporation and the Alaska Mental Health Trust Authority.
Referencing housing outside urban areas, she opined that it was
important to identify ways to improve accessibility in the home
so that people would not have to leave their homes.
3:30:30 PM
REPRESENTATIVE TARR asked whether the four full time employees
listed on the fiscal note were enough to do the job. She asked
if the current travel freeze would impact the commission.
MS. DANIELLO, in response to Representative Tarr, stated that
the commission budget had been reduced by $3000, mainly for
travel, so the commission will be having more meetings by audio
and video conference. She relayed that, as the commission was
required by statute to have four board meetings each year, they
would try to limit this to one face to face meeting.
3:32:00 PM
REPRESENTATIVE TARR asked if this would compromise the work of
the commission.
MS. DANIELLO expressed her agreement that this was a valid
concern, sharing that an on-site rural outreach commission
meeting was invaluable, but expensive.
3:34:08 PM
KRISTIN CURTIS, Legislative Auditor, Division of Legislative
Audit, Alaska State Legislature, reported that the division had
conducted a sunset review and the main points had been presented
by Representative Hawker. She stated that she was available for
questions.
3:35:08 PM
MARIE DARLIN, Coordinator, AARP Capital City Task Force,
Commission on Aging, referenced her earlier letter of support to
HB 226 from AARP to the committee [Included in members' packet].
She pointed out that over the years AARP had worked closely with
the commission on many different projects, as the two groups
were faced with many of the same issues. She stated that the
two groups had a very good working relationship. She
acknowledged that the commission had successfully addressed the
issues on the audit, and had been updated on senior housing
issues and the restructuring of fund distribution through Alaska
Housing Finance Corporation.
3:38:46 PM
REPRESENTATIVE TARR asked if AARP and other groups were
coordinating to consider the net impact on seniors if there were
changes, and whether the commission be involved.
MS. DARLIN replied that this was already happening, especially
for the concerns and impacts in the outlying areas.
3:41:25 PM
CHARLES MCKEE read from a letter he wrote to U.S. Representative
Paul Ryan regarding the welfare of senior citizens.
CHAIR SEATON asked that Mr. McKee focus his comments directly on
proposed HB 226 and the Alaska Commission on Aging.
3:45:07 PM
MARY SHIELDS, Chair, Alaska Commission on Aging, stated that the
senior population was the fastest growing demographic in Alaska,
while contributing about $3 billion annually to the state
economy. She relayed that the commission members were the eyes
and ears for the senior community, especially for the older,
vulnerable Alaskans. The commission brought these messages back
to the policy makers, noting that a lot of information came from
the rural outreach meetings. She pointed out that the
commission also contacted the state ombudsman to ensure any
wrongdoings directed at seniors were properly addressed. She
lauded the central positioning of the commission, and she
declared support for HB 226.
3:48:09 PM
GORDON GLASER, Alaska Commission on Aging, shared that he was
also on the board of the Anchorage Senior Activities Center. He
relayed that the commission looked at broad policy as well as
individual cases, as their mission was to determine what was
going on and what needed to be changed, then making
recommendations to the legislature, the state agencies, and the
governor. He stated support of HB 226, adding that the aging
population was a resource, with vital, active leadership and
involvement in the community.
3:50:57 PM
PETER ZUYUS directed attention to his letter in support of the
commission [Included in members' packets] and pointed out that,
although the Kenai Peninsula Borough had more than 18,000 senior
citizens, growing at 16 percent annually, it did not have any
representation on the commission. He asked that the proposed
bill contain an amendment to include a member of the Kenai
Peninsula Borough on the commission.
3:53:03 PM
DAVID LEVY, Senior Services Coordinator, Anchorage Senior
Advisory Commission, testified that the Anchorage Senior
Advisory Commission supported HB 226. He reported that the
commission looked at issues of concern for seniors in the
Anchorage area. He shared that the Anchorage Senior Advisory
Commission had worked closely with the Alaska Commission on
Aging.
3:54:45 PM
CHAIR SEATON closed public testimony.
REPRESENTATIVE STUTES offered anecdotal testimony regarding the
Kodiak Senior Center, and how well all the services interact.
