04/11/2017 03:00 PM House HEALTH & SOCIAL SERVICES
| Audio | Topic |
|---|---|
| Start | |
| HB159 | |
| HB25 | |
| HB118 | |
| SB32 | |
| Adjourn |
+ teleconferenced
= bill was previously heard/scheduled
| *+ | HB 118 | TELECONFERENCED | |
| + | SB 32 | TELECONFERENCED | |
| + | TELECONFERENCED | ||
| += | HB 159 | TELECONFERENCED | |
| += | HB 25 | TELECONFERENCED | |
ALASKA STATE LEGISLATURE
HOUSE HEALTH AND SOCIAL SERVICES STANDING COMMITTEE
April 11, 2017
3:06 p.m.
MEMBERS PRESENT
Representative Ivy Spohnholz, Chair
Representative Bryce Edgmon, Vice Chair
Representative Sam Kito
Representative Geran Tarr
Representative David Eastman
Representative Jennifer Johnston
Representative Colleen Sullivan-Leonard
MEMBERS ABSENT
Representative Matt Claman (alternate)
Representative Dan Saddler (alternate)
COMMITTEE CALENDAR
HOUSE BILL NO. 159
"An Act relating to the prescription of opioids; establishing
the Voluntary Nonopioid Directive Act; relating to the
controlled substance prescription database; relating to the
practice of dentistry; relating to the practice of medicine;
relating to the practice of podiatry; relating to the practice
of osteopathy; relating to the practice of nursing; relating to
the practice of optometry; relating to the practice of
veterinary medicine; related to the duties of the Board of
Pharmacy; and providing for an effective date."
- MOVED CSHB 159(HSS) OUT OF COMMITTEE
HOUSE BILL NO. 25
"An Act relating to insurance coverage for contraceptives and
related services; relating to medical assistance coverage for
contraceptives and related services; and providing for an
effective date."
- MOVED CSHB 25(HSS) OUT OF COMMITTEE
HOUSE BILL NO. 118
"An Act relating to compensation for wrongful conviction and
imprisonment."
- HEARD & HELD
SENATE BILL NO. 32
"An Act relating to biological products; relating to the
practice of pharmacy; relating to the Board of Pharmacy; and
providing for an effective date."
- HEARD & HELD
PREVIOUS COMMITTEE ACTION
BILL: HB 159
SHORT TITLE: OPIOIDS;PRESCRIPTIONS;DATABASE;LICENSES
SPONSOR(s): RULES BY REQUEST OF THE GOVERNOR
03/06/17 (H) READ THE FIRST TIME - REFERRALS
03/06/17 (H) HSS, FIN
03/18/17 (H) HSS AT 3:00 PM CAPITOL 106
03/18/17 (H) Heard & Held
03/18/17 (H) MINUTE(HSS)
03/25/17 (H) HSS AT 3:00 PM CAPITOL 106
03/25/17 (H) -- MEETING CANCELED --
03/30/17 (H) HSS AT 3:00 PM CAPITOL 106
03/30/17 (H) Heard & Held
03/30/17 (H) MINUTE(HSS)
04/04/17 (H) HSS AT 3:00 PM CAPITOL 106
04/04/17 (H) Scheduled but Not Heard
04/08/17 (H) HSS AT 3:00 PM CAPITOL 106
04/08/17 (H) -- MEETING CANCELED --
04/11/17 (H) HSS AT 3:00 PM CAPITOL 106
BILL: HB 25
SHORT TITLE: INSURANCE COVERAGE FOR CONTRACEPTIVES
SPONSOR(s): CLAMAN
01/18/17 (H) PREFILE RELEASED 1/9/17
01/18/17 (H) READ THE FIRST TIME - REFERRALS
01/18/17 (H) HSS, FIN
02/28/17 (H) HSS AT 3:00 PM CAPITOL 106
02/28/17 (H) Heard & Held
02/28/17 (H) MINUTE(HSS)
03/09/17 (H) HSS AT 3:00 PM CAPITOL 106
03/09/17 (H) Heard & Held
03/09/17 (H) MINUTE(HSS)
04/06/17 (H) HSS AT 3:00 PM CAPITOL 106
04/06/17 (H) Scheduled but Not Heard
04/08/17 (H) HSS AT 3:00 PM CAPITOL 106
04/08/17 (H) -- MEETING CANCELED --
04/11/17 (H) HSS AT 3:00 PM CAPITOL 106
BILL: HB 118
SHORT TITLE: COMPENSATION FOR WRONGFUL CONVICTION
SPONSOR(s): KAWASAKI
02/13/17 (H) READ THE FIRST TIME - REFERRALS
02/13/17 (H) HSS, JUD, FIN
04/11/17 (H) HSS AT 3:00 PM CAPITOL 106
BILL: SB 32
SHORT TITLE: PRESCRIPTIONS FOR BIOLOGICAL PRODUCTS
SPONSOR(s): HUGHES
01/23/17 (S) READ THE FIRST TIME - REFERRALS
01/23/17 (S) HSS, L&C
02/10/17 (S) HSS AT 1:30 PM BUTROVICH 205
02/10/17 (S) Heard & Held
02/10/17 (S) MINUTE(HSS)
02/15/17 (S) HSS AT 1:30 PM BUTROVICH 205
02/15/17 (S) Moved SB 32 Out of Committee
02/15/17 (S) MINUTE(HSS)
02/17/17 (S) HSS RPT 2DP 1NR 1AM
02/17/17 (S) NR: WILSON
02/17/17 (S) DP: VON IMHOF, BEGICH
02/17/17 (S) AM: GIESSEL
03/07/17 (S) L&C AT 1:30 PM BELTZ 105 (TSBldg)
03/07/17 (S) Heard & Held
03/07/17 (S) MINUTE(L&C)
03/14/17 (S) L&C AT 1:30 PM BELTZ 105 (TSBldg)
03/14/17 (S) Moved SB 32 Out of Committee
03/14/17 (S) MINUTE(L&C)
03/15/17 (S) L&C RPT 5DP
03/15/17 (S) DP: COSTELLO, HUGHES, MEYER, STEVENS,
GARDNER
03/15/17 (S) FIN REFERRAL ADDED AFTER L&C
03/29/17 (S) FIN AT 9:00 AM SENATE FINANCE 532
03/29/17 (S) Heard & Held
03/29/17 (S) MINUTE(FIN)
03/30/17 (S) FIN AT 9:00 AM SENATE FINANCE 532
03/30/17 (S) Moved SB 32 Out of Committee
03/30/17 (S) MINUTE(FIN)
03/31/17 (S) FIN AT 1:30 PM SENATE FINANCE 532
03/31/17 (S) -- MEETING CANCELED --
04/03/17 (S) FIN RPT 1DP 3NR 1AM
04/03/17 (S) NR: MACKINNON, BISHOP, DUNLEAVY
04/03/17 (S) DP: VON IMHOF
04/03/17 (S) AM: OLSON
04/04/17 (S) TRANSMITTED TO (H)
04/04/17 (S) VERSION: SB 32
04/05/17 (H) READ THE FIRST TIME - REFERRALS
04/05/17 (H) HSS, FIN
04/11/17 (H) HSS AT 3:00 PM CAPITOL 106
WITNESS REGISTER
JAY BUTLER, M.D., Chief Medical Officer/Director
Central Office
Division of Public Health (DPH)
Department of Health and Social Services (DHSS)
Anchorage, Alaska
POSITION STATEMENT: Answered questions during the discussion of
HB 159.
