04/16/2024 03:00 PM House HEALTH & SOCIAL SERVICES
| Audio | Topic |
|---|---|
| Start | |
| HB285 | |
| HB336 | |
| SB24 | |
| Adjourn |
+ teleconferenced
= bill was previously heard/scheduled
| + | HB 285 | TELECONFERENCED | |
| *+ | HB 336 | TELECONFERENCED | |
| + | TELECONFERENCED | ||
| += | SB 24 | TELECONFERENCED | |
ALASKA STATE LEGISLATURE
HOUSE HEALTH AND SOCIAL SERVICES STANDING COMMITTEE
April 16, 2024
3:04 p.m.
MEMBERS PRESENT
Representative Mike Prax, Chair
Representative Justin Ruffridge, Vice Chair
Representative CJ McCormick
Representative Jesse Sumner
Representative Zack Fields
Representative Genevieve Mina
MEMBERS ABSENT
Representative Dan Saddler
COMMITTEE CALENDAR
HOUSE BILL NO. 285
"An Act relating to insurance; relating to mammograms; and
providing for an effective date."
- MOVED HB 285 OUT OF COMMITTEE
HOUSE BILL NO. 336
"An Act relating to athletic trainers; and providing for an
effective date."
- MOVED HB 336 OUT OF COMMITTEE
CS FOR SENATE BILL NO. 24(FIN)
"An Act relating to mental health education; and providing for
an effective date."
- MOVED CSSB 24(FIN) OUT OF COMMITTEE
PREVIOUS COMMITTEE ACTION
BILL: HB 285
SHORT TITLE: MAMMOGRAMS: INSURANCE COVERAGE
SPONSOR(s): REPRESENTATIVE(s) FIELDS
01/22/24 (H) READ THE FIRST TIME - REFERRALS
01/22/24 (H) HSS, FIN
01/29/24 (H) L&C REFERRAL ADDED AFTER HSS
01/29/24 (H) BILL REPRINTED
02/14/24 (H) HSS REFERRAL MOVED TO AFTER L&C
02/21/24 (H) L&C AT 3:15 PM BARNES 124
02/21/24 (H) -- MEETING CANCELED --
02/28/24 (H) L&C AT 3:15 PM BARNES 124
02/28/24 (H) -- MEETING CANCELED --
03/04/24 (H) L&C AT 3:15 PM BARNES 124
03/04/24 (H) Heard & Held
03/04/24 (H) MINUTE(L&C)
03/13/24 (H) L&C AT 3:15 PM BARNES 124
03/13/24 (H) Heard & Held
03/13/24 (H) MINUTE(L&C)
03/20/24 (H) L&C AT 3:15 PM BARNES 124
03/20/24 (H) Moved HB 285 Out of Committee
03/20/24 (H) MINUTE(L&C)
03/21/24 (H) L&C RPT 3DP 4NR
03/21/24 (H) DP: FIELDS, CARRICK, SUMNER
03/21/24 (H) NR: RUFFRIDGE, WRIGHT, PRAX, SADDLER
04/09/24 (H) HSS AT 3:00 PM DAVIS 106
04/09/24 (H) -- MEETING CANCELED --
04/16/24 (H) HSS AT 3:00 PM DAVIS 106
BILL: HB 336
SHORT TITLE: ATHLETIC TRAINER SCOPE OF PRACTICE
SPONSOR(s): REPRESENTATIVE(s) FIELDS
02/20/24 (H) READ THE FIRST TIME - REFERRALS
02/20/24 (H) HSS, L&C
04/16/24 (H) HSS AT 3:00 PM DAVIS 106
BILL: SB 24
SHORT TITLE: PUBLIC SCHOOLS: MENTAL HEALTH EDUCATION
SPONSOR(s): SENATOR(s) GRAY-JACKSON
01/18/23 (S) PREFILE RELEASED 1/9/23
01/18/23 (S) READ THE FIRST TIME - REFERRALS
01/18/23 (S) EDC, HSS, FIN
02/22/23 (S) EDC AT 3:30 PM BELTZ 105 (TSBldg)
02/22/23 (S) Heard & Held
02/22/23 (S) MINUTE(EDC)
03/06/23 (S) EDC AT 3:30 PM BELTZ 105 (TSBldg)
03/06/23 (S) Moved SB 24 Out of Committee