3:56:32 PM
CHAIR SEATON offered his comments on the Alzheimer's conference
in Anchorage, and suggested that committee members try to attend
any future meetings.
3:57:16 PM
REPRESENTATIVE HAWKER directed attention to the fiscal note,
noting that it needed a correction, as the revenues line on page
1 should reflect the $11 million dollars in federal revenue.
3:58:13 PM
CHAIR SEATON declared that HB 226 would be held over.
HB 260-DAY CARE ASSISTANCE & CHILD CARE GRANTS
3:58:39 PM
CHAIR SEATON announced that the next order of business would be
HOUSE BILL NO. 260, "An Act relating to the recovery of
overpayments of day care assistance and child care grants; and
providing for an effective date."
3:59:23 PM
SEAN O'BRIEN, Director, Director's Office, Division of Public
Assistance, Department of Health and Social Services (DHSS),
explained that the division provided child care funding to
qualified individuals with low to moderate incomes who needed
assistance in order to return to work. He reported that the
proposed bill would allow for the collection of overpayments and
misspent funds through the garnishment of permanent fund
dividends (PFDs) when it could not be collected through
voluntary repayment, as was the current strategy. Reflecting on
FY15, he reported that the division had about 30 open claims,
with about half actively repaying. He stated that most of the
department's claims occurred when there was either a lack of
accurate information or neglect for the reporting of a change to
circumstances. The proposed bill included four important
aspects, which the department considered justification for its
passage. The bill supported federal compliance with the child
care development program to recover improper or fraudulent
payments, and addressed a gap in the division's current
authority to recoup those payments. He shared that the
inability to recoup these payments through voluntary means,
resulted in the cost being covered through state general funds.
The proposed bill would provide a consistency of collection
practices with other Division of Public Assistance programs,
thereby streamlining the process. He clarified that the
effective date would be July 1, 2016, in order to allow leverage
of the 2016 PFD. He shared that the division had a policy
allowing for a one year look back period, which was consistent
with practices for recouping payment in other public assistance
programs. He clarified that child care assistance was paid to
providers on a parent's behalf, so that the collections would
come from the parents. He noted that, for child care grants
paid to licensed providers for specific purposes, the division
would go directly to the provider to recoup the funds.
4:03:33 PM
CHAIR SEATON asked if the proposed bill enabled collection of
overpayment of grants for daycare and child care assistance
similar to collection from adult public assistance and medical
assistance.
MR. O'BRIEN expressed agreement, stating that the proposed bill
would make consistent and align the recovery collection systems.
CHAIR SEATON asked if the proposed bill would necessitate a new
set of regulations for implementation.
MR. O'BRIEN explained that the Child Care Program Office
currently had a notice of proposed rulemaking, and within that
language two major features were indicated: identify fraud or
other program violations and investigate the recovery of
fraudulent payments with accompanying sanctions on clients and
providers. He offered his belief that the ability to collect
the payments was in place, but the methodology for enforcement
and collection was in volunteer status.
CHAIR SEATON asked for clarification whether regulations would
need to be written. He opined that regulations would need to be
written for Section 2 of the proposed bill.
4:06:39 PM
STACIE KRALY, Chief Assistant Attorney General, Statewide
Section Supervisor, Human Services Section, Civil Division
(Juneau), Department of Law, offered her belief that it was not
necessary to draft regulations to implement the proposed bill,
as the ability for recovery already existed, and the proposed
bill offered an additional tool with the statutory provision for
the garnishment of PFDs. In response to Chair Seaton, she
explained that Section 2, the retroactive provision,
contemplated the ability to garnish the 2016 PFD for debts or
overpayments that had accrued prior to the effective date of the
proposed bill. She pointed out that the department policy was
to look back one year for collection of debts.
4:09:10 PM
REPRESENTATIVE VAZQUEZ expressed her support for the closure of
this loophole, and she asked about inclusion in the proposed
bill for collection of overpayments to the heating assistance
program.
MR. O'BRIEN replied that he did not know the background for
whether this program had been considered for inclusion to the
proposed bill.
MS. KRALY acknowledged that this program should be considered by
the committee for addition to the proposed bill.
CHAIR SEATON asked for more information so this could be
considered in an amendment.