REPRESENTATIVE MATT CLAMAN
Alaska State Legislature
Juneau, Alaska
POSITION STATEMENT: Presented the proposed CS for HB 25, as
prime sponsor of the bill.
LIZZIE KUBBITZ, Staff
Representative Matt Claman
Alaska State Legislature
Juneau, Alaska
POSITION STATEMENT: Presented the changes to HB 25, on behalf
of the prime sponsor, Representative Claman.
ANNA LATHAM, Deputy Director
Juneau Office
Division of Insurance
Department of Commerce, Community & Economic Development (DCCED)
Juneau, Alaska
POSITION STATEMENT: Answered questions during discussion of HB
25.
MICHELE MICHAUD, Chief Health Official
Central Office
Division of Retirement and Benefits (DRB)
Department of Administration (DOA)
Juneau, Alaska
POSITION STATEMENT: Answered questions during discussion of HB
25.
OLIVIA GARRETT, Staff
Representative Scott Kawasaki
Alaska State Legislature
Juneau, Alaska
POSITION STATEMENT: Presented HB 118 on behalf of the prime
sponsor, Representative Kawasaki.
KACI SCHROEDER, Assistant Attorney General
Legal Services Section
Criminal Division
Department of Law
Juneau, Alaska
POSITION STATEMENT: Answered questions during discussion of HB
118.
BARBARA BRINK
Alaska Innocence Project
Anchorage, Alaska
POSITION STATEMENT: Testified during discussion of HB 118.
DON HABEGER, Community Coordinator
Juneau Reentry Coalition
Juneau, Alaska
POSITION STATEMENT: Testified during discussion of HB 118.
DIANE CASTO, Behavioral Health Policy Advisor
Division of Behavioral Health
Department of Health and Social Services
Juneau, Alaska
POSITION STATEMENT: Testified during discussion of HB 118.
SENATOR SHELLEY HUGHES
Alaska State Legislature
Juneau, Alaska
POSITION STATEMENT: Presented SB 32 as prime sponsor.
THOMAS FELIX, M.D.
AMGEN
Washington, DC
POSITION STATEMENT: Testified during discussion of SB 32.
AIMEE BUSHNELL, Staff
Senator Shelley Hughes
Alaska State Legislature
Juneau, Alaska
POSITION STATEMENT: Presented SB 32 on behalf of the prime
sponsor, Senator Hughes.
ACTION NARRATIVE
3:06:25 PM
CHAIR IVY SPOHNHOLZ called the House Health and Social Services
Standing Committee meeting to order at 3:06 p.m.
Representatives Spohnholz, Sullivan-Leonard, Kito, Johnston,
Edgmon, and Tarr were present at the call to order.
Representative Eastman arrived as the meeting was in progress.
HB 159-OPIOIDS;PRESCRIPTIONS;DATABASE;LICENSES
3:07:44 PM
CHAIR SPOHNHOLZ announced that the first order of business would
be HOUSE BILL NO. 159, "An Act relating to the prescription of
opioids; establishing the Voluntary Nonopioid Directive Act;
relating to the controlled substance prescription database;
relating to the practice of dentistry; relating to the practice
of medicine; relating to the practice of podiatry; relating to
the practice of osteopathy; relating to the practice of nursing;
relating to the practice of optometry; relating to the practice
of veterinary medicine; related to the duties of the Board of
Pharmacy; and providing for an effective date."
3:08:04 PM
REPRESENTATIVE EDGMON moved to adopt the proposed committee
substitute (CS) for HB 159, labeled 30-GH1021\J, Bruce, 4/6/17,
as the working draft.
CHAIR SPOHNHOLZ objected for discussion.
3:08:34 PM
JAY BUTLER, M.D., Chief Medical Officer/Director, Central
Office, Division of Public Health (DPH), Department of Health
and Social Services (DHSS), said that Version J incorporated 4
amendments to address the core intent of HB 159 - to address the
floor of legal prescription opioids in Alaska's communities and
to improve patient safety. The first amendment incorporated
under Version J, he noted, would align language under HB 159
with the federal Comprehensive Addiction and Recovery Act (CARA)
to allow partial prescription fills without requiring voiding of
the remaining portion of the prescriptions, as addressed on page
24, Section 8, of Version J. Second, Version J would clarify
the role and responsibilities of the prescribing providers and
pharmacists filling the prescriptions. He stated, "The
intention of the bill all along was that the responsibility to
check [the] prescription drug monitoring program (PDMP) prior to
writing new prescriptions for schedule II and III medications
falls to the prescribers; whereas ... the responsibility for ...
populating the prescription drug monitoring program with ...
unfilled prescriptions falls to the pharmacist."
DR. BUTLER said the third amendment made under Version J would
address the implementation of the PDMP update frequency; it
would delay implementation of daily updates until July 2018 in
order to address the potential administrative burden on some of
the smaller pharmacies. Finally, he said there is an amendment
under Version J that would clarify the liability waiver for
advance directives that include not just failure to administer
an opioid but also the inadvertent administration of opioids to
a person who has an opioids advance directive on his/her medical
record. He said the related language is in Section 31, on page
27, of Version J.
3:11:15 PM
REPRESENTATIVE SULLIVAN-LEONARD directed attention to page 28,
Sections 32 and 33, and asked for clarification regarding the
justification for amended language related to correctional
facilities.
3:11:46 PM
DR. BUTLER replied that the reason for specifically calling out
correctional facilities is to make clear the goal of the updated
PDMP was never to include patients already institutionalized.
He said much of the focus has been on people who are
hospitalized. He said it was pointed out to his division that
it may not be clear that people who are in correctional
facilities are similarly institutionalized. He said he thinks
that what often has driven the over prescription of opioids has
been misapplication of data on hospitalized patients, which
shows people in a hospital receiving opioid medications are at
remarkably low risk of having subsequent substance misuse or
addiction as opposed to those who receive the drugs on an
outpatient basis. He said the change in language to include the
correctional facility is to clarify that someone who is begin
treated in the infirmary of a correctional facility during a
prolonged incarceration is being viewed similarly. He
specified, however, that someone being discharged from a
correctional facility on outpatient opioids would need to be
monitored under the PDMP.
3:13:52 PM
CHAIR SPOHNHOLZ removed her objection to the motion to adopt the
proposed committee substitute (CS) for HB 159, labeled 30-
GH1021\J, Bruce, 4/6/17, as the working draft. There being no
further objection, Version J was before the committee as the
working draft.
3:14:08 PM
CHAIR SPOHNHOLZ noted that an issue had been brought to her
attention regarding hospitals and emergency rooms that dispense
less than a 24-hour supply of opioids to patients leaving a
hospital. She said this relates to [Sections 32 and 33], about
which Representative Sullivan-Leonard just queried. She said
these supplies are dispensed as prepackaged supplies of medicine
and requiring such a small supply to be reported to the PDMP
would be an "overly onerous burden on inpatient hospital
pharmacies."