03/06/23 (S) MINUTE(EDC)
03/08/23 (S) EDC RPT 4DP 1NR
03/08/23 (S) DP: TOBIN, GRAY-JACKSON, STEVENS, KIEHL
03/08/23 (S) NR: BJORKMAN
03/23/23 (S) HSS AT 3:30 PM BUTROVICH 205
03/23/23 (S) Heard & Held
03/23/23 (S) MINUTE(HSS)
04/11/23 (S) HSS AT 3:30 PM BUTROVICH 205
04/11/23 (S) Heard & Held
04/11/23 (S) MINUTE(HSS)
04/13/23 (S) HSS AT 3:30 PM BUTROVICH 205
04/13/23 (S) Moved CSSB 24(HSS) Out of Committee
04/13/23 (S) MINUTE(HSS)
04/14/23 (S) HSS RPT CS 3DP 2NR SAME TITLE
04/14/23 (S) NR: WILSON, KAUFMAN
04/14/23 (S) DP: TOBIN, DUNBAR, GIESSEL
02/07/24 (S) FIN AT 9:00 AM SENATE FINANCE 532
02/07/24 (S) Heard & Held
02/07/24 (S) MINUTE(FIN)
02/15/24 (S) FIN AT 1:30 PM SENATE FINANCE 532
02/15/24 (S) Moved CSSB 24(FIN) Out of Committee
02/15/24 (S) MINUTE(FIN)
02/19/24 (S) FIN RPT CS 4DP SAME TITLE
02/19/24 (S) DP: HOFFMAN, OLSON, KIEHL, BISHOP
03/06/24 (S) TRANSMITTED TO (H)
03/06/24 (S) VERSION: CSSB 24(FIN)
03/11/24 (H) READ THE FIRST TIME - REFERRALS
03/11/24 (H) HSS, EDC, FIN
04/11/24 (H) HSS AT 3:00 PM DAVIS 106
04/11/24 (H) Heard & Held
04/11/24 (H) MINUTE(HSS)
04/16/24 (H) HSS AT 3:00 PM DAVIS 106
WITNESS REGISTER
REPRESENTATIVE ZACK FIELDS
Alaska State Legislature
Juneau, Alaska
POSITION STATEMENT: As prime sponsor, presented HB 285.
COURTNEY OWENS, Staff
Representative Zack Fields
Alaska State Legislature
Juneau, Alaska
POSITION STATEMENT: Gave the sectional analysis for HB 285 on
behalf of Representative Fields, prime sponsor.
REBECCA BIRCH, Director
State Policy & Advocacy
Susan G. Komen
Dallas, Texas
POSITION STATEMENT: Gave invited testimony in support of HB
285.
BEVERLY WOOLEY, representing self
Big Lake, Alaska
POSITION STATEMENT: Testified in support of HB 185.
LISA PEABODY
FORCE - Facing Our Risk of Cancer Empowered, Inc.
Bethesda Maryland
POSITION STATEMENT: Testified in support of HB 285.
KELLEY MARRE, representing self
Kasilof, Alaska
POSITION STATEMENT: Testified in support of HB 285.
EMILY NENON
Alaska Government Relations Director
American Cancer Society Cancer Action Network
Anchorage, Alaska
POSITION STATEMENT: Testified in support of HB 285.
ZACK FIELDS
Alaska State Legislature
Juneau, Alaska
POSITION STATEMENT: As prime sponsor, presented HB 336.
COURTNEY OWENS, Staff
Representative Zach Fields
Alaska State Legislature
Juneau, Alaska
POSITION STATEMENT: Gave the sectional analysis for HB 336 on
behalf of Representative Fields, prime sponsor.
LYNNE YOUNG, Head Athletic Trainer
Orthopedic Physicians Alaska
Anchorage, Alaska
POSITION STATEMENT: Gave invited testimony in support of HB
336.
CARY KELLER, MD, representing self
Fairbanks, Alaska
POSITION STATEMENT: Testified during the hearing on HB 336.