REPRESENTATIVE VAZQUEZ expressed the desire for the Department
of Health and Social Services to have any necessary tools to
recover any overpayments, "especially in the light of our fiscal
gaps."
4:11:08 PM
REPRESENTATIVE TARR, referencing the fiscal note, asked for
clarification of the breakdown between the grants and the
individual recipients for day care assistance. She noted that
she had been pondering ways for program improvement, and shared
that one challenge posed by many providers was that the
assistance was done in time blocks, which made it difficult for
"drop-in" services and often resulted in payment for time that
was not necessary. She asked if flexibility for shorter time
blocks could be considered.
4:13:17 PM
JANICE BRADEN, Child Care Program Office, Division of Public
Assistance, Department of Health and Social Services, in
response to Representative Tarr, said that she did not have that
information readily available. She relayed that, as the recent
re-authorization of the federal child care development and block
grants had made many changes, states also needed to make changes
within the regulations. She reported that her office was in the
process of reviewing the necessary changes to meet these new
requirements for the child care assistance program.
CHAIR SEATON asked that any federal changes be brought forward
to be included in the proposed bill.
REPRESENTATIVE TARR asked if the aforementioned breakdown could
be sent to the committee.
MS. BRADEN acknowledged that she would send them.
4:16:58 PM
REPRESENTATIVE WOOL asked if the funding went directly to the
child care provider or to the parent, and how often was this
audited to reconcile any overpayments.
MS. BRADEN explained that with the Child Care Assistance program
the family would apply and provide documentation for household,
income, and activity, such as work or school, in support of
eligibility. She explained that recipients were asked to report
any changes and eligibility was then reviewed and re-determined
at six months. She shared that the most common unreported
change was for a second parent back in the home, which affects
the family size and income to determine benefit levels. In the
childcare assistance program, the benefits were paid directly to
the child care provider on the family's behalf, so any recoup of
overpayment came from the parent.
CHAIR SEATON asked for clarification that, if there was a single
parent upon determination of eligibility, but then the parents
reunited prior to the six month review resulting in a second
income to the household, this was an example of "things not
getting reported."
MS. BRADEN expressed her agreement that this was one of the most
common examples.
REPRESENTATIVE WOOL asked for clarification that, when the
payments went to the child care provider, if there were a change
in situation, then the parent was responsible for any
overpayment. He asked if they would have to approach the child
care provider for reimbursement. He opined that the discrepancy
was not for the amount of child care provided, but for the
amount of [financial] assistance that was provided.
REPRESENTATIVE TARR asked for clarification that although the
overpayment went directly to the provider, the individual parent
was responsible for repayment. She asked if the provider was
entitled to keep the funding, as they had provided the service.
MS. BRADEN explained that the provider would not be penalized by
recouping money as they had provided the services, and they had
a cost for those services. What the state had paid on behalf of
the family was too much, as the family should have paid more of
the portion to the provider.
REPRESENTATIVE WOOL asked if the child's PFD could be garnished.
MS. KRALY explained that, as the agreement was with the parent,
not with the child, it would be garnishment of the parent's PFD.
CHAIR SEATON said that HB 260 would be held over.
HB 262-SENIOR BENEFITS PROG. ELIGIBILITY
4:23:33 PM
CHAIR SEATON announced that the next order of business would be
HOUSE BILL NO. 262, "An Act relating to eligibility requirements
of the Alaska senior benefits payment program; and providing for
an effective date."
SEAN O'BRIEN, Director, Director's Office, Division of Public
Assistance, Department of Health and Social Services (DHSS),
summarized the senior benefits program to Alaskan seniors with a
low to moderate income as three different cash benefit amounts,
$125, $175, and $250 per month, dependent on the income of the
applicant and tied to the Alaska Federal Poverty Guidelines. He
explained that the intent of proposed HB 262 was four fold: one
additional eligibility requirement for the necessity to be a
U.S. citizen or qualified alien is added; qualified aliens would
be eligible with all other public assistance programs; the
original intent of the program to be in alignment with the adult
public assistance program is corrected with this one criteria;
and, about $43,000 annually based on the 16 non-qualified aliens
currently known to be in the system is saved. He reported that,
in order to meet citizenship requirements, a person must be a
U.S. citizen or national, or a qualified alien. He noted that a
qualified alien must have been in the U.S. for five years,
whereas a non-qualified alien would either be someone who the
U.S. Immigration Service is aware of but has no plan to deport;
a non-immigrant, an individual in the U.S. lawfully but
temporarily; or an illegal alien. He reported that of the 16
aforementioned non-qualified individuals, 12 had not yet met the
five year waiting period, 3 were non-immigrants, and 1 was
illegal.