CHAIR SPOHNHOLZ moved to adopt Amendment 1, labeled 30-
GH1021\J.1, Bruce, 4/6/17, which read as follows:
Page 28, lines 5 - 7:
Delete "those administered to a patient at a
health care facility or a correctional facility,
except when prescribing opioids to an inmate at the
time of the inmate's release"
Insert "under the circumstances described in (u)
of this section [THOSE ADMINISTERED TO A PATIENT AT A
HEALTH CARE FACILITY]"
Page 28, lines 13 - 15:
Delete "administered to a patient at a health
care facility or a correctional facility, except when
prescribing opioids to an inmate at the time of the
inmate's release"
Insert "dispensed or administered under the
circumstances described in (u) of this section
[ADMINISTERED TO A PATIENT AT A HEALTH CARE FACILITY]"
Page 29, lines 7 - 9:
Delete "administered to a patient at a health
care facility or a correctional facility, except when
prescribing opioids to an inmate at the time of the
inmate's release"
Insert "dispensed or administered under the
circumstances described in (u) of this section"
Page 32, line 22:
Delete "a new subsection"
Insert "new subsections"
Page 32, following line 30:
Insert a new subsection to read:
"(u) A practitioner or a pharmacist is not
required to comply with the requirements of (a) and
(b) of this section if a controlled substance is
(1) administered to a patient at
(A) a health care facility; or
(B) a correctional facility;
(2) dispensed to a patient for an
outpatient supply of 24 hours or less at a hospital
(A) inpatient pharmacy; or
(B) emergency department."
Page 35, following line 11:
Insert a new bill section to read:
"* Sec. 51. Section 41 of this Act takes effect on
the effective date of secs. 21 and 23, ch. 25, SLA
2016."
Renumber the following bill sections accordingly.
Page 35, line 15:
Delete "secs. 45 - 52"
Insert "secs. 45 - 53"
CHAIR SPOHNHOLZ objected for purposes of discussion. She asked
Dr. Butler if he had seen Amendment 1.
DR. BUTLER said he had not seen the text of Amendment 1 but
understood the concept of it. In response to a follow-up
question, he reiterated that the focus of HB 159 is to address
the flood of opioids into Alaska's communities, and Amendment 1
would address small dispensing of medication. He said the
current law surrounding the PDMP does not require that
prescribers "check the PDMP" if dispensing less than a three-day
supply. He said the intent behind this is to incentivize the
subscription of smaller amounts [of opioids] and to reduce the
administrative burden. He surmised that Amendment 1 could
achieve a similar aim, as concerns the administrative burden on
hospital pharmacies, which dispense small amounts through the
emergency departments. He indicated that the administration
would not object [to Amendment 1].
3:16:20 PM
CHAIR SPOHNHOLZ removed her objection to the motion to adopt
Amendment 1. There being no further objection, Amendment 1 was
adopted.
3:16:45 PM
REPRESENTATIVE EDGMON moved to report CSHB 159, Version 30-
GH1021\J, Bruce, 4/6/17, as amended, out of committee with
individual recommendations and the accompanying fiscal notes.
There being no objection, CSHB 159(HSS) was moved from House
Health and Social Services Standing Committee.
3:17:08 PM
The committee took an at-ease from 3:17 p.m. to 3:19 p.m.
HB 25-INSURANCE COVERAGE FOR CONTRACEPTIVES
3:19:04 PM
CHAIR SPOHNHOLZ announced that the next order of business would
be HOUSE BILL NO. 25, "An Act relating to insurance coverage for
contraceptives and related services; relating to medical
assistance coverage for contraceptives and related services; and
providing for an effective date."
3:19:33 PM
REPRESENTATIVE EDGMON moved to adopt the proposed committee
substitute (CS) for HB 25, labeled 30-LS0261\J, Wallace,
3/31/17, as the working draft.
3:19:41 PM
CHAIR SPOHNHOLZ objected for discussion.
3:19:55 PM
REPRESENTATIVE MATT CLAMAN, Alaska State Legislature, stated
that proposed HB 25 sought to make prescriptive contraceptives
more easily available by mandating that health care insurers
provide coverage for a 12-month supply of contraceptives at one
time. He reported that his office had worked with individuals
from the Division of Insurance, (Department of Administration),
and the Department of Law to find language which captured active
state employee programs and allowed insurers and the state to
apply reasonable medical management techniques and cost
containment strategies when providing coverage for
contraceptives.
3:20:43 PM
LIZZIE KUBBITZ, Staff, Representative Matt Claman, Alaska State
Legislature, paraphrased the changes made to Version J [Included
in members' packets], which read:
"An Act relating to insurance coverage for
contraceptives and related services; relating to
medical assistance coverage for contraceptives and
related services; and providing for an effective
date."
Section 1 Amends AS 21.42.427(d) to give health care
insurers the ability to enact reasonable cost
containment measures and provides a definition of cost
containment. Adds a new subsection (e) which states
that if the covered therapeutically equivalent version
of a prescription contraceptive is not available or is
considered medically inadvisable, a health care
provider shall provide coverage without cost sharing
for an alternative version of the prescription
contraceptive.
Section 2 Amends AS 39.30.090(a) by adding a new
subsection (13) to include: "a group health insurance
policy covering employees of a participating
governmental unit is subject to the requirements of AS
21.42.427."
Section 3 Amends AS 39.30.091 to include: "a self-
insured group medical plan covering active employees
provided under this section is subject to the
requirements of 21.42.427."
3:23:34 PM
REPRESENTATIVE JOHNSTON asked if all state employees, except
retirees, as well as other public employees, would be covered.
She asked which programs would not be covered by this proposed
bill.
MS. KUBBITZ replied that the Department of Administration had
advised the sponsor to only attempt to capture active state
employees.
REPRESENTATIVE JOHNSTON asked if this would apply to private
employer programs.
MS. KUBBITZ reiterated that AS 39 would only capture state
employees; however, other portions of the proposed bill would
apply to Medicaid and private employers. She said that Version
J would ensure that active state employees were included.
REPRESENTATIVE JOHNSTON asked about other public employees,
including the self-insured Municipality of Anchorage.
MS. KUBBITZ said that she would defer that question to the
Department of Administration. She offered her belief that
municipal employees had not been included in any of the bill
discussions.
REPRESENTATIVE JOHNSTON expressed her concern that private
individuals and companies were required to participate, although
state employees had been excluded. She stated that "I am trying
to look for what is fair is fair."
3:26:57 PM
REPRESENTATIVE CLAMAN pointed out that the proposed Version J
specifically addressed earlier questions for coverage to state
employees. He opined that it would get even more complicated
for coverage of municipalities, although many of these programs
participated in state programs, even though it was not intended
to give them an out.
REPRESENTATIVE JOHNSTON declared that it would be necessary for
this to be addressed.
3:28:29 PM
ANNA LATHAM, Deputy Director, Juneau Office, Division of
Insurance, Department of Commerce, Community & Economic
Development (DCCED), in response to earlier questions, stated
that the proposed bill did not cover municipal plans, although
other vetted language could be added to include them. She
offered her belief that the sponsor only intended to include
active state employees.
3:29:18 PM
REPRESENTATIVE JOHNSTON directed attention to page 5, lines 28 -
29, which stated that a group health policy was subject to AS
21.42.427 and asked if this would cover the municipalities.
3:30:05 PM
MS. LATHAM opined that this would not cover municipalities, but
she deferred to the Department of Law.
REPRESENTATIVE JOHNSTON asked if this would also apply to the
government bargaining units.
3:30:58 PM
MICHELE MICHAUD, Chief Health Official, Central Office, Division
of Retirement and Benefits (DRB), Department of Administration
(DOA), in response, stated that the Municipality of Anchorage
was not currently participating, although it could. She stated
that there were union health trusts which were not covered under
the Alaska Care plan, as they were exempted through regulation,
and these would also not be covered under the proposed bill.
3:32:02 PM
The committee took a brief at ease.