TINA MCLEAN, Chair
Alaska Physical Therapy and Occupational Therapy Board
Sterling, Alaska
POSITION STATEMENT: Testified in opposition to HB 336.
SENATOR ELVI GRAY-JACKSON
Alaska State Legislature
Juneau, Alaska
POSITION STATEMENT: As prime sponsor, presented SB 24.
BESSE ODOM, Staff
Senator Elvi Gray-Jackson
Alaska State Legislature
Juneau, Alaska
POSITION STATEMENT: Provided definitions during the hearing on
SB 24 on behalf of Senator Gray-Jackson, prime sponsor.
ACTION NARRATIVE
3:04:35 PM
CHAIR PRAX called the House Health and Social Services Standing
Committee meeting to order at 3:04 p.m. Representatives
McCormick, Sumner, Fields, Mina, and Prax were present at the
call to order. Representative Ruffridge arrived as the meeting
was in progress.
HB 285-MAMMOGRAMS: INSURANCE COVERAGE
3:06:22 PM
CHAIR PRAX announced that the first order of business would be
HOUSE BILL NO. 285, "An Act relating to insurance; relating to
mammograms; and providing for an effective date."
3:06:43 PM
REPRESENTATIVE ZACK FIELDS, Alaska State Legislature, as prime
sponsor, introduced HB 285. He noted that the bill came as a
suggestion from Susan G. Komen, the organization that did the
research on the bill. He stressed that of the different types
of mammograms, many Alaskan women cannot afford diagnostic
imaging exams. He said that the Affordable Care Act (ACA) does
not cover diagnostic screenings; therefore, high risk women who
are not wealthy struggle to pay for these mammograms. He said
that when cancer is detected early, it is less expensive to
treat; the bill would require an up-front cost which pales in
comparison to the cost of delaying detection. He went through
the number of detections in Alaska as well as the rest of the
U.S. He further related impacts in detection in regard to a
woman's race. He drew attention to a slide [hard copy included
in the committee packet], which went over cost comparisons. He
noted many states have enacted this type of legislation and he
welcomed questions from committee members.
3:12:05 PM
COURTNEY OWENS, Staff, Representative Zack Fields, Alaska State
Legislature, on behalf of Representative Fields, prime sponsor,
gave the sectional analysis for HB 285 [included in the
committee packet], which read as follows [original punctuation
provided]:
Section 1: Amends AS 21.42.375(e) to define
"diagnostic breast examination" and "supplemental
breast examination" and offers guidelines for the
basis of additional testing.
Section 2: Adds a new subsection to AS 21.42.375
guaranteeing that mammography screening, diagnostic
breast examinations, and supplemental breast
examinations are covered by applicable insurance
plans, with the exception of high deductible health
plans that are eligible for a health savings account
tax deduction.
Section 3: Amends the law of the State of Alaska by
applying Sec. 1 and Sec. 2 to an insurance policy or
contract on or after the effective date of the law.
Section 4: Amends the law of the State of Alaska to
allow the Division of Insurance to adopt regulations
necessary to implement this act under AS 44.62.
Section 5: Section 4 take effect immediately under AS
01.10.070(c).
Section 6: This Act takes effect January 1, 2025.
3:13:08 PM
REPRESENTATIVE MINA asked what the average cost share of
diagnostic imaging was.
REPRESENTATIVE FIELDS answered that he heard in public testimony
there was a range of rates including hundreds of dollars, but he
did not know if that was the average.
3:13:54 PM
REPRESENTATIVE PRAX offered his belief that diagnostic screening
followed the regular screening.
REPRESENTATIVE FIELDS confirmed that was correct. For the high-
risk group, which he noted in Alaska is 12,000 people, it was
recommended by doctors that they have the diagnostic screening.
REPRESENTATIVE PRAX questioned whether the diagnostic screening
would need pre-authorization and why the insurance company
wouldn't pay it.
REPRESENTATIVE FIELDS answered that the issue is that ACA
required no cost share for a standard mammogram, but the
diagnostic would need a co-pay. He went over scenarios where
people may not be able to pay the costs.
3:16:08 PM
REPRESENTATIVE RUFFRIDGE asked for clarity whether high
deductible plans would be exempt under the proposed legislation.