CHAIR SEATON asked for clarification about the three non-
immigrants.
MR. O'BRIEN explained that these individuals were here lawfully
but on a temporary basis, such as work visas, student visas, or
diplomats.
CHAIR SEATON asked about the amounts paid relative to the
percentage of poverty.
4:29:22 PM
MONICA MITCHELL, Chief, Policy and Program Development, Division
of Public Assistance, Department of Health and Social Services,
explained that the monthly payment of $250 was for an income
level up to 75 percent of the federal poverty level, the $175
monthly payment was for an income level between 75 and 100
percent of federal poverty level, and the $125 monthly payment
was for income between 100 percent and 175 percent of the
federal poverty level.
CHAIR SEATON directed attention to page 2, line 5 of the
proposed bill, and asked for clarification regarding the payment
of $120 a month.
MS. MITCHELL offered her belief that this senior benefit could
be a holdover from the general assistance program which would
need to be corrected.
CHAIR SEATON asked for this to be identified, and, if necessary,
cleaned up at this time.
REPRESENTATIVE TARR opined that this was in reference to the
senior longevity program.
CHAIR SEATON asked for the definitive answer.
REPRESENTATIVE VAZQUEZ declared her support of the proposed bill
as it closed a loophole. She asked if the general relief
statutes should also be addressed and imposed with the same
requirement.
MR. O'BRIEN said he would review this.
4:32:16 PM
CHAIR SEATON opened public testimony. After ascertaining that
no one wished to testify, closed public testimony.
[HB 262 was held over.]
4:33:27 PM
The committee took an at-ease from 4:33 p.m. to 4:36 p.m.
HB 237-INTERSTATE MEDICAL LICENSURE COMPACT
4:36:23 PM
CHAIR SEATON brought the committee back to order.
CHAIR SEATON announced that the final order of business would be
HOUSE BILL NO. 237, "An Act relating to an interstate compact on
medical licensure; amending the duties of the State Medical
Board; and relating to the Department of Public Safety's
authority to conduct national criminal history record checks of
physicians."
4:36:55 PM
TANEEKA HANSEN, Staff, Representative Paul Seaton, Alaska State
Legislature, reported that proposed HB 237 was model
legislation, already entered into by 12 states with 11 other
states considering it, and passage would enter Alaska into the
Interstate Medical Licensure Compact. She stated that the
purpose of this compact was to create another venue into medical
licensure by joining other compact states in creating an
expedited license process for qualified physicians, as well as
creating an interstate commission to administer the compact and
maintain all the necessary information.
CHAIR SEATON asked for an explanation to the necessity of the
proposed bill.
MS. HANSEN shared that the proposed bill was a result of the
delays in the licensure process, and she directed attention to a
letter from Aaron Kusano [Included in members' packets] which
listed specific changes for improvement to the process. Upon
investigation, she shared that awareness of the Interstate
Medical Licensure Compact became an option. She relayed that
the basic premise of the compact, that physicians in a compact
state could verify eligibility within the state of primary
licensure, and then, if eligible, register with the interstate
commission and list the other states in which they requested
licensure. These states would then be notified of the
physician's eligibility, and upon receipt of the licensing fees,
the doctor would be licensed. This would allow a physician to
work through the compact for verification instead of through
each state individually, thereby avoiding the duplicative
process.
CHAIR SEATON pointed out the need for physicians, emphasizing
that these were medical licenses, and noted that there was also
a nurses licensing compact, which was not included in this
proposed bill.
MS. HANSEN expressed agreement, reiterating that a goal was to
ensure that the state had enough providers to address all the
health care needs, which was "a real concern in some
communities, that we do have a shortage of health care
providers."
