03/21/2023 03:00 PM House HEALTH & SOCIAL SERVICES
| Audio | Topic |
|---|---|
| Start | |
| Confirmation Hearing(s): Department of Family and Community Services | |
| HB57 | |
| HB46 | |
| Adjourn |
+ teleconferenced
= bill was previously heard/scheduled
| + | TELECONFERENCED | ||
| + | HB 57 | TELECONFERENCED | |
| + | HB 46 | TELECONFERENCED | |
| + | TELECONFERENCED | ||
ALASKA STATE LEGISLATURE
HOUSE HEALTH AND SOCIAL SERVICES STANDING COMMITTEE
March 21, 2023
3:03 p.m.
MEMBERS PRESENT
Representative Mike Prax, Chair
Representative Justin Ruffridge, Vice Chair
Representative CJ McCormick
Representative Dan Saddler
Representative Jesse Sumner
Representative Zack Fields
Representative Genevieve Mina
MEMBERS ABSENT
All members present
COMMITTEE CALENDAR
CONFIRMATION HEARING(S):
Department of Family and Community Services
Kim Kovol Anchorage
- CONFIRMATION(S) ADVANCED
HOUSE BILL NO. 57
"An Act relating to review organizations and permitting an
emergency medical services provider to establish a review
organization; and relating to patient records."
- HEARD & HELD
HOUSE BILL NO. 46
"An Act allowing child care providers that receive state aid to
organize and collectively bargain with the Department of Health;
and establishing the child care provider fund."
- HEARD & HELD
PREVIOUS COMMITTEE ACTION
BILL: HB 57
SHORT TITLE: EMERGENCY MED. SVCS: REVIEW ORGANIZATIONS
SPONSOR(s): REPRESENTATIVE(s) WRIGHT
02/03/23 (H) READ THE FIRST TIME - REFERRALS
02/03/23 (H) L&C, HSS
02/17/23 (H) L&C AT 3:15 PM BARNES 124
02/17/23 (H) Heard & Held
02/17/23 (H) MINUTE(L&C)
03/03/23 (H) L&C AT 3:15 PM BARNES 124
03/03/23 (H) Moved HB 57 Out of Committee
03/03/23 (H) MINUTE(L&C)
03/06/23 (H) L&C RPT 4DP 1NR
03/06/23 (H) DP: SADDLER, PRAX, RUFFRIDGE, SUMNER
03/06/23 (H) NR: CARRICK
03/21/23 (H) HSS AT 3:00 PM DAVIS 106
BILL: HB 46
SHORT TITLE: CHILD CARE PROVIDER COLLECTIVE BARGAINING
SPONSOR(s): REPRESENTATIVE(s) FIELDS
01/25/23 (H) READ THE FIRST TIME - REFERRALS
01/25/23 (H) L&C, STA, FIN
01/30/23 (H) L&C AT 3:15 PM BARNES 124
01/30/23 (H) Heard & Held
01/30/23 (H) MINUTE(L&C)
02/10/23 (H) L&C AT 3:15 PM BARNES 124
02/10/23 (H) Heard & Held
02/10/23 (H) MINUTE(L&C)
02/20/23 (H) L&C AT 3:15 PM BARNES 124
02/20/23 (H) Heard & Held
02/20/23 (H) MINUTE(L&C)
02/27/23 (H) HSS REPLACES STA REFERRAL
02/27/23 (H) BILL REPRINTED
03/01/23 (H) L&C AT 3:15 PM BARNES 124
03/01/23 (H) Moved CSHB 46(L&C) Out of Committee
03/01/23 (H) MINUTE(L&C)
03/06/23 (H) L&C RPT CS(L&C) NEW TITLE 2DP 2NR 2AM
03/06/23 (H) DP: FIELDS, WRIGHT
03/06/23 (H) NR: PRAX, RUFFRIDGE
03/06/23 (H) AM: SADDLER, SUMNER
03/21/23 (H) HSS AT 3:00 PM DAVIS 106
WITNESS REGISTER
KIM KOVOL, Commissioner Designee
Department of Family and Community Services
Anchorage, Alaska
POSITION STATEMENT: Testified as commissioner designee of the
Department of Family and Community Services.
DAVID IGNELL, representing self
Juneau, Alaska
POSITION STATEMENT: Testified during the confirmation hearing
for commissioner of the Department of Family and Community
Services.