REPRESENTATIVE FIELDS explained the differences between
deductibles and delays in care.
REPRESENTATIVE RUFFRIDGE sought confirmation that the bill would
cover people covered under private insurance and would not
affect Medicaid or Medicare. Further, he inquired whether a
person with a high deductible plan would not be mandated to
cost-share under the bill.
REPRESENTATIVE FIELDS responded that's correct.
3:17:47 PM
REPRESENTATIVE PRAX welcomed invited testifiers.
3:17:59 PM
REBECCA BIRCH, Director, State Policy & Advocacy, Susan G.
Komen, said she strongly supported HB 285 and shared a story
about a patient who was "barely making ends meet" who had to
take out a loan to take the diagnostic test and the costs that
ensued because of late detection. She commented about a study
on cost averages and said high deductible plans are eliminated
with the health savings accounts.
3:21:29 PM
REPRESENTATIVE PRAX opened public testimony on HB 285.
3:22:11 PM
BEVERLY WOOLEY, representing self, testified in support of HB
285. She described her history with breast cancer and how her
ultrasound finally found a tumor. She said she was an example
of how the cost savings can be realized through early detection,
and the bill would provide an increase to much needed access.
She noted because of delayed diagnosis, 20 years out she was
still paying for follow-up care. She opined that HB 285 would
save lives and encouraged the committee to pass it without
delay.
3:25:13 PM
LISA PEABODY, FORCE - Facing Our Risk of Cancer Empowered, Inc.,
said she represented a high-risk community and testified in
support of HB 285. She further discussed high risk individuals
with a predisposition that the average person does not have.
This high-risk community, according to national guidelines,
needed their mammograms to start at age 25. In addition to
mammograms, this group may also need a breast ultrasound or MRI
every year, even when it costs hundreds of dollars, and she
opined that the proposed bill would close the gap for the high-
risk individuals.
3:27:57 PM
KELLEY MARRE, representing self, testified in support of HB 285
and shared that she was an oncology social worker. She offered
statistics on annual diagnoses and noted that men also get
breast cancer. She discussed costs and delays in diagnosis due
to the lack of affordability. She stressed that no one should
have to choose between basic needs or health care and asked the
committee to pass HB 285 so individuals would not be charged for
high-risk screening and diagnostic imaging.
3:29:53 PM
EMILY NENON, Alaska Government Relations Director, American
Cancer Society Cancer Action Network, testified in support of HB
285 and gave a history of coverage for cancer screenings. She
spoke to state-regulated plans and how they set the precedence
for what other plans do and opined that the bill would be about
setting precedence for every plan offered in the state. She
shared a story of a woman who needed follow up treatment, who
had to set aside money each month for over a year to be able to
afford the treatment, and she said the bill would help people
like her. She offered to address deductibles and [health]
savings accounts, the latter which are specific kinds of
accounts that have federal law issues. She said she looked
forward to progressing and that she was available for questions.
3:33:43 PM
REPRESENTATIVE PRAX, after ascertaining that no one else wished
to testify, closed public testimony on HB 285.
3:34:29 PM
REPRESENTATIVE RUFFRIDGE moved to report HB 285 out of committee
with individual recommendations and the accompanying fiscal
notes. There being no objection, HB 285 was reported out of the
House Health and Social Services Standing Committee.
3:35:17 PM
The committee took an at-ease from 3:35 p.m. to 3:36 p.m.
HB 336-ATHLETIC TRAINER SCOPE OF PRACTICE
3:36:32 PM
CHAIR PRAX announced that the next order of business would be
HOUSE BILL NO. 336, "An Act relating to athletic trainers; and
providing for an effective date."
3:38:28 PM
ZACK FIELDS, Alaska State Legislature, as prime sponsor,
presented HB 336 and summarized that the bill was about
resolving an ambiguity in the law related to work that athletic
trainers can do. He elaborated on what their training looked
like and pointed out that the level of training for an athletic
trainer was similar to that of a physical therapist. He noted
that invited testifiers could give more real-world examples of
trainers in Alaska.