4:41:03 PM
REPRESENTATIVE VAZQUEZ directed attention to the FAQ, page 1,
[Included in members' packets] and read: "possess specialty
certification or be in possession of a time unlimited specialty
certificate." She asked for clarification about whether a
general practitioner would be eligible for participation.
MS. HANSEN acknowledged that they would "take feedback from the
medical board and practitioners as to who would be eligible."
She shared that her research indicated that almost 80 percent of
physicians would currently be eligible for the expedited license
under the current definitions, and that the other physicians
would still be able to apply for a license in the State of
Alaska. She declared that this did not supersede the licensing
procedure in Alaska, it only provided another venue.
REPRESENTATIVE VAZQUEZ reiterated that this appeared that only
doctors with a specialty certification would be allowed to use
the compact mechanism.
MS. HANSEN deferred the question to the medical board, noting
that the bill defined the specialty certifications.
REPRESENTATIVE VAZQUEZ declared her support for the goal of the
proposed bill. Noting that it was necessary for 7 states to
join the compact for it be launched, she asked how many states
had currently joined the compact.
MS. HANSEN replied that there were already 12 states in the
compact, although no licenses had yet been awarded. She
reported that the interstate commission had met on December 18,
2015, and would meet again in the near future, in order to
establish the by-laws.
REPRESENTATIVE WOOL asked if this was also designed for
physicians practicing telemedicine in multiple states.
MS. HANSEN explained that it would still depend on the specific
statutes on an eligible physician for telemedicine in Alaska,
although eligibility would also be dependent on being licensed
in the State of Alaska.
REPRESENTATIVE VAZQUEZ asked if this was a step toward more use
of telemedicine.
CHAIR SEATON explained this was a step that would permit this,
but it would not institute it, as a person had to be licensed
and pay the licensing in the state. He clarified that it was
necessary for an expedited license in each state, and that the
compact did not create a single license for use in all compact
states.
4:46:15 PM
REPRESENTATIVE VAZQUEZ directed attention to the FAQ, page 2,
and read: "have successfully completed a graduate medical
education (GME) program." She said that she would have a
question about this, opining that it was a question for the
medical board. She directed attention to another requirement on
page 2, of the FAQ, and read: "have passed the USMLE or COMLEX
within three attempts." She acknowledged that these were both
technical questions.
MS. HANSEN explained that the examination requirement was
similar to what was currently in the medical statutes, and that
there was a similarly worded requirement for having passed an
approved GME program. She noted that the approving bodies in
Alaska were different than those approving bodies in the
compact, and she deferred to the state medical board for further
discussion. She directed attention to the letter dated January
13, 2015, from the Director of the Division of Corporations,
Business and Professional Licensing detailing interest by the
Department of Commerce, Community & Economic Development but not
indicating any current reservations.
4:48:17 PM
MS. HANSEN referenced the Sectional Analysis of HB 237,
[Included in members' packets] explaining that Sections 1 - 6
were Alaska specific language to include the Interstate Medical
Licensure Compact; whereas, Section 7, the main body of the
proposed bill, was the model language to enter into the Compact,
and could not be substantially changed if Alaska desired to be a
part of the Compact. She reported that Section 8 of the
Sectional Analysis was also Alaska specific language. She
paraphrased from the Sectional Analysis of HB 237, which read:
Section 1- Amends AS 08.64.101, duties of the state
medical board, to include implementation of the
Interstate Medical Licensure Compact.
Section 2- Adds to AS 08.64.190 to require a physician
applying for an expedited license under this compact
to submit the fingerprints and fees necessary for a
criminal background check. Statute does not currently
require physicians licensed in Alaska to have a
background check.
Section 3- Requires the medical board to waive
licensure requirements if a physician is eligible for
expedited licensure under the Interstate Medical
Compact.
Section 4- Authorizes the Department of Commerce,
Community, and Economic Development to set fees for
the issuance or renewal of expedited licenses.
Section 5- Clarifies in AS 08.64.370 the exceptions to
licensure requirements under chapter 08.64.
Section 6- Amends the definition of the "practice of
medicine" or "practice of osteopathy" to allow for the
definition under the Interstate Medical Licensure
Compact.