JASON FLOYD, representing self
Kenai, Alaska
POSITION STATEMENT: Testified during the confirmation hearing
for commissioner of the Department of Family and Community
Services.
YVETTE DEBLOIS, representing self
(No address provided)
POSITION STATEMENT: Testified during the confirmation hearing
for commissioner of the Department of Family and Community
Services.
JARED KOSIN, President, CEO
Alaska Hospital and Healthcare Association
Anchorage, Alaska
POSITION STATEMENT: Testified during the confirmation hearing
for commissioner of the Department of Family and Community
Services.
BILL GALIC, representing self
Anchorage, Alaska
POSITION STATEMENT: Testified during the confirmation hearing
for commissioner of the Department of Family and Community
Services.
CHRIS KOLEROK, Public Policy Director
Cook Inlet Housing Authority
Anchorage, Alaska
POSITION STATEMENT: Testified during the confirmation hearing
for commissioner of the Department of Family and Community
Services.
JASMINE BOYLE, representing self
Anchorage, Alaska
POSITION STATEMENT: Testified during the confirmation hearing
for commissioner of the Department of Family and Community
Services.
LAURIE VANDENBERG, representing self
Wasilla, Alaska
POSITION STATEMENT: Testified during the confirmation hearing
for commissioner of the Department of Family and Community
Services.
LINDA BREINER, representing self
Talkeetna, Alaska
POSITION STATEMENT: Testified during the confirmation hearing
for commissioner of the Department of Family and Community
Services.
REPRESENTATIVE STANLEY WRIGHT
Alaska State Legislature
Juneau, Alaska
POSITION STATEMENT: As the prime sponsor, presented HB 57.
PI RIORDAN-RANDALL, Staff
Representative Stanley Wright
Alaska State Legislature
Juneau, Alaska
POSITION STATEMENT: On behalf of Representative Wright, prime
sponsor, gave the sectional analysis of HB 57.
BRIAN WEBB, representing self
Anchorage, Alaska
POSITION STATEMENT: Provided invited testimony on HB 57.
JOSEPH LIVENGOOD, MD, representing self
Fairbanks, Alaska
POSITION STATEMENT: Provided invited testimony on HB 57.
CANDACE RICHEY, Owner
Candi's Tot Stop
North Pole, Alaska
POSITION STATEMENT: Testified in support of HB 46.
BRIAN HOLST, Executive Director
Juneau Economic Development Council
Juneau, Alaska
POSITION STATEMENT: Testified in support of HB 46.
EVAN ANDERSON, Staff
Representative Zach Fields
Alaska State Legislature
Juneau, Alaska
POSITION STATEMENT: On behalf of Representative Fields, prime
sponsor, presented CSHB 46 (L&C).
BRANDON SPANOS, Deputy Director
Tax Division
Department of Revenue
Eagle River, Alaska
POSITION STATEMENT: Answered questions relating to CSHB 46
(L&C).
ACTION NARRATIVE
3:03:11 PM
CHAIR MIKE PRAX called the House Health and Social Services
Standing Committee meeting to order at 3:03 p.m.
Representatives McCormick, Ruffridge, Sumner, Saddler, Fields,
Mina, and Prax were present at the call to order.
^CONFIRMATION HEARING(S): DEPARTMENT OF FAMILY AND COMMUNITY
SERVICES
3:04:19 PM
CHAIR PRAX announced that the first order of business would be
the confirmation hearing on the governor's appointee to the
Department of Family and Community Services.
3:05:27 PM
KIM KOVOL, Commissioner Designee, Department of Family and
Community Services (DFCS), shared that she has been acting
commissioner since July 1, 2022, after the reorganization of the
Department of Health and Social Services. Prior to being
appointed commissioner, she stated that she had served as the
governor's special assistant. Before this, she had spent 25
years working in private and nonprofit organizations. She said
she has been told that she has a "lovingly firm" leadership
style. She shared that she grew up in a traditional military
family, traveling nationally and internationally. After her
father retired, he and her mother, who worked in civil service,
helped refugees during Operation Eli on Grande Island,
Philippines. She said she has an administrative certification
in early child education and a master's degree in social work
from the University of Alaska Anchorage (UAA). She shared that
she is designated as a Leadership, Education, Neurodevelopmental
and Related Disabilities (LEND) fellow, focusing on service
access and availability for families and individuals living with
autism. She shared that two of her three children were
diagnosed with autism in preschool. She explained that DFCS is
new, but the divisions are not, and the reorganization will give
Alaskans an intensive level of engagement, focus, attention,
redress, and corrections.