3:32:25 PM
CHAIR SPOHNHOLZ removed her objection. There being no further
objection, Version J was adopted as the working draft.
3:32:59 PM
REPRESENTATIVE JOHNSTON expressed her concern that moving
forward a certain element of the population would be segregated
out. She said that she would probably be a no vote and would
recommend an amendment.
3:33:28 PM
REPRESENTATIVE SULLIVAN-LEONARD said that she struggled with the
mandate aspect of the proposed legislation for certain coverage
of contraceptives, and she could not conceptually support the
legislation.
3:34:29 PM
REPRESENTATIVE EDGMON moved to report CSHB 25, Version 30-
LS0261\J, Wallace, 3/31/17, out of committee with individual
recommendations and the accompanying fiscal notes.
3:34:41 PM
REPRESENTATIVE EASTMAN objected. He said that much of the early
testimony dealt with obtaining prescriptions, and yet the
proposed bill was much broader based, directing attention to the
voluntary sterilization procedures, the consultations,
examinations, procedures, and medical services. He opined that
the State of Alaska should not require that insurance coverage
be provided for these items.
3:35:41 PM
REPRESENTATIVE EASTMAN maintained his objection.
3:35:46 PM
A roll call vote was taken. Representatives Spohnholz, Edgmon,
Kito, and Tarr voted in favor of CSHB 25. Representatives
Sullivan-Leonard, Eastman, and Johnston voted against it.
Therefore, CSHB 25(HSS) was reported out of the House Health and
Social Services Standing Committee by a vote of 4 yeas-3 nays.
3:36:21 PM
The committee took an at-ease from 3:36 p.m. to 3:39 p.m.
HB 118-COMPENSATION FOR WRONGFUL CONVICTION
3:39:18 PM
CHAIR SPOHNHOLZ announced that the next order of business would
be HOUSE BILL NO. 118, "An Act relating to compensation for
wrongful conviction and imprisonment."
3:39:46 PM
OLIVIA GARRETT, Staff, Representative Scott Kawasaki, Alaska
State Legislature, presented proposed HB 118 on behalf of the
bill sponsor, Representative Kawasaki. She stated that HB 118
would create an administrative process so that those who were
wrongfully convicted of crimes and subsequently served time in
prison would be able to apply for compensation for time served.
She paraphrased from the Sectional Analysis [Included in
members' packets], which read:
Section 1. Amends AS 44.29.20 by adding a subsection
that directs the Department of Health and Social
Services to establish a re-entry program to assist
wrongfully convicted persons in obtaining mental
health services, including treatment for post-
traumatic stress disorder.
Section 2. Provides that every claim of reimbursement
for wrongful conviction and imprisonment shall be
promptly presented to the appropriate administrative
or executive officer of a department or branch for
approval or payment.
Section 3.
(a) Establishes that a person must file a claim with
the attorney general to receive compensation, and must
show by preponderance of the evidence that they were
convicted of one or more offenses and served any or
all of the resulting sentence and:
(1) either the conviction for the resulting sentence
was vacated or reversed and the charges were later
dismissed or the person was retried and found not
guilty, or the person was pardoned.
(2) the person did not commit any of the crimes of
which they were convicted, commit perjury, get another
person to commit perjury or fabricate evidence. A
false confession, admission, or guilty plea does not
entitle a person to compensation for wrongful
conviction.
(b) States that compensation for wrongful convictions
only extends to the specific case and does not include
compensation for a concurrent sentence.
(c) States that individuals receiving compensation for
wrongful conviction will receive $50,000 dollars for
each year of imprisonment up to a lifetime total of
$2,000,000.
(d) States that a person who has received compensation
for wrongful conviction by the State of Alaska may not
bring any further action to the state or
municipalities regarding the same subject matter for
which they have received compensation.
(e) States that an individual must file a claim for
compensation within 2 years after their exoneration,
however the attorney general may authorize payment for
a claim filed past that time if they determine that
there is good cause for delay.
(f) Lists social services and programs a person
receiving compensation for wrongful conviction is
entitled to.
1) Reentry services as provided by the Department of
Health and Social Services under AS 44.29.020.
2) Tuition and fees at any University of Alaska campus
for themselves and any children or stepchildren ages
17-26.
3) 3 years of job training services through
appropriate state programs.
4) Up to 10 years of state funded healthcare coverage.
5) Economic damages including lost wages and attorney
fees.
(g) States that all compensation provided under this
section, except for awarded attorney fees, is exempt
from taxation and that it may not be used to offset
expenses incurred by the state in providing services
to the person during their imprisonment.
Section 4. The claimant may appeal the decision
through the Department of Administration and they may
obtain a judicial review of the decision. Amends AS
44.77.040(c) so that anyone who is denied a claim for
wrongful conviction compensation is prevented from
taking further action against the state for the same
claim.
Section 5. Claims made for compensation for wrongful
convictions fall under claims and appeals procedures
under AS 44.77.010- 44.77.060 even if a department or
branch already has separate claims and appeals
procedures.
3:43:44 PM
REPRESENTATIVE JOHNSTON asked for the list of states that
already had some form of the proposed bill.
MS. GARRETT, in response, offered her belief that 31 states, as
well as the District of Columbia, provided for wrongful
conviction compensation.
REPRESENTATIVE JOHNSTON asked how this would integrate into the
court system. She offered her belief that once a wrongful
conviction was recognized by the courts, it became a legal issue
for how to compensate and what was done in each matter, as part
of the settlement. She asked if the proposed bill would
supersede any legal discussion.
MS. GARRETT asked for further clarification.
REPRESENTATIVE JOHNSTON opined that there had been negotiation
and settlement at the court level.
3:45:45 PM
KACI SCHROEDER, Assistant Attorney General, Legal Services
Section, Criminal Division, Department of Law, asked for
clarification of the question.
REPRESENTATIVE JOHNSTON in response, questioned whether the
legal process for wrongful conviction would be superseded by the
proposed bill, and she expressed her concern that the proposed
bill was overstepping.
MS. SCHROEDER stated that the department did not see this as
limiting anything in the settlement context.
3:47:36 PM
REPRESENTATIVE JOHNSTON asked if, in other states with this
legislation, had this decreased the state's liability for
wrongful convictions.
MS. GARRETT replied that she did not have the information but
that she would provide it to the members.
3:48:31 PM
BARBARA BRINK, Alaska Innocence Project, stated her support of
the proposed bill. She shared her background as a state and
federal public defender for more than 30 years, representing
indigent people who were accused of crimes and then tried in the
state and federal courts. She offered her belief, in review of
compensation statutes in other states, that the proposed bill
had taken "the best bits that other states have tried, and not
taken the parts that haven't been successful." She opined that
32 states and the federal government "already try to make whole
those who have been wrongfully convicted and then exonerated
with their own compensation statutes." She pointed out that the
proposed bill would fill a recognized need for Alaska. She
stated that the proposal to provide a reentry service program,
assist with job training and skills, tuition and fees, and 10
years of health insurance were especially needed when a person
was released from custody after a long period of incarceration.
She noted that these people had lost touch with societal
expectations, pointing out how difficult this could be for
someone. She reported that the annual $50,000 compensation was
in the "middle of the pack of what other jurisdictions provide
for the wrongfully convicted." She offered some examples from
California, Texas, and Colorado. She reported that the federal
government paid $50,000 for each year of incarceration, and
$100,000 for each year if someone had been on death row. She
added that most states allowed for inflation adjustment. She
offered her belief that it was beneficial to have public
recognition by the government for the harm inflicted on people
who were wrongfully convicted. She stated that the proposed
bill was an assurance to the public that the state government
would take ownership of the errors, and that the state was
working to ensure the integrity of the criminal justice system.