4:50:20 PM
MS. HANSEN moved on to explain that Section 7 of the proposed
bill was the model legislation, and that the first seven
sections of Section 7 dealt with the ground rules for entry into
the Compact. She paraphrased from Section 7, which read:
Section 08.64.500- Enacts and enters Alaska into the
Interstate Medical Licensure Compact as created in the
following sections.
Section 08.64.510- States that the purpose of the
compact is to provide a streamlined licensure process
that enhances portability while complementing existing
state license authority. Maintains the jurisdiction of
individual state medical boards.
Section 08.64.520- Defines terms to be used throughout
the compact, including definitions of "expedited
license" and "physician" for the purpose of
qualification for an interstate expedited license.
Section 08.64.530- Declares that a physician must meet
the eligibility requirements defined in 08.64.520(11)
to receive an expedited license. Allows that a
physician that does not meet these requirements may
obtain an individual state license if all state laws
and requirements are met.
Section 08.64.540- Directs a physician to designate a
compact member state as the state of principal
licensure to register for an expedited license and
defines what qualifies as a principal state of
licensure.
4:52:28 PM
MS. HANSEN moved on to the next section, which outlined how to
get an expedited license, and read:
Section 08.64.550- Outlines how a physician shall
apply for an expedited compact licensure through an
application with the medical board of the physician's
state of principal license. The board shall evaluate
the physician's eligibility under the compact,
including through primary source verification and
criminal background checks. If determined eligible,
the physician shall then register with the Interstate
Commission, select states of licensure, and pay any
necessary fees to each selected member state before
receiving licenses in those states. A physician must
follow all applicable laws and regulations of the
issuing state.
REPRESENTATIVE WOOL asked whether a physician arriving in Alaska
from a state not participating in the Compact could simply
fulfill the Alaska requirements, although this would take
longer.
4:54:50 PM
MS. HANSEN expressed her agreement. She returned attention to
the Sectional Analysis, which read:
Section 08.64.560- Allows compact member states to
impose a fee for expedited licensure and authorizes
the Interstate Commission to develop rules regarding
these fees.
Section 08.64.570- Describes how a qualified physician
may seek renewal of an expedited license through the
Interstate Commission. States that the physician shall
comply with any continuing education requirements of
any member state where they seek a renewed license,
and that member states may charge renewal fees through
the Interstate Commission.
Section 08.64.580- Establishes a database of all
physicians licensed through the Interstate Commission
and describes what information compact member states
must report.
Section 08.64.590- Outlines how compact member boards
may participate in joint investigations.
Section 08.64.600- States that any disciplinary action
taken by one member board may be acted upon or imposed
by other member states, that if a license is revoked
by the state of principal license all other member
state licenses are automatically revoked, and that if
the license is revoked by a state that is not the
principal state of license all other licenses are
automatically suspended for 90 days for investigation
by each member board.
4:57:23 PM
MS. HANSEN described the last sections of the model legislation,
which read:
Section 08.64.610- Creates the Interstate Medical
Licensure Compact Commission to administer the
Interstate Medical Licensure Compact and describes the
voting members and meeting procedures of the
commission. Each member state shall have two voting
representatives.
Section 08.64.620- Describes the powers and duties of
the Interstate Commission.
Section 08.64.630- Authorizes the Interstate
Commission to levy an assessment against member states
to cover its costs and requires certain financial
restrictions of the commission.
Section 08.64.640- Sets out the organization and
operation of the Interstate Commission including the
adoption of bylaws, the election of officers, and the
immunity and liability of commission directors and
employees.
Section 08.64.650- States that the Interstate
Commission shall promulgate reasonable rules for the
administration of the compact and describes a petition
against a commission rule.
Section 08.64.660- Declares that all branches of a
state government shall enforce the Compact and
maintains that the Compact shall not override existing
state authority to regulate medicine.
Section 08.64.670- Provides guidelines for how the
Interstate Commission may take legal action to enforce
the provisions and the rules of the Compact.
Section 08.64.670- Outlines procedures of the
Interstate Commission should a member state default in
its obligations under the Compact.
Section 08.64.690- Allows the Interstate Commission to
promulgate rules for dispute mediation and resolution
at the request of a member state or states. The
following sections relate to the effective date,
withdrawal proceedings, and other construction
questions relating to the Compact.