3:09:44 PM
MS. KOVOL pointed out that she has visited DFCS employees across
the state, and she acknowledged the current workforce crisis.
She discussed a visit with the Office of Children's Services
(OCS) staff in the Bethel office where a caseworker talked about
her travels to remote sites to visit families and children. She
said that her vision for DFCS is to focus on "person first," as
well as ensuring a high standard of care to patients. She added
that other priorities include addressing the needs of staff,
workforce training, wellness training, wages, and retention.
She said that addressing the needs of youth and adults in DFCS's
care is an absolute priority, requiring both public and private
sectors to work together. She explained that she has received
feedback that reinforced the following opportunities:
collaborate and focus on delivery services and exchanges;
establish both divisional and department cross-programming
opportunities; encourage more internships and mentorships in
educational systems; and examine DFCS's role in the child
welfare and elder care systems in the state. She stressed that
adequate housing, access to nutrition, healthcare, safe
childhood experiences, and educational opportunities are part of
the overall system for healthy children, elders, families, and
communities.
3:13:01 PM
CHAIR PRAX opened public testimony on the confirmation hearing
for commissioner of the Department of Family and Community
Services.
3:13:32 PM
DAVID IGNELL, representing self, shared that he is a forensic
journalist in Juneau and has spent 10 years as a litigator in
equity courts. He informed members that he has submitted
numerous written comments and exhibits to the committee [copies
included in the committee packet]. He stated that the topic of
his testimony would be on how "bad" children are doing in the
state's care and under Ms. Kovol's leadership. As an example,
he named a child who was diagnosed with fetal alcohol syndrome,
autism, and attention deficit hyperactivity disorder (ADHD). He
expressed the understanding that this child was well cared for
by family until OCS took the child at 11 years old. Since this
time, the child has been moved 18 times. Offering another
example, he described a child, who was diagnosed with fetal
alcohol syndrome, autism, ADHD, depression, and bi-polar
disorder. He expressed the understanding that this child was
also being well cared for until taken by OCS at 15 years old.
He noted that this child has been moved 7 times in the last 2
years. He voiced an accusation that this child had been bribed
by OCS to miss a call with family. He gave a third, similar
example of another child, where OCS put the child in "a life-
threatening situation."
MR. IGNELL continued to the issue of Katelynn Shelhamer, who was
murdered two months after turning 18 years old. He expressed
the understanding that she had been in OCS's care and was
"trafficked" since she was 14 years old. He continued that
after Katelynn left OCS's care, she "started turning her life
around, according to a friend." He posed the question of
whether Katelynn was killed because "she knew too much." He
directed attention to the class action lawsuit filed in federal
court. He stated that there are 13 named plaintiffs in the
lawsuit, and this includes the three children described in his
previous examples of OCS's actions.
MR. IGNELL advised that the state is working to get the class
action lawsuit dismissed. He then addressed that the grand jury
investigations against OCS have been "hijacked" by state
officials. He recounted that six years ago former
Representative Tammie Wilson expressed the opinion that the
grand jury investigations into OCS were "hijacked." He
suggested that if those investigations had gone forward, Katelyn
would be alive today. Furthermore, he questioned who the next
Katelyn would be if this injustice is not stopped.
3:18:09 PM
CHAIR PRAX informed the testifier that the committee is unable
to discuss active legal cases.
3:19:10 PM
JASON FLOYD, representing self, shared that he was previously an
employee of OCS. He stated that he had been the executive
director of a department related to the Indian Child Welfare Act
(ICWA). He stated that he had also served two terms on the
Board of Social Work Licensing Examiners. He asserted that the
state continues to exempt itself from its own laws, specifically
AS 08.95, and AAC 12.18, which both are cited by the board as
the governing law for people practicing social work. He
explained that social workers often say they are not "social
workers," but "case managers;" however, he pointed out that the
OCS website lists these employees as being directed by the
National Association of Social Work Code of Ethics. He
expressed the opinion that commissioners should know the law, so
best practices are guided and overseen by the licensing
authority. He expressed the opinion that social workers are
changing job titles to exempt themselves from the law. He said
he was a social worker with OCS and carried a license for 11
years. He argued that he knows what best practice is and OCS is
not completing best practice. He shared that in his last case,
he had worked for a Tribe fighting OCS for two years concerning
the right placement for an ICWA child. Concerning this case, he
stated that the judge had said that "in all of her time on the
bench she had never seen such a miscarriage of justice and abuse
of power in her entire career." While he voiced appreciation
for Ms. Kovol's desire to help people, he argued that a position
as important as commissioner requires someone who has "boots on
the ground," is ethical, has practice experience, and is
committed to the licensure process.
