Legislature(2025 - 2026)DAVIS 106
01/28/2025 03:15 PM House HEALTH & SOCIAL SERVICES
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| Audio | Topic |
|---|---|
| Start | |
| Overview(s): Department of Health | |
| Adjourn |
* first hearing in first committee of referral
+ teleconferenced
= bill was previously heard/scheduled
+ teleconferenced
= bill was previously heard/scheduled
| + | TELECONFERENCED | ||
ALASKA STATE LEGISLATURE
HOUSE HEALTH AND SOCIAL SERVICES STANDING COMMITTEE
January 28, 2025
3:17 p.m.
MEMBERS PRESENT
Representative Genevieve Mina, Chair
Representative Andrew Gray
Representative Zack Fields
Representative Donna Mears
Representative Mike Prax
Representative Justin Ruffridge
Representative Rebecca Schwanke
MEMBERS ABSENT
All members present
OTHER LEGISLATORS PRESENT
Representative Alyse Galvin
COMMITTEE CALENDAR
OVERVIEW(S): DEPARTMENT OF HEALTH
- HEARD
PREVIOUS COMMITTEE ACTION
No previous action to record
WITNESS REGISTER
HEIDI HEDBERG, Commissioner
Department of Health
Anchorage, Alaska
POSITION STATEMENT: Co-offered the Department of Health
overview.
EMILY RICCI, Deputy Commissioner
Department of Health
Anchorage, Alaska
POSITION STATEMENT: Co-offered the Department of Health
overview.
ROBERT LAWRENCE, MD, Chief Medical Officer
Department of Health
Anchorage, Alaska
POSITION STATEMENT: Co-offered the Department of Health
overview.
ACTION NARRATIVE
3:17:11 PM
CHAIR MINA called the House Health and Social Services Standing
Committee meeting to order at 3:17 p.m. Representatives
Schwanke, Prax, Ruffridge, Mears, Fields, Gray, and Mina were
present at the call to order.
[In response to Chair Mina, committee member introductions were
made.]
^OVERVIEW(S): DEPARTMENT OF HEALTH
OVERVIEW(S): DEPARTMENT OF HEALTH
3:21:26 PM
CHAIR MINA announced that the only order of business would be
the Department of Health overview.
3:21:57 PM
HEIDI HEDBERG Commissioner, Department of Health, as co-
presenter, began the Department of Health overview with a
PowerPoint [hard copy included in the committee packet]. She
explained that the Department of Health (DOH) has employed three
strategies to improve its service of Alaskans: modernize
systems, increase capacity, and stabilize workforce.
3:23:20 PM
CHAIR MINA called an at-ease from 3:23 p.m. to 3:26 p.m.
3:26:36 PM
COMMISSIONER HEDBERG continued with the PowerPoint. She
announced that the DOH will be launching a website to increase
accessibility and she described the different facets of this
website. She stated the four "arcs of effort" that DOH is using
to improve healthcare in Alaska: transformation of care, child
care, overdose and suicide prevention, and strengthening the
behavioral health system.
3:29:56 PM
EMILY RICCI, Deputy Commissioner, Department of Health, , as co-
presenter, began by describing the transformation of care arc of
effort. She said that the DOH is conducting a Medicaid rate
review. She said Medicaid demonstration projects allow Medicaid
to cover services not typically covered. The department is also
focusing on school-based services and supporting youth as they
are discharged from detention centers.
3:34:11 PM
DEPUTY COMMISSIONER RICCI responded to questions from various
committee members. She said she does not know what percentage
of justice-involved youth lack of safe home to which to return.
She defined a 1115 Medicaid waiver as referring to a section of
federal law that gives the Secretary of Health and Human
Services the authority to evaluate Medicaid demonstration
projects that promote the objectives of the Medicaid program,
with a hypothesis, research objectives, a report, and a
conclusion on the objective at the end of five years. She said
DOH is still conducting the first phase of a Medicaid rate
review, the findings of which are due by July 2025. She said
the department is bringing on a contractor to help evaluate and
prioritize projects. She correlated the reduction of costs in
health care to streamlining efficiency. In terms of whether DOH
can reduce the cost of health care in Alaska beyond Medicaid,
she noted that Medicaid is a large component in making changes
to the health care system.
3:40:33 PM
REPRESENTATIVE FIELDS remarked that the lack of behavioral
health services in communities causes increases in Department of
Corrections (DOC) costs and private sector costs.
3:42:04 PM
DEPUTY COMMISSIONER RICCI responded to further questions from
various committee members. She said the rates selected for the
first phase of the Medicaid rate review were chosen with intent
and with input from providers. She said that behavioral health
is DOH's first priority in this review. She said Medicaid
demonstration projects can vary greatly depending on the state.