She opined that this was good for the state, as it was an
exclusive remedy, comparing it to the workers' compensation
statute. She pointed out that this could reduce the liability
for a state as it would no longer be bombarded by lawsuits from
those who had been exonerated. She reported that it was
estimated that between 8 and 12 percent of individuals in the
criminal justice system had been wrongfully convicted. She
stated that this was a uniform, fair, equitable procedure to
allow for some compensation for the wrong that had been done.
3:53:53 PM
REPRESENTATIVE TARR asked for other examples of cases.
MS. BRINK replied that the Fairbanks 4 case was the only case
the Innocence Project had obtained in Alaska for exoneration.
She noted that the appellate process could also bring
exoneration, although she had no records for the numbers of
cases each year.
3:54:56 PM
CHAIR SPOHNHOLZ shared that the proposed bill simplified things
from the state perspective as it allowed exact knowledge of the
promises to those wrongfully convicted. She asked if there were
any specific elements which were key to ensure people's success
to get over the trauma for loss of freedom as they move forward.
3:56:02 PM
MS. BRINK, in response, said that the first provision to provide
assistance through the Department of Health and Social Services
was one that many states had neglected to include, noting that
even financial compensation did not guarantee success to
exonerees. She offered her belief that the proposed bill did
well in setting forth the grounds that would show exoneration
and what would not demonstrate exclusion. She lauded Section 3
which covered all the issues which had gone wrong in other
states.
3:57:36 PM
REPRESENTATIVE JOHNSTON asked about the indeterminate fiscal
note, and she asked about the payments made outside the
Department of Law's operating appropriation. She asked what the
source of funds would be.
3:58:33 PM
MS. SCHROEDER, in response, explained that this would clarify
that the payments would not come from the Department of Law
budget; although the settlement negotiations and subsequent
settlements would appear as a budget request from the general
fund.
3:59:34 PM
DON HABEGER, Community Coordinator, Juneau Reentry Coalition,
referred to a pamphlet [Included in members' packets] and
explained that the Juneau Reentry Coalition was a collaboration
of individuals, community stakeholders, public and not for
profit agencies, and faith-based business partners who were
united in commitment to reduce recidivism among ex-offenders
returning to the community of Juneau. He reported that the
coalition was a small group effort that got started in 2013 and
grew into a larger effort with a steering team, community
membership, and eight different work groups, which he listed.
When the work group reports come back to the coalition, there
was work to resolve these issues. He mentioned the current
partnerships with the Alaska Mental Health Trust Authority, the
Department of Corrections, and the Department of Health and
Social Services. He noted that these partnerships included a
re-entry case manager from Department of Health and Social
Services who worked with Department of Corrections, utilizing a
pre-release form for work on all the issues and services needed
to enter the community successfully. He reported that, upon
release, a plan for securing resources and successful use of
supports and treatments was put into place.
4:05:28 PM
DIANE CASTO, Behavioral Health Policy Advisor, Division of
Behavioral Health, Department of Health and Social Services,
expressed support for the proposed bill, and explained that the
proposed bill mentioned the Department of Health and Social
Services for mental health services, including post-traumatic
stress disorders, and for re-entry services. She directed
attention to the 10 years of state funded coverage. She
reported that re-entry work was already in progress, and that
Medicaid Expansion had provided coverage for almost all
individuals leaving the correctional system, offering mental
health services and Medicaid services. She noted that there was
a re-entry center in Anchorage for partners, as well as
coalitions in Fairbanks, Matanuska-Susitna, Juneau, Kenai, Nome,
and Anchorage. She added that there was active solicitation for
three additional communities, which included Dillingham, Bethel,
and Ketchikan. She explained that these coalitions were a group
of people, services, and agencies in the community committed to
doing this work and ensuring that individuals had the best
opportunity possible when leaving a correctional institution.
She listed jobs, housing, and treatment as the highest
priorities for individuals.
MS. CASTO moved on to discuss the proposal for state funded
health coverage for 10 years and offered her belief that this
had to be equivalent to medical assistance services available in
AS 47.07.030, the Medicaid program. She offered clarification
for what was currently doable and what might be doable even
though it had not yet been fully examined. She relayed that
most individuals covered by the proposed bill would be Medicaid
eligible, as the compensation would be tax deductible and "would
not count against this individual being eligible for Medicaid."
This would allow for immediate enrollment, with coverage for
treatment and health care services. She explained that it
became more complicated as they began to make more money, as
they would move out of the eligibility range for Medicaid. She
pointed out that it would become necessary to determine what
kind of insurance coverage was intended in the proposed bill.
She offered the possibility for the Division of Insurance,
(Department of Administration), to purchase health care
equivalent to Medicaid. She suggested that a state only
Medicaid funded program, solely for this use which would not use
federal money, could be set up. She declared a need for this to
be further examined so that the Department of Health and Social
Services (DHSS) was clear for its responsibilities. She pointed
out that DHSS did not offer any insurance other than Medicaid.
4:14:12 PM
CHAIR SPOHNHOLZ announced that HB 118 would be held over.
SB 32-PRESCRIPTIONS FOR BIOLOGICAL PRODUCTS
4:14:22 PM
CHAIR SPOHNHOLZ announced that the final order of business would
be SENATE BILL NO. 32, "An Act relating to biological products;
relating to the practice of pharmacy; relating to the Board of
Pharmacy; and providing for an effective date."
4:15:12 PM
SENATOR SHELLEY HUGHES, Alaska State Legislature, paraphrased
from the Sponsor Statement [Included in members' packets], which
read:
Senate Bill 32 allows for Alaskans to have access to
safe, new, and effective treatment options called
interchangeable biological products. Under current
state law, pharmacists are allowed to substitute a
generic product for drugs that are identical to their
proprietary product but cannot do the same with
interchangeable biological products. Under SB 32,
pharmacists will be able to dispense an FDA approved
interchangeable product as a substitute for the
proprietary biological product.
Due to the complexity and nature of biological
products, an exact replication of these drugs is
impossible, so a new category of interchangeable
products was created by the FDA. This category of drug
allows for pharmaceutical companies to create safe and
affordable substitutes for drugs that help treat
conditions including cancer, multiple sclerosis,
severe rheumatoid arthritis, heart disease, and other
immune system, neurological and hematologic disorders.
In addition to the clear benefits to patients, the
lower costs and competition should also bring
measurable costs savings to Alaska's Medicaid program
and budget. The Center for Medicare and Medicaid
Services recommends that state Medicaid programs "view
the launch of biosimilar biological products as a
unique opportunity to achieve measurable cost savings
and greater beneficiary access to expensive
therapeutic treatments for chronic conditions."
SB 32 allows pharmacists to dispense interchangeable
biological products if they communicate this with the
prescribing doctor. This bill only allows a pharmacist
to substitute an interchangeable product if it is
approved by the FDA, and it allows for doctors to
require the pharmacist to only dispense the
proprietary product if they feel it is a more
effective option. Patient consent will also be
required before any substitution is made for an
interchangeable over the proprietary product.
It is important for Alaska to address this issue now
as more interchangeable products become available to
patients. Senate Bill 32 will allow for new and
effective options at a lower cost, without
jeopardizing patient safety, and will allow for
measurable Medicaid and budget savings for the State.
Please join in supporting access to an affordable
medication option for Alaskans.