3:23:31 PM
YVETTE DEBLOIS, representing self, said her testimony would
cover how OCS has victimized her family. She shared that her
brother, Thomas Jack, was a foster parent; however, she
expressed the opinion that because of OCS's manipulation, he is
now in prison. She referred members to the Powered by Justice's
website, which details Mr. Jack's case. She expressed the
importance of exposing these issues through a grand jury. She
suggested that if grand juries were stronger, there would be a
desire to fix the problems. She expressed low confidence in Ms.
Kovol's ability to do the job as commissioner and suggested that
grand juries should not be "rubberstamps" for prosecutors.
3:25:55 PM
CHAIR PRAX reminded testifiers that the committee could not talk
about specific cases that are currently in the court system.
3:26:14 PM
JARED KOSIN, President, CEO, Alaska Hospital and Healthcare
Association, expressed support for the appointment of Ms. Kovol.
He expressed the opinion that she is the perfect nominee to lead
the department, as she has made it clear that improving the
lives of Alaskan children, adults, and families is her highest
priority. On behalf of the association, he expressed support
for her confirmation as commissioner of DFCS.
3:27:37 PM
BILL GALIC, representing self, said that he holds a master's
degree in social work. He shared that he is a retired clinical
social worker and was a supervisor in the Kenai office for 19
years. He noted that he was an assistant professor with the UAA
School of Social Work. He said that Ms. Kovol was a student in
three of his master level classes and had a full career in the
social services field before returning to school for her
master's degree. He added that she also has experience managing
business in the private sector; therefore, she understands the
needs, problems, and costs associated with providing services.
He added that he was her field supervisor in the master's
program as she interned on the governor's staff for two years,
with the governor later appointing her as the special assistant
for social services. He expressed the opinion that Ms. Kovol
has both the personality and work ethic that suits the position.
He expressed wholehearted support for her confirmation as
commissioner of DFCS.
3:30:18 PM
CHRIS KOLEROK, Public Policy Director, Cook Inlet Housing
Authority, expressed full support for Ms. Kovol's confirmation
as commissioner of DFCS. He said that balancing public service
while completing a master's degree in social work speaks to her
dedication.
3:33:03 PM
JASMINE BOYLE, representing self, testified in support of Ms.
Kovol's appointment as commissioner of DFCS. She pointed out
that Ms. Koval has over 20 years in senior and executive
experience in child welfare and family services. She stated
that OCS is a "challenging beast" and needs improvement and
Alaskan families deserve better. She stated that she has worked
directly with Ms. Koval for five years in a variety of
professional roles and expressed the belief that Ms. Koval would
be a responsible commissioner of DFCS. She continued that even
though they have different political affiliations, they share "a
mutual, unwavering commitment to Alaskans, particularly those
most vulnerable in our state." She stated that she has worked
side-by-side with Ms. Kovol during a humanitarian crisis
regarding Anchorage homelessness and she has witnessed Ms.
Koval's immediate responses to those in crisis. She stated that
they "share the belief that it is absolutely possible to build
systems to care for our most vulnerable in a sustainable way."
She added that this includes creating a budget rooted in
reality.
3:36:59 PM
LAURIE VANDENBERG, representing self, shared that she is a
registered nurse and a prior foster parent. She said that,
while it sounds like Ms. Kovol has done a great amount of work,
she has not seen any of the results. She stated that her heart
breaks to hear that Ms. Koval has two children who are autistic,
but she has not stepped up to the injustices occurring in the
OCS system, as there are changes that could be made. She urged
that OCS be fixed, and she expressed the desire to speak with
Ms. Kovol about what changes could be done to help the program.
3:38:47 PM
LINDA BREINER, representing self, shared that she has known a
woman for two years who lost her five children to OCS. She
expressed the understanding that "OCS was claiming things that
were not true and have yet to prove her case, or even let her
defend herself." She explained that OCS has taken five
siblings, separated them, and moved them over 55 times. She
suggested that OCS continually disregards its own regulations,
and if Ms. Kovol is accepted, she asked that the case of these
children be investigated.