4:59:35 PM
MS. HANSEN paraphrased from the Compact, that for any change to
the Compact, the member states would have to give unanimous
consent, which read:
Section 08.64.700- Declares that the Compact shall be
effective and binding on member states once enacted by
no less than seven states, that nonmember states shall
be invited to participate as a non-voting member, and
that a proposed amendment to the Compact shall not
become binding unless enacted by unanimous consent of
the members states.
Section 08.64.710- Provides that a member state may
withdraw from the Compact one year after the effective
date of a statute repealing the Compact in that state.
Section 08.64.720- States that the Compact and the
Interstate Commission shall dissolve if the Compact
membership is reduced to one member state.
Section 08.64.730- Allows that the provisions of the
Compact are severable, should any one provision be
deemed unenforceable.
Section 08.64.740- Details the interaction between the
Compact and other laws of member states, including
that laws in conflict with the Compact are supersede
to the extent of the conflict and that Compact
provisions that are in conflict with a state
constitution shall be ineffective to the extent of the
conflict.
Section 08.64.750- Allows the state medical board to
designate a compact administer to facilitate that
administration of the Compact across state departments
and agencies.
5:00:35 PM
MS. HANSEN reviewed the final section, Section 8, which read:
Section 8- Amends existing Alaska statute AS 12.62.400
to allow the Department of Public Safety to submit
fingerprints to the Federal Bureau of Investigation to
obtain a national criminal background check for
physicians applying for expedited licensure.
[HB 237 was held over]
5:01:07 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 |
|---|---|---|
| HB260 ver A.pdf |
HHSS 1/28/2016 3:00:00 PM HHSS 3/15/2016 3:00:00 PM |
HB 260 |
| HB260 Sectional Analysis.pdf |
HHSS 1/28/2016 3:00:00 PM HHSS 3/15/2016 3:00:00 PM |
HB 260 |
| HB260 Sponsor statement_Governor Transmittal Letter.pdf |
HHSS 1/28/2016 3:00:00 PM HHSS 3/15/2016 3:00:00 PM |
HB 260 |
| HB260 Fiscal Note_DHSS-CCB-1-16-16.pdf |
HHSS 1/28/2016 3:00:00 PM HHSS 3/15/2016 3:00:00 PM |
HB 260 |
| HB260 Fiscal Note_DOR-PFD-01-19-2016.pdf |
HHSS 1/28/2016 3:00:00 PM HHSS 3/15/2016 3:00:00 PM |
HB 260 |
| HB262 ver A.pdf |
HHSS 1/28/2016 3:00:00 PM HHSS 3/15/2016 3:00:00 PM |
HB 262 |
| HB262 Sponsor Statement_Governor Transmittal Letter.pdf |
HHSS 1/28/2016 3:00:00 PM HHSS 3/15/2016 3:00:00 PM |
HB 262 |
| HB262 Fiscal Note_DHSS-SBPP 1-23-16.pdf |
HHSS 1/28/2016 3:00:00 PM HHSS 3/15/2016 3:00:00 PM |
HB 262 |
| HB262 Sectional Analysis.pdf |
HHSS 1/28/2016 3:00:00 PM HHSS 3/15/2016 3:00:00 PM |
HB 262 |
| HB 226 ver a.PDF |
HHSS 1/28/2016 3:00:00 PM |
HB 226 |
| HB 226 Sponsor Statement.pdf |
HHSS 1/28/2016 3:00:00 PM |
HB 226 |
| HB 226 Fiscal Note_DHSS-COA-1-25-16.pdf |
HHSS 1/28/2016 3:00:00 PM |
HB 226 |
| HB 226 Background_Commission fact sheet.pdf |
HHSS 1/28/2016 3:00:00 PM |
HB 226 |
| HB 226 Support Letters.pdf |
HHSS 1/28/2016 3:00:00 PM |
HB 226 |
| HB 226 Backgound_ACOA sunset audit executive summary.pdf |
HHSS 1/28/2016 3:00:00 PM |
HB 226 |
| HB 237 Background_Letter Dr Kusano_Licensing issues.pdf |
HHSS 1/28/2016 3:00:00 PM HHSS 3/15/2016 3:00:00 PM |
HB 237 |