SENATOR HUGHES reported that 31 states had already adjusted
statutes to allow for these bio-similars when they became
available, and that competition should make these much more
affordable than the original. She read: "state Medicaid
programs should view the launch of bio-similar biologic products
as a unique opportunity to achieve measurable cost savings and
greater beneficiary access to expansive therapeutic treatments
for chronic conditions." She reiterated that there were the
original biologic products, the bio-similar products, and now
the interchangeable product. The proposed bill would clarify
this in statute to allow for a pharmacist to substitute, with
patient consent and notification to the prescriber. She pointed
out that this proposed bill offered equal control to both
pharmacists and physicians.
4:22:07 PM
REPRESENTATIVE KITO asked about the character of the biologics.
He said that the generic drug replacement for a name brand drug
had the exact same chemical make-up. He offered his
understanding that patents did not allow biologics to use the
same process or procedure, even though they were aiming for the
same result. He asked if there were recognitions for how these
act or react to different people. He asked if these were the
same drug or different, or similar enough to be considered
similar to a generic.
SENATOR HUGHES said that the cells, as they were derived from
living organisms, would never be identical. Even with the same
process, these would be "incredibly similar but not identical."
She noted that this was part of the thorough FDA testing for
this new category. She declared that the drugs would have to
reach a level of no clinical difference in results to the
original or the interchangeable drugs.
4:24:19 PM
REPRESENTATIVE SULLIVAN-LEONARD asked about the aspect of the
bio-chemical use for pharmaceuticals, and whether this included
blood born pathogens or blood products.
4:25:03 PM
THOMAS FELIX, M.D., AMGEN, explained that the definition for
biologics in federal statute was very broad, and included
vaccines and blood products and components. He said it was
important to realize that blood components were not currently
being considered for bio-similar development. He noted that the
focus was for products created in a living cell that either
mimicked something already existing in our body such as insulin,
or something that targeted a pathway of disease that would
interfere with a cell cycle for growth related to a tumor cell
or a growth around a tumor.
REPRESENTATIVE SULLIVAN-LEONARD asked if stem cells would be
interspersed in this biological system.
DR. FELIX, in response, said that stem cells were biologics in
terms of concepts, but bio-similars would not be stem cell
therapies. He explained that stem cells were what was
administered to a patient as therapy, whereas biologics and bio-
similars were derived from cells, which were not embryonic or
human cells, to make it produce a protein which was then
isolated, purified from the cell, and injected into the patient
as a therapy.
4:27:25 PM
CHAIR SPOHNHOLZ asked if all insulin were derived from the same
original set of cells, and therefore not a bio-similar or
biologic interchangeable.
DR. FELIX pointed out that insulins were covered by a separate
legal and regulatory pathway, the Federal Food, Drug, and
Cosmetic Act. By 2020, these insulins would be rolled into the
legal and regulatory pathway for approval of biologics, the
Public Health Service Act. He shared that the history for
making insulins had evolved over time, as it used to be
collected from animals, whereas now a cell was programmed to
produce the insulin more closely to a human insulin. He shared
that there was a spectrum of complexity of other types of
biologics which were more complex than insulin. He pointed out
that a standard biologic technology called a monoclonal antibody
was used, which could target a pathway of disease or a healthy
pathway.
4:29:56 PM
CHAIR SPOHNHOLZ asked if insulin had been traditionally held
under an older regulatory model and, in 2020, this would be
rolled into the more modern laws which related to biologics.
DR. FELIX expressed his agreement and said that insulins and
other older biologics which had been approved a long time ago
and were much simpler would be transitioned, with a very strict
scientific standard for inclusion based on the number of amino
acids each contained.
CHAIR SPOHNHOLZ reflected on the definition of biologic
interchangeables, which were designed to have the same
therapeutic outcome, even though they were not exactly 100
percent replicable. She asked if this was related to
proprietary law or if it was a biological limitation.
DR. FELIX explained that when a bio similar was developed, there
was not a recipe book for the process to manufacture the
original, hence the need to reverse engineer from an original
reference products vial or injection device. He shared that
keeping an understanding of the intellectual property landscape
in mind would include, in the development, an approach for a
slight structural variation whether or not it had clinical
significance that was important. He pointed out that, once
approved, these would be highly similar to an existing product.
He emphasized that this was very different than the way generics
were approved, as they typically did not require clinical
trials. He said that it would require clinical trials for a bio
similar or for an interchangeable biologic product.
CHAIR SPOHNHOLZ mused that there was both a cellular reason for
difference as well as for avoidance of conflict for intellectual
property.
4:34:20 PM
AIMEE BUSHNELL, Staff, Senator Shelley Hughes, Alaska State
Legislature, paraphrased from the Sectional Analysis [Included
in members' packets], which read:
Sec. 1 AS 08.80.030 Adds a new subsection requiring
the Board of Pharmacy to have a link on the board's
website to the United States Food and Drug
Administration's (FDA) list of approved
interchangeable biological products.
Sec. 2 AS 08.80.294 Amends this section by requiring
a pharmacist to include on the label of a biological
product container the proprietary or proper name of
the biological product. This section also includes
language to differentiate between drugs that are and
are not biological products to ensure that statutes
regarding equivalent generic drugs are not
substantively changed.
Sec. 3 AS 08.80.294 Adds a new subsection to define
the term "proper name" being the name that reflects
scientific characteristics of a biological product.
This new subsection also defines "proprietary name"
which is the trademarked and registered name of the
product.
Sec. 4 AS 08.80.295 Adds language to differentiate
between equivalent drug products and interchangeable
biological products.
Sec. 5 AS 08.80.295 Adds new subsections to provide
guidelines as to how pharmacists or their designee
will need to communicate with a prescribing doctor
when dispensing a biological or interchangeable
biological product if an interchangeable product is
available.
Under subsection (c), a pharmacist must communicate to
the prescribing doctor the name and manufacturer of
the biological product provided to the patient. This
communication must happen within three days after
dispensing the product by an entry through an
interoperable electronic medical records system, an
electronic prescribing technology, a pharmacy benefit
management system, or a pharmacy record. If an entry
under this subsection is not possible, the pharmacist
may communicate by e-mail, telephone, fax, or by any
other prevailing means.
Under subsection (d) provides an exception to the
communication requirement under (c) if the dispensed
biological product is a refill of the prescription and
is the same biological product. Subsection (e)
provides that communication provided under (c)(1) of
this section is providing notice to the prescribing
doctor. Under subsection (f), a pharmacist is required
to maintain a record for two years after a biological
product is dispensed. Finally subsection (g) defines
"designee" as an agent or employee of a pharmacist who
has been authorized to communicate information under
subsection (c).
Sec. 6 AS 08.80.480(34) Changes language, and gives
option to change the term "drug" and "equivalent drug"
to "biological product" and "interchangeable
biological product".
Sec. 7 AS 08.80.480 Adds new subsection (37) to define
term "biological product". Adds new subsection (36) to
define term "interchangeable biological product" as a
biological product as determined by the United States
Food and Drug Administration. Under subsection (A)
provides that it meets the standard for
interchangeability under US code (Regulation of
biological products, Safety standards for determining
interchangeability). Under subsection (B) provides
that it is therapeutically equivalent in the most
recent edition of the United States Food and Drug
Administration evaluations.
Sec. 8 AS 08.80.480 Amends this section by adding
transition regulations if necessary to implement
changes made by this Act. Having changes take place in
accordance with AS 44.62 (Administrative Procedure
Act) but not before the effective date of this Act.