3:40:12 PM
CHAIR PRAX, after ascertaining that there was no one else who
wished to testify, closed public testimony.
3:40:34 PM
REPRESENTATIVE FIELDS thanked Ms. Kovol for her work. He said
that last year the Department of Justice (DOJ) released an
investigative report addressing the overabundance of Alaska
children being institutionalized, and in some cases in out-of-
state, for-profit facilities. He explained that the problems
identified in the DOJ report predate Ms. Kovol's appointment as
acting commissioner, and he asked that she explain her, as well
as the department's, role in fixing the problems found in the
report.
MS. KOVOL, regarding the DOJ report, said that the Department of
Health and DFCS are in the final stages of answering the
questions presented by DOJ, and as it is still being finalized
and reviewed, it would be preemptive to comment. In addressing
the question concerning out-of-state facilities, she explained
that sometimes the facilities in the state are not sufficient,
so out-of-state facilities are used only as a last resort. She
said DFCS looks for facilities that can accept the condition of
the child and provide the best treatment, and whether the
facility is for profit is not considered. She reported that the
number of children currently out of state is 25, and the goal is
to bring them home, but this would need to be a treatment center
in Alaska that could meet their needs. She argued there are not
enough treatment centers in the state, whether private, public,
or a partnership.
REPRESENTATIVE FIELDS expressed support of DFCS.
3:43:54 PM
REPRESENTATIVE MINA asked what Ms. Kovol's vision is for the
Tribal Child Welfare Compact Program.
MS. KOVOL answered that DFCS is looking at adding one more Tribe
at the end of the fiscal year, and another next year. She said
that the most meaningful engagements with Tribal partners are
around prevention work, where the compact and the state
collaborate to make a decision of what is best for communities.
3:45:26 PM
REPRESENTATIVE SADDLER pointed out the strong allegations made
during public testimony. He asked that Ms. Kovol address these
allegations as broad or as narrow as she would like.
MS. KOVOL stated that in order to protect due process, DFCS does
not comment on [active] litigation; furthermore, commissioners
are not involved personally in the cases, which are at the
division level and in congruence with law.
3:46:43 PM
REPRESENTATIVE RUFFRIDGE expressed concern about the DFCS's
direction, as it relates to the safety of children. He
questioned Ms. Kovol's ideas for the divisions going forward.
MS. KOVOL explained that the DFCS has four divisions: the Alaska
Psychiatric Institute (API), the Division of Juvenile Justice
(DJJ), the Alaska Pioneer Home, and OCS. She expressed the
opinion that it is imperative that the department is focused on
"person first," always looking at what is in the best interest
of the client, patient, or resident, as well as the staff.
Regarding OCS, she stated that she is currently in conversation
with the governor. This discussion regards whether there are
ways to restructure the operations, so divisions best align with
children and families. She reiterated that it would be
preemptive for her to talk specifics. She stated that things
cannot remain status quo and advised that "the ship can be
turned around."
REPRESENTATIVE RUFFRIDGE congratulated Ms. Kovol for recently
attaining her master's degree in social work. He asked if she
is pursuing a license.
MS. KOVOL responded that she is not pursuing her license but did
enroll for her master's in public health, but this has been put
on hold for the next few years.
REPRESENTATIVE RUFFRIDGE asked what "person first" looks like
for Alaska's children. He clarified that the report indicates
there are struggles in having a "person-first" mentality.
MS. KOVOL answered that "person centered" means the focus is
individual needs and not "lumping" individuals into cohorts
based on characteristics. She explained that DFCS would be
looking more into the complex nature of the person's individual
needs. She said that often when a child is presenting complex
behaviors or medical needs, different communities would need to
be involved.
3:53:53 PM
REPRESENTATIVE MINA referred to an API presentation and how it
has made progress in vacancies. She asked if Ms. Kovol's vision
on addressing these vacancies could be used in the other
divisions.
MS. KOVOL commented that API has done amazing work, coming from
a very low bed count, as now it has 77 beds, which is considered
full. Furthermore, she stated that staff and patient assault
has been reduced by 50 percent, and this is because programing
was redesigned. To replicate this, she said that it comes down
to training and communicating expectations of safety.
3:56:05 PM
REPRESENTATIVE SADDLER expressed the opinion that the human
services world is very challenging, and the state has
responsibilities to care for the less fortunate. He asked if
Alaska faces special challenges in dealing with its disabled,
aged, foster children, and mentally ill.