Regarding Medicaid demonstration projects, she said they can
vary greatly depending on the state. Alaska stated its first
Medicaid waiver with a focus on behavioral health reform, which
includes researching how nutrition affects the health of
individuals. She added that DOH is focusing on re-entry support
for adults post-incarceration. She affirmed she would be able
to speak on some provider and payment changes that have been
made in the last year.
3:46:50 PM
COMMISSIONER HEDBERG returned to the PowerPoint and addressed
the second arc of effort, which is child care. She stated that
the governor launched a task force which assessed child care
needs and made recommendations that are being implemented by the
department. She said DOH has launched the Alaska Childcare
Information System (ACIS) and explained the efficiencies of this
new system. She described the pilot project DOH has launched
regarding background checks for childcare providers.
Commissioner Hedberg described a new license for subsidized
childcare. She explained the two new positions the governor has
announced within the childcare program office.
3:54:04 PM
COMMISSIONER HEDBERG responded to questions from various
committee members. Regarding child care regulations being
perceived as "a barrier to addressing the licensing component"
and mention of a "Friends Family Neighbors" license option, she
explained it is home-based rather than center-based and the
health and safety standards are federal standards that are
applied by the state. Regarding this licensing, she said work
must be initiated first, and then she would update the
committee. She said she could follow up with information
related to a list of recommendations that have been implemented.
Regarding the department's method for working with local
governments, she said the state defers to the Municipality of
Anchorage (MOA) to license all childcare centers in Anchorage,
and DOH has ongoing conversations with the task force within
MOA.
3:56:55 PM
ROBERT LAWRENCE, MD, Chief Medical Officer, Department of
Health, as co-presenter, continued the PowerPoint by introducing
the third arc of effort, which is overdose and suicide
prevention. He said there continue to be high rates of overdose
and suicide in Alaska. He said that he was authorized to
establish the formation of an opioid fatality review committee,
which will work in parallel with the Alaska opioid response. He
described the five areas of intervention: interdiction,
prevention, harm reduction, treatment, and recovery. He said
this work is being funded by the opioid settlement fund. He
said the same amount of effort has been applied to suicide
prevention.
4:00:37 PM
DR. LAWRENCE responded to questions from various committee
members. He noted that the third arc of effort is focused on
overdose and suicides, while also looking at other causes of
preventable death, which includes alcohol. He reported that
review committees will begin meeting every other month and will
provide an annual report of recommendations. He informed the
committee that opioid settlement fund began at $58 million and
is growing. The divisions within DOH responsible for
distributing these funds are the Division of Public Health and
the Division of Behavioral Health. He said he knows neither
whether Alaska opted out of reporting related to the opioid
settlement funds nor, if it did, what the reasoning would have
been. Regarding pregnant women with syphilis, he related that
the reported numbers of syphilis cases have increased while the
reports of congenital syphilis have decreased.
4:07:24 PM
COMMISSIONER HEDBERG, returning attention to the PowerPoint,
introduced the final arc of effort, which is strengthening the
behavioral health system. She explained the efforts DOH made to
hear from community members and emphasized the differences
between regional needs. She explained that these responses
contributed to their implementation of a Youth Behavioral Health
Roadmap. She described the collaboration between DOH and the
Department of Justice regarding the continuum of care for
behavioral health. She said that DOH is continuing to improve
access to community-based services. In response to a question
from Representative Ruffridge regarding success with increasing
access to care within the last 12 months, noted that there has
been a lot of necessary foundational work, and she emphasized
the need for a strong Medicaid program and the importance of the
Medicaid rate review.
MS. RICCI, in response to a follow-up question, stated that it
takes time for system changes to take effect. She offered some
successes that DOH has seen as the system continues to make
improvements.
4:17:49 PM
COMMISSIONER HEDBERG, in response to Chair Mina, confirmed the
department regularly meets with the Division of Justice (DOJ).
4:18:35 PM
MS. RICCI continued the presentation on slide 7 and spoke about
complex care, wherein people with complex medical, behavioral,
and potential developmental disability diagnoses may need
services from multiple division or departments. She talked
about looking for trends and gaps in the system and looking for
ways to meet needs. In response to Representative Prax, she
said the department meets regularly with behavioral health
providers to consider their perspective and address any
differences.
4:22:05 PM
COMMISSIONER HEDBERG moved to slide 8 to name the five
departments within DOH: the Division of Behavioral Health, the
Division of Health Care Services, the Division of Public
Assistance, the Division of Senior & Disabilities Services, and
the Division of Public Health.
