Legislature(2023 - 2024)SENATE FINANCE 532

03/07/2023 09:00 AM Senate FINANCE

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* first hearing in first committee of referral
+ teleconferenced
= bill was previously heard/scheduled
+ SB 58 MEDICAID ELIGIBILITY: POSTPARTUM MOTHERS TELECONFERENCED
Heard & Held
-- Invited & Public Testimony --
-- Testimony <Time Limit May Be Set> --
+ SB 55 EXTEND STATE MEDICAL BOARD TELECONFERENCED
Heard & Held
-- Invited & Public Testimony --
-- Testimony <Time Limit May Be Set> --
+= SB 38 INTERFERENCE WITH EMERGENCY SERVICES TELECONFERENCED
Moved SB 38 Out of Committee
+ Bills Previously Heard/Scheduled TELECONFERENCED
                  SENATE FINANCE COMMITTEE                                                                                      
                       March 7, 2023                                                                                            
                         9:02 a.m.                                                                                              
                                                                                                                                
                                                                                                                                
9:02:29 AM                                                                                                                    
                                                                                                                                
CALL TO ORDER                                                                                                                 
                                                                                                                                
Co-Chair  Olson  called  