MS. KOVOL shared her personal history, in that she has seem many
different scenarios around the world, including living through a
war. She said that trauma is different for everyone, as are
disabilities. She stated that disabilities may demonstrate
similar needs and traits, but it is important that communities
and medical centers are able to focus on an individual's needs,
as this would set the tone for success. She added that every
family is unique, reacting differently depending on its stress.
She reiterated that it is different for every culture and every
person, so there is no one answer across the board.
3:58:51 PM
CHAIR PRAX stated that the House Health and Social Services
Standing Committee has reviewed the qualifications of the
governor's appointees and recommends that the following names be
forwarded to a joint session for consideration: Kim Kovol,
Department of Family and Community Services. He said that
signing the report regarding appointments to boards and
commissions in no way reflects an individual member's approval
or disapproval of the appointee, and the nomination is merely
forwarded to the full legislature for confirmation or rejection.
3:59:14 PM
The committee took an at-ease from 3:59 p.m. to 4:02 p.m.
HB 57-EMERGENCY MED. SVCS: REVIEW ORGANIZATIONS
4:02:06 PM
CHAIR PRAX announced that the next order of business would be
HOUSE BILL NO. 57, "An Act relating to review organizations and
permitting an emergency medical services provider to establish a
review organization; and relating to patient records."
4:02:31 PM
REPRESENTATIVE STANLEY WRIGHT, Alaska State Legislature, as
prime sponsor, paraphrased the sponsor statement [copy in the
committee packet], which read as follows [original punctuation
provided]:
House Bill 57 gives EMS agencies protections for peer
review activities.
Peer review is an intensive self-evaluation process
used within healthcare organizations in order to
continuously monitor and improve patient care. Peer
review activities are non-discoverable this
important protection is provided by states to
healthcare organizations to establish an environment
conducive to improvement, without fear of discovery
and litigation. The current status provides a chilling
effect on the openness and educational process that
EMS peer review provides.
This proposed legislation will promote candor and
objectivity in EMS system review and discussion. It is
essential that allowing EMS medical practitioners to
frankly discuss care and conduct in a confidential
setting, without worry about external access to the
information, would enhance the quality of pre-hospital
medical practice.
Past legal decisions have asserted that the existing
statutory provisions which provide this protection to
medical facilities, institutions, or hospital
governing bodies and their committees, provide the
same protections to emergency medical services (EMS)
and fire-based pre-hospital agencies. This is an
untested theory and places pre-hospital medical
agencies in an unprotected status which other entities
enjoy.
HB 57 changes the definition of "review organization"
to include EMS groups who perform quality improvement
functions. By doing so, they are afforded equitable
immunity and confidentiality protection that hospitals
and other healthcare workers enjoy. Peer review
protection is essential if Alaska's EMS systems are to
be used to their maximum potential. Passage of this
legislation enhances the safety of the public and the
educational process for EMS through the peer review
program.
4:04:35 PM
PI RIORDAN-RANDALL, Staff, Representative Stanley Wright, Alaska
State Legislature, on behalf of Representative Wright, prime
sponsor of HB 57, gave the sectional analysis [copy included in
the committee packet], which read as follows [original
punctuation provided]:
Section I:
Amends AS 18.23.070(1) to Include EMT's, dispatchers,
and paramedics in the definition of "health care
provider" for the purpose of peer review protection.
Section II:
Amends the definition of "healthcare provider" in AS
18.23.070(3) to include EMS agencies and employees who
are conducting peer review activities.
Section III:
AS 18.23.070(5) is amended to include emergency
medical services agencies and employees under the
definition of a "review organization"
4:07:28 PM
BRIAN WEBB, representing self, provided invited testimony on HB
57. He referred to his written testimony [copy included in the
committee packet]. He noted that he has previously spoken to
the importance of recruitment and retention of medical directors
for emergency medical services (EMS), and he called HB 57 a
request to provide protections to these services. He stated
that EMS committees not only review patient care activities but
also openly challenge medical directors and training officers to
defend the care given. He said that the proposed legislation
would just be asking the legislature to provide a level of
equity in statute for EMS.