3:41:31 PM
COURTNEY OWENS, Staff, Representative Zach Fields, Alaska State
Legislature, gave the sectional analysis for HB 336 [included in
the committee packet], on behalf of Representative Fields, prime
sponsor, which read as follows [original punctuation provided]:
Section 1: Amends AS 08.07.030(b) to update the
Athletic Trainers Practice Act to reflect the
professional education requirements more accurately.
Requires that athletic trainers refer patients to
medical professionals in the event of condition and/or
injury present outside of the scope of their practice:
clarifies who they can provide services to.
Section 2: Amends AS 08.07.030(c) by clarifying
responsibilities of athletic trainers:
• Includes individuals who can benefit from athletic
training services; and
• Permits athletic trainers to clinically diagnose
injuries, illnesses, & conditions; and
• Allows athletic trainers to treat conditions, in
addition to injury and illness.
Section 3: AS 08.07.090(4) Amends definition of
"athletic training" to permit clinical diagnosis and
treatment of conditions.
Section 4: Repeals the definitions of "athlete" and
"athletic injury or illness."
Section 5: Applies an immediate effective date.
3:43:06 PM
LYNNE YOUNG, Head Athletic Trainer, Orthopedic Physicians
Alaska, clarified that athletic trainers are healthcare
professionals who provide services in collaboration with
physicians. She expounded on the tasks they perform and the
medical-based education they follow, as well as ongoing
certifications they must meet. She noted none of the asked
changes in the bill would change athletic training but would
further explain what the athletic trainers can provide and to
whom.
3:48:00 PM
REPRESENTATIVE MINA asked whether athletic trainers diagnose
conditions.
MS. LYNNE answered that they provide a clinical diagnosis,
sometimes known as a differential diagnosis.
REPRESENTATIVE MINA referenced a letter that expressed concerns
that the bill broadens the scope for athletic trainers and asked
Ms. Lynne if she wished to address the letter.
MS. LYNNE confirmed a trainer's educational background included
accredited training and rigorous components including
certifications that must be met.
3:51:16 PM
REPRESENTATIVE RUFFRIDGE asked for clarity about a phrase in the
bill that noted "athlete" to "individual".
MS. LYNNE responded that the core of the bill was for an
athletic trainer to provide training to individuals. When
spectators, for example, fall or get hit with a ball, an
athletic trainer may further evaluate these injuries but not go
beyond the scope [of their training]. She provided examples of
other types of evaluations. She noted the possibility of adding
the word "movement" that may help with definitions.
3:55:24 PM
REPRESENTATIVE FIELDS noted that a testifier who could not be
present suggested a refinement of the language in the bill.
3:56:24 PM
CHAIR PRAX opened public testimony on HB 336.
3:57:10 PM
CARY KELLER, MD, representing self, testified during the hearing
on HB 336 and provided his medical background as an orthopaedic
surgeon, who has worked with athletic trainers. He defined
"athlete" as being someone who engages in high-performance
activity, but there are also "community athletes" such as
walkers or cyclists. He noted it was a mistake to think
athletic trainers could only provide to team-based athletes. He
focused on Alaska-based athletic trainers in his examples.
3:59:46 PM
TINA MCLEAN, Chair, Alaska Physical Therapy and Occupational
Therapy Board, spoke in opposition to HB 336 on behalf of the
board. She stated there was no argument that athletic trainers
are of value to the healthcare system but expressed concern
surround the wording in the bill that would allow for any
individual to be treated or evaluated by an athletic trainer.
She noted their training is not extensive, and even in the
master's program, it is not geared towards the general public
and all conditions. Additional wording should be inserted for
more clarification in the bill, she opined.
4:03:47 PM
CHAIR PRAX, after ascertaining no one else wished to testify,
closed public testimony on HB 336.
4:04:29 PM
REPRESENTATIVE FIELDS noted there could be opportunities to work
on the language in the bill.
REPRESENTATIVE RUFFRIDGE agreed and expressed concern about
language in Section 2, suggesting that "scope of practice" could
be limiting. He opined there needed to be further
clarification.
4:06:21 PM
REPRESENTATIVE RUFFRIDGE moved to report HB 336 out of committee
with individual recommendations and the accompanying fiscal
notes. There being no objection, HB 336 was reported out of the
House Health and Social Services Standing Committee.