MS. RICCI moved to slide 9, which lists the following focal
points of the Division of Behavioral Health: 1115 Behavioral
Health Waiver Services; Behavioral Health Grants; Behavioral
Health Medicaid Program & Payments; Facility Licensing &
Provider Support; Prevention & Early Intervention; and 988
Suicide Prevention & Crisis Services. She offered the
division's operational update and 2025 focus, listed on slide
10. She talked about the need for the Medicaid program to
create its own certified community behavioral health clinic
program in order to received enhanced payment. She offered
further details and said she would follow up with further
information in response to Representatives Gray, Fields, and
Prax.
4:32:58 PM
MS. RICCI brought attention to slide 11, which lists the focal
points of the Division of Health Care Services as: Medicaid
Provider Enrollment & Payment; Tribal Reclaiming & Recoveries;
Clinical & Pharmacy Services; Medicaid Operations & Quality
Assurance; Background Checks; and Facility Licensing &
Certification. She offered further details and offered to
provide follow-up information in response to questions from
Representatives Ruffridge and Schwanke. She moved on to slide
12 to provide the operational update and 2025 focus, including
the modernization of the Medicaid system. In response to
Representative Ruffridge, she confirmed that even with use of
the national systems, it takes the effort of someone to connect
that to a provider enrollment packet. To Chair Mina, she
confirmed that the issue of late payments is a focal point.
4:44:30 PM
COMMISSIONER HEDBERG moved to slide 13, which lists the focal
points of the Division of Public Assistance as: Medicaid
Eligibility & Enrollment; SNAP & Family Nutrition; Alaska
Temporary Assistance Program; Heating & General Relief; Adult
Public Assistance & Senior Benefits; and Child Care Licensing &
Child Care Assistance. She said the programs do not stand
alone; they have support. She talked about fairness and
efficiency in the use of benefits. She covered the goals of the
Division of Public Assistance, as listed on slide 14, including
simplified engagement with the client and improved operations,
such as Supplemental Nutrition Assistance Program (SNAP)
application process completion rates. She offered further
details. In response to Representative Gray, she allowed that
short staffing was a contributing factor but the not the sole
reason related to SNAP application completion rates, and
staffing levels have improved. In response to Representative
Ruffridge, she reviewed the categories and certification periods
related to SNAP. She then related the information from slide
15, regarding information technology (IT) modernization within
the Division of Public Assistance, with the focus for 2025 being
a move from paper to digital forms.
4:56:04 PM
MS. RICCI picked up the PowerPoint on slide 16, which showed the
focal points for the Division of Senior & Disabilities Services
as: Medicaid Home & Community Based Waivers; Community Based
Grants; General Relief Assisted Living Care; Adult Protective
Services; Early Intervention & Infant Learning Program; and
Medicare Information Office. She talked about the operational
update and 2025 focus, shown on slide 17, including mention of
waiver services, community-based grants, and a self-directed
assessment tool previously mentioned by Representative
Ruffridge.
5:01:21 PM
DR. LAWRENCE stepped back in to bring the committee's attention
to slide 18, which addresses the Division of Public Health and
lists its focal points: Chronic Disease Prevention & Health
Promotion Epidemiology & Public Health Nursing; Health
Analytics & Vital Records; State Labs & Medical Examiner's
Office; Women's, Children's & Family Health; and Emergency
Programs. He covered the operational update and 2025 focus, as
shown on slide 19, including recognition as an accredited public
health system and data integration and modernization.
5:04:47 PM
MS. RICCI, in response to Representative Fields, defined the
Infant Learning Program.
5:07:38 PM
DR. LAWRENCE, in response to Representative Gray, spoke about
the biggest barriers to optimizing public health and used a
metaphor of looking upstream to view the threats to public
health, including access to nutritious food and clean water and
protection from exposure. The Division of Public Health
anticipates those problems. To a follow-up question, he said,
"We have the resources we need."
COMMISSIONER HEDBERG added that DOH looks at communities to
determine current needs. To a comment from Representative Prax,
she the work done today by DOH is a testament to the
partnerships it has with other state agencies, its partners, and
its clients.
5:13:11 PM
CHAIR MINA thanked the presenters.
5:13:51 PM
ADJOURNMENT
There being no further business before the committee, the House
Health and Social Services Standing Committee meeting was
adjourned at 5:13 p.m.
| Document Name | Date/Time | Subjects |
|---|---|---|
| HHSS DOH Overview 1.28.25.pdf |
HHSS 1/28/2025 3:15:00 PM |