4:12:18 PM
JOSEPH LIVENGOOD, MD, representing self, provided invited
testimony on HB 57. He shared that he is an acute care surgeon
who works in Fairbanks and Ketchikan, serving as the EMS
director for several agencies. He said that HB 57 would clarify
that EMS agencies are covered under the Health Insurance
Portability and Accountability Act (HIPPA) privacy rules. He
stated that these rules allow patient information to be shared
for the purpose of quality management, and the proposed
legislation would allow discussions to occur without the context
being misconstrued during an outside review. He relayed to
members that such protections are in place already for hospitals
and clinics, but not for EMS.
4:14:39 PM
REPRESENTATIVE MINA noted that podiatrists are not included in
the statute. She asked whether the "chilling effect happening
with quality assurance for EMS" is happening with podiatry.
MR. WEBB answered that in 2015, podiatrists had the same
concerns as EMS. He said that there was an amendment to the
original bill adding podiatrists, and it was decided during the
drafting that this would be left in.
4:15:55 PM
CHAIR PRAX announced that HB 57 was held over.
4:16:12 PM
The committee took a brief at-ease.
HB 46-CHILD CARE PROVIDER COLLECTIVE BARGAINING
4:16:16 PM
CHAIR PRAX announced that the final order of business would be
HOUSE BILL NO. 46, "An Act allowing child care providers that
receive state aid to organize and collectively bargain with the
Department of Health; and establishing the child care provider
fund." [Before the committee was CSHB 46 (L&C).]
4:17:35 PM
[Public testimony was opened.]
4:17:53 PM
CANDACE RICHEY, Owner, Candi's Tot Stop, shared that she has
been in business for 17 years. She said that child care
providers have been asked about their needs; however, she
expressed the opinion that "they are not heard." She stated
that HB 46 would offer support to providers. She thanked
members who helped pass similar legislation through the House
last year; however, it was blocked in the Senate. She expressed
hope that the proposed legislation would make it to the governor
this year. She explained that the bill would cover topics of
concern in the child care industry, including wages, benefits,
and retirement. She said that the low wages earned in the
industry are not a living wage, resulting in high staff
turnovers. She shared that families on her waitlist for child
care consists of many military service members, and she
suggested that this lack of child care is impacting the
[country's] preparedness. She explained that benefits are not
possible because of the unaffordable insurance premiums for
small businesses. She argued that the bill would give providers
more of a say as to where the state funds marked for child care
would go.
4:21:56 PM
BRIAN HOLST, Executive Director, Juneau Economic Development
Council, explained that child care is an important economic
development issue for the state, as it provides a high return on
public investment. He suggested that high quality early care
for children is critical and pointed out the Heckman Curve, as
it shows that investment has diminishing returns as children get
older. He argued that the lack of child care hurts the economy,
as data from 2019 has shown that $165 million is lost annually
from the state's economy. He continued that 77 percent of
Alaska parents missed school or work for child care in a three-
month period; 36 percent of Alaska parents postpone school or
training due to such issues; and 47 percent of families rely on
other family members or friends for child care. He said that
every state ranks child care readiness, and two-thirds of the
state's students are not ready for kindergarten. He explained
that the Journal of Education Psychology identified that if 50
first graders have problems reading, 44 of them would still have
problems reading by the time they are in fourth grade. He
argued that a lack of access to affordable high-quality child
care has an impact on the workforce. While employers want more
child care options, there are significant barriers, such as cost
and scarcity. He explained that the current model of child care
in the state is broken, as wages are uncompetitive, and workers
can earn more in an entry level retail job. He pointed out that
operators are small because of the cost of rent and the child-
to-adult ratio requirements. He opined that these programs
cannot raise wages without increasing prices.
4:27:19 PM
REPRESENTATIVE RUFFRIDGE questioned whether businesses would
offer child care services in regard to the added tax incentives
for this in the proposed legislation.
MR. HOLST answered that, when businesses were surveyed, they
said they are interested in supporting child care operations,
however; he expressed the understanding that the challenge would
be in the size of the business, as smaller businesses would not
be able to make these investments.
4:28:37 PM
[Public testimony was closed.]
4:28:43 PM
REPRESENTATIVE ZACK FIELDS, Alaska State Legislature, as prime
sponsor, addressed CSHB 46 (L&C). He explained that the
proposed legislation has three provisions: 1) it would establish
the opportunity for child care providers to enter intersectoral
bargaining with the state. Intersectoral bargaining is when
employees and owners of businesses bargain with the state over
terms and conditions of employment. This would include how
federal and state child care funds are used, and it would give
providers more of a voice concerning any regulation changes; 2)
it would establish a child care trust fund, allowing savings to
trickle out for child care when state revenues are low; and 3)
it would provide tax credits to companies who participate in
helping provide child care.