4:07:02 PM
The committee took an at-ease from 4:07 p.m. to 4:09 p.m.
SB 24-PUBLIC SCHOOLS: MENTAL HEALTH EDUCATION
4:09:38 PM
CHAIR PRAX announced that the final order of business would be
CS FOR SENATE BILL NO. 24(FIN), "An Act relating to mental
health education; and providing for an effective date."
4:09:56 PM
SENATOR ELVI GRAY-JACKSON, Alaska State Legislature, as prime
sponsor, recapped SB 24. She summarized the bill stating that
it would add mental health education to the already existing
health education for students grades K-12.
4:10:46 PM
BESSE ODOM, Staff, Senator Elvi Gray-Jackson, Alaska State
Legislature, on behalf of Senator Gray-Jackson, prime sponsor of
SB 24, clarified that the definition of "mental health" came
from the Center of Disease Control and Prevention (CDC).
4:11:24 PM
REPRESENTATIVE MCCORMICK moved to report CSSB 24(FIN) out of
committee with individual recommendations and the accompanying
fiscal notes.
4:12:06 PM
REPRESENTATIVE SUMNER objected. He noted he was contacted by
his local school board and that the bill would result in an
unfunded mandate.
4:13:08 PM
A roll call vote was taken. Representatives Mina, McCormick,
Fields, and Prax voted in favor of reporting CSSB 24(FIN) out of
committee with individual recommendations and the accompanying
fiscal notes. Representatives Ruffridge and Sumner voted
against it. Therefore, CSSB 24(FIN) was reported out of the
House Health and Social Services Standing Committee by a vote of
4-2.
4:14:21 PM
SENATOR GRAY-JACKSON provided closing comments and stated that
she would be more than happy to work with school districts and
asked for information to be provided to her staff.
4:14:43 PM
ADJOURNMENT
There being no further business before the committee, the House
Health and Social Services Standing Committee meeting was
adjourned at 4:15 p.m.
| Document Name | Date/Time | Subjects |
|---|---|---|
| HB 285 Fiscal Note DCCED-DOI.pdf |
HHSS 4/16/2024 3:00:00 PM |
HB 285 |
| HB 285 - Komen Report.pdf |
HHSS 4/16/2024 3:00:00 PM |
HB 285 |
| HB 285 Key Highlights.pdf |
HHSS 4/16/2024 3:00:00 PM |
HB 285 |
| HB 285 - Preventing Chronic Disease.pdf |
HHSS 4/16/2024 3:00:00 PM |
HB 285 |
| HB 285 Sectional Analysis.pdf |
HHSS 4/16/2024 3:00:00 PM |
HB 285 |
| HB 285 Sponsor Statement.pdf |
HHSS 4/16/2024 3:00:00 PM |
HB 285 |
| HB 285 Version B.pdf |
HHSS 4/16/2024 3:00:00 PM |
HB 285 |
| HB 336 PHY - Letter of Opposition.pdf |
HHSS 4/16/2024 3:00:00 PM |
HB 336 |
| HB 336 Version A.pdf |
HHSS 4/16/2024 3:00:00 PM |
HB 336 |
| HB 336 Fiscal Note DCCED-CBPL.pdf |
HHSS 4/16/2024 3:00:00 PM |
HB 336 |
| HB 336 APTA NATA Joint Principles.pdf |
HHSS 4/16/2024 3:00:00 PM |
HB 336 |
| HB 336 AT PPT.pdf |
HHSS 4/16/2024 3:00:00 PM |
HB 336 |
| HB 336 ATs in Schools.pdf |
HHSS 4/16/2024 3:00:00 PM |
HB 336 |
| HB 336 ATs in the Armed Forces.pdf |
HHSS 4/16/2024 3:00:00 PM |
HB 336 |
| HB 336 What is an Athletic Trainer.pdf |
HHSS 4/16/2024 3:00:00 PM |
HB 336 |
| HB 336 Sectional Analysis 4.15.24.pdf |
HHSS 4/16/2024 3:00:00 PM |
HB 336 |
| HB 336 Sponsor Statement 4.15.24.pdf |
HHSS 4/16/2024 3:00:00 PM |
HB 336 |