Sec. 9 AS 08.80.480 Adds language that section 8 of
this Act takes effect July 1, 2017.
Sec. 10 AS 08.80.480 Adds language that this Act will
take effect January 1, 2018, except for a provided in
section 9.
MS. BUSHNELL stated that there were also several letters of
support, including from the Alaska State Hospital and Nursing
Home Association (ASHNHA) and from the Alaska State Medical
Association (ASMA). She pointed out that ASMA had first written
a letter of neutrality and, subsequently, had written a letter
of support for the proposed bill.
4:36:21 PM
CHAIR SPOHNHOLZ announced that SB 32 would be held over.
4:37:05 PM
ADJOURNMENT
There being no further business before the committee, the House
Health and Social Services Standing Committee meeting was
adjourned at 4:37 p.m.
| Document Name | Date/Time | Subjects |
|---|---|---|
| HB 159 Sectional Analysis ver A 3.6.17.pdf |
HHSS 3/18/2017 3:00:00 PM HHSS 3/25/2017 3:00:00 PM HHSS 3/30/2017 3:00:00 PM HHSS 4/4/2017 3:00:00 PM HHSS 4/11/2017 3:00:00 PM |
HB 159 |
| HB0159 ver A 3.6.17.pdf |
HHSS 3/18/2017 3:00:00 PM HHSS 3/25/2017 3:00:00 PM HHSS 3/30/2017 3:00:00 PM HHSS 4/4/2017 3:00:00 PM HHSS 4/11/2017 3:00:00 PM |
HB 159 |
| HB159 Fiscal Note DHSS-PHAS 3.6.17.pdf |
HHSS 3/18/2017 3:00:00 PM HHSS 3/25/2017 3:00:00 PM HHSS 3/30/2017 3:00:00 PM HHSS 4/4/2017 3:00:00 PM HHSS 4/11/2017 3:00:00 PM |
HB 159 |
| HB159 Sponsor Statement 3.6.17.pdf |
HHSS 3/18/2017 3:00:00 PM HHSS 3/25/2017 3:00:00 PM HHSS 3/30/2017 3:00:00 PM HHSS 4/4/2017 3:00:00 PM HHSS 4/11/2017 3:00:00 PM |
HB 159 |
| HB159 Supporting Document - Letter from Alaska Dental Society.pdf |
HHSS 3/25/2017 3:00:00 PM HHSS 3/30/2017 3:00:00 PM HHSS 4/4/2017 3:00:00 PM HHSS 4/11/2017 3:00:00 PM |
HB 159 |
| HB159 Supporting Document - PDMP side by side comparison 3.23.17.pdf |
HHSS 3/25/2017 3:00:00 PM HHSS 3/30/2017 3:00:00 PM HHSS 4/4/2017 3:00:00 PM HHSS 4/11/2017 3:00:00 PM |
HB 159 |
| HB159 Supporting Document - Opioid Bill FAQ 3.23.17.pdf |
HHSS 3/25/2017 3:00:00 PM HHSS 3/30/2017 3:00:00 PM HHSS 4/4/2017 3:00:00 PM HHSS 4/11/2017 3:00:00 PM |
HB 159 |
| HB 159 Governor's Amendment.pdf |
HHSS 3/30/2017 3:00:00 PM HHSS 4/4/2017 3:00:00 PM HHSS 4/11/2017 3:00:00 PM |
HB 159 |
| HB 159 Draft Proposed Proposed Amendment J.1 4.6.2017.pdf |
HHSS 4/8/2017 3:00:00 PM HHSS 4/11/2017 3:00:00 PM |
HB 159 |
| HB 159 Draft Proposed Blank CS ver J 4.6.2017.pdf |
HHSS 4/8/2017 3:00:00 PM HHSS 4/11/2017 3:00:00 PM |
HB 159 |
| HB025 Sectional Analysis ver A 2.16.17.pdf |
HHSS 2/28/2017 3:00:00 PM HHSS 3/9/2017 3:00:00 PM HHSS 4/6/2017 3:00:00 PM HHSS 4/11/2017 3:00:00 PM |
HB 25 |
| HB025 Opposing Document-Letter NFIB 2.16.17.pdf |
HHSS 2/28/2017 3:00:00 PM HHSS 3/9/2017 3:00:00 PM HHSS 4/6/2017 3:00:00 PM HHSS 4/11/2017 3:00:00 PM |
HB 25 |
| HB025 Sponsor Statement 2.16.17.pdf |
HHSS 2/28/2017 3:00:00 PM HHSS 3/9/2017 3:00:00 PM HHSS 4/6/2017 3:00:00 PM HHSS 4/11/2017 3:00:00 PM |
HB 25 |
| HB025 Supporting Document-ADN Commentary 2.16.17.pdf |
HHSS 2/28/2017 3:00:00 PM HHSS 3/9/2017 3:00:00 PM HHSS 4/6/2017 3:00:00 PM HHSS 4/11/2017 3:00:00 PM |
HB 25 |
| HB025 Supporting Document-Cost Savings Study 2.16.17.pdf |
HHSS 2/28/2017 3:00:00 PM HHSS 3/9/2017 3:00:00 PM HHSS 4/6/2017 3:00:00 PM HHSS 4/11/2017 3:00:00 PM |
HB 25 |
| HB025 Supporting Document-Guttmacher Alaska Statistics 2.16.17.pdf |
HHSS 2/28/2017 3:00:00 PM HHSS 3/9/2017 3:00:00 PM HHSS 4/6/2017 3:00:00 PM HHSS 4/11/2017 3:00:00 PM |
HB 25 |
| HB025 Supporting Document-Guttmacher Public Costs from Unintended Pregnancies 2.16.17.pdf |
HHSS 2/28/2017 3:00:00 PM HHSS 3/9/2017 3:00:00 PM HHSS 4/6/2017 3:00:00 PM HHSS 4/11/2017 3:00:00 PM |
HB 25 |
| HB025 Supporting Document-HB025 Support Emails 2.27.17.pdf |
HHSS 3/9/2017 3:00:00 PM HHSS 4/6/2017 3:00:00 PM HHSS 4/11/2017 3:00:00 PM |
HB 25 |
| HB025 Supporting Document-Letter Kachemak Bay Family Planning Clinic 2.23.17.pdf |
HHSS 2/28/2017 3:00:00 PM HHSS 3/9/2017 3:00:00 PM HHSS 4/6/2017 3:00:00 PM HHSS 4/11/2017 3:00:00 PM |
HB 25 |
| HB025 Supporting Document-Letter League of Women Voters Alaska 2.24.17.pdf |
HHSS 2/28/2017 3:00:00 PM HHSS 3/9/2017 3:00:00 PM HHSS 4/11/2017 3:00:00 PM |
HB 25 |
| HB025 Supporting Document-UCSF Study Newspaper Article 2.16.17.pdf |
HHSS 2/28/2017 3:00:00 PM HHSS 3/9/2017 3:00:00 PM HHSS 4/11/2017 3:00:00 PM |
HB 25 |
| HB025 Supporting Document-Unintended Pregnancies Study 2.16.17.pdf |
HHSS 2/28/2017 3:00:00 PM HHSS 3/9/2017 3:00:00 PM HHSS 4/6/2017 3:00:00 PM HHSS 4/11/2017 3:00:00 PM |
HB 25 |
| HB025 ver A 2.16.17.PDF |
HHSS 2/28/2017 3:00:00 PM HHSS 3/9/2017 3:00:00 PM HHSS 4/6/2017 3:00:00 PM HHSS 4/11/2017 3:00:00 PM |
HB 25 |
| HB025 Supporting Document-Letter Planned Parenthood Votes Northwest & Hawaii 2.16.17.pdf |
HHSS 2/28/2017 3:00:00 PM HHSS 3/9/2017 3:00:00 PM HHSS 4/6/2017 3:00:00 PM HHSS 4/11/2017 3:00:00 PM |
HB 25 |
| HB025 Fiscal Note DHSS-DHCS 2.28.17.pdf |
HHSS 2/28/2017 3:00:00 PM HHSS 3/9/2017 3:00:00 PM HHSS 4/6/2017 3:00:00 PM HHSS 4/11/2017 3:00:00 PM |
HB 25 |
| HB025 Fiscal Note DCCED-DIO 2.28.17.pdf |
HHSS 2/28/2017 3:00:00 PM HHSS 3/9/2017 3:00:00 PM HHSS 4/6/2017 3:00:00 PM HHSS 4/11/2017 3:00:00 PM |
HB 25 |
| HB025 Opposing Document-America's Health Insurance Plans 2.27.17.pdf |
HHSS 2/28/2017 3:00:00 PM HHSS 3/9/2017 3:00:00 PM HHSS 4/6/2017 3:00:00 PM HHSS 4/11/2017 3:00:00 PM |
HB 25 |
| HB025 Supporting Document-Letter Dr. Tina Tomsen 2.27.17.pdf |
HHSS 2/28/2017 3:00:00 PM HHSS 3/9/2017 3:00:00 PM HHSS 4/6/2017 3:00:00 PM HHSS 4/11/2017 3:00:00 PM |
HB 25 |
| HB025 Supporting Document-Support Emails 2.27.17.pdf |
HHSS 2/28/2017 3:00:00 PM HHSS 3/9/2017 3:00:00 PM HHSS 4/6/2017 3:00:00 PM HHSS 4/11/2017 3:00:00 PM |
HB 25 |
| HB025 Fiscal Note DHSS-Medicaid Services 2.28.17.pdf |
HHSS 2/28/2017 3:00:00 PM HHSS 3/9/2017 3:00:00 PM HHSS 4/6/2017 3:00:00 PM HHSS 4/11/2017 3:00:00 PM |
HB 25 |
| HB025 Supporting Document-HB025 Support Emails 3.7.17.pdf |
HHSS 3/9/2017 3:00:00 PM HHSS 4/6/2017 3:00:00 PM HHSS 4/11/2017 3:00:00 PM |
HB 25 |
| HB025 Opposing Document-Letters of Opposition 3.8.2017.pdf |
HHSS 3/9/2017 3:00:00 PM HHSS 4/6/2017 3:00:00 PM HHSS 4/11/2017 3:00:00 PM |
HB 25 |
| HB025 Summary of Changes ver J 4.5.17.pdf |
HHSS 4/6/2017 3:00:00 PM HHSS 4/11/2017 3:00:00 PM |
HB 25 |
| HB025 Proposed Blank CS ver J 4.5.17.pdf |
HHSS 4/6/2017 3:00:00 PM HHSS 4/11/2017 3:00:00 PM |
HB 25 |
| HB025 Supporting Document-HB025 Support Emails 4.5.17.pdf |
HHSS 4/6/2017 3:00:00 PM HHSS 4/11/2017 3:00:00 PM |
HB 25 |
| HB025 Supporting Document-Letter Alaska Pharmacists Association 4.5.17.pdf |
HHSS 4/6/2017 3:00:00 PM HHSS 4/11/2017 3:00:00 PM |
HB 25 |
| HB025 Supporting Document-Letter ANDVSA 4.5.17.pdf |
HHSS 4/6/2017 3:00:00 PM HHSS 4/11/2017 3:00:00 PM |
HB 25 |
| HB025 Supporting Document-Letter APRN Alliance 4.5.17.pdf |
HHSS 4/6/2017 3:00:00 PM HHSS 4/11/2017 3:00:00 PM |
HB 25 |
| HB025 Supporting Document-Letter Tanana Chiefs Conference 4.5.17.pdf |
HHSS 4/6/2017 3:00:00 PM HHSS 4/11/2017 3:00:00 PM |
HB 25 |
| SB032 Fiscal Note DOCCED 04.04.17.pdf |
HHSS 4/11/2017 3:00:00 PM |
SB 32 |
| SB032 Sectional Analysis ver J 04.04.17.pdf |
HHSS 4/11/2017 3:00:00 PM HHSS 4/13/2017 3:00:00 PM |
SB 32 |
| SB032 Opposing Document-Opposition Letters 04.04.17.pdf |
HHSS 4/11/2017 3:00:00 PM HHSS 4/13/2017 3:00:00 PM |
SB 32 |
| SB032 Sponsor Statement 04.04.17.pdf |
HHSS 4/11/2017 3:00:00 PM HHSS 4/13/2017 3:00:00 PM |
SB 32 |
| SB032 Supporting Documents-Support Letters 04.04.17.pdf |
HHSS 4/11/2017 3:00:00 PM HHSS 4/13/2017 3:00:00 PM |
SB 32 |
| SB032 ver J 04.04.17.pdf |
HHSS 4/11/2017 3:00:00 PM |
SB 32 |
| HB 118 Sponsor Satement 4.10.2017.pdf |
HHSS 4/11/2017 3:00:00 PM HHSS 4/13/2017 3:00:00 PM |
HB 118 |
| HB 118 Supporting Document - Doyon support letter 4.10.2017.pdf |
HHSS 4/11/2017 3:00:00 PM HHSS 4/13/2017 3:00:00 PM |
HB 118 |
| HB 118 Supporting Document - Medical Compsensation by State 4.10.2017.pdf |
HHSS 4/11/2017 3:00:00 PM HHSS 4/13/2017 3:00:00 PM |
HB 118 |
| HB 118 Supporting Document - PBS Article 4.10.2017.pdf |
HHSS 4/11/2017 3:00:00 PM HHSS 4/13/2017 3:00:00 PM |
HB 118 |
| HB 118 Supporting Document - Support letters 4.10.2017.pdf |
HHSS 4/11/2017 3:00:00 PM HHSS 4/13/2017 3:00:00 PM |
HB 118 |
| HB 118 Supporting Document - TCC letter of support 4.10.2017.pdf |
HHSS 4/11/2017 3:00:00 PM HHSS 4/13/2017 3:00:00 PM |
HB 118 |
| HB 118 Supporting Documents 4.10.2017.pdf |
HHSS 4/11/2017 3:00:00 PM HHSS 4/13/2017 3:00:00 PM |
HB 118 |
| HB 118 ver A 4.10.2017.PDF |
HHSS 4/11/2017 3:00:00 PM HHSS 4/13/2017 3:00:00 PM |
HB 118 |
| HB 118 Fiscal Note DHSS--BHTRG 4.10.17.pdf |
HHSS 4/11/2017 3:00:00 PM HHSS 4/13/2017 3:00:00 PM |
HB 118 |
| HB 118 Fiscal Note DOL--CJL 4.10.17.pdf |
HHSS 4/11/2017 3:00:00 PM HHSS 4/13/2017 3:00:00 PM |
HB 118 |
| HB 118 Sectional Analysis ver A 4.10.2017.pdf |
HHSS 4/11/2017 3:00:00 PM HHSS 4/13/2017 3:00:00 PM |
HB 118 |