4:32:46 PM
REPRESENTATIVE SUMNER questioned the experience other states may
have had with intersectoral bargaining agreements.
REPRESENTATIVE FIELDS explained that legislatures can only
implement sectoral bargaining for child care or farmwork, as
these are the only two areas excluded from the National Labor
Relations Act. He said that 10 states have implemented this
framework, with some being successful. He shared that last year
the House Labor and Commerce Standing Committee heard from
providers in Washington State, which have this bargaining.
These providers described how, over time, the profession was
built up to a living wage, which increased the supply of labor
and child care.
4:35:28 PM
EVAN ANDERSON, Staff, Representative Zack Fields, Alaska State
Legislature, on behalf of Representative Fields, prime sponsor,
gave the sectional analysis for CSHB 46 (L&C) [copy included in
the committee packet], which read as follows [original
punctuation provided]:
Section 1: This section amends AS 23.05.360(f) to
allow the Alaska Labor Relations Agency board in the
Department of Labor & Workforce Development the
authority to include workers in the child care sector
for the purpose of holding hearings. This is a
conforming change to language added in Sec 4.
Section 2: This section amends AS 23.05.370(a) to
direct the Alaska Labor Relations Agency to serve as
labor relations agency for workers in the child care
sector covered by the new language added in Sec. 4.
Section 3: This section amends AS 23.05.380 to give
Department of Labor & Workforce Development the
authority to update regulations pertaining to
collective bargaining rights for workers in the child
care sector. This is a conforming change to language
added in Sec 4.
Section 4: This section amends AS 23.40 to give child
care providers the right to self-organize, join, or
assist an organization to bargain collectively and
engage in concerted activities for the purposes of
collective bargaining or other mutual aid or
protection. This section prohibits the Department of
Health from engaging in unfair labor practices, and it
provides a process for investigation and conciliation
of complaints. This section also provides definitions.
Section 5: This section establishes a child care
provider fund as a separate fund in the state
treasury. This section also establishes a child care
stakeholder group to recommend disbursements from the
fund.
4:41:59 PM
CHAIR PRAX mentioned that New Mexico has a $2 billion trust fund
for child care. He asked if such a fund is designated or
dedicated.
REPRESENTATIVE FIELDS said he does not know if New Mexico has
the same designated fund restrictions as Alaska. He expressed
the understanding from Legislative Legal Services that the key
phrase is "funds do not last". He said there were hundreds of
millions of additional dollars last year, and there were $400
million put towards capital funding, as an example.
CHAIR PRAX pointed out that the fiscal note contemplates just an
annual appropriation.
4:43:57 PM
MR. ANDERSON explained that the bill's two fiscal notes, one
from the Department of Health and another from the Department of
Revenue, clearly lay out protected deficits around the tax
credit program.
4:44:56 PM
BRANDON SPANOS, Deputy Director, Tax Division, Department of
Revenue, answered that on the fiscal note there would be three
parts that would reduce the revenue: 1) broadening what is
allowed to be an expenditure on credits and how many companies
would take advantage of this; 2) expanding the program to $3
million from the capped $1 million. He added that companies
often contribute more than they can take as a credit; and 3)
extending the sunset date.
CHAIR PRAX suggested that this would be the only anticipated
loss for the tax revenue, and this is because the companies
would donate money to the program.
MR. SPANOS responded in the affirmative.
CHAIR PRAX asked whether it would be a one-to-one tax credit.
He also asked whether the money would go into the child care
fund.
MR. SPANOS explained that the tax credit in current statute has
changed over the years, but in the first year and after the
first $100,000, 50 percent would be applied to the credit;
therefore, it is a 5:1 ratio.
CHAIR PRAX inquired as to whether the proposed $15 million
initial appropriation would have sufficient interest earnings to
maintain the fund.
4:48:39 PM
REPRESENTATIVE FIELDS expressed the opinion that a $15 million
fund could be managed, but it would not be large enough to make
a difference in the sector; however, it could be something to
establish and be built up over time.
4:48:55 PM
CHAIR PRAX announced that CSHB 46 (L&C) was held over.
4:49:13 PM
ADJOURNMENT
There being no further business before the committee, the House
Health and Social Services Standing Committee meeting was
adjourned at 4:49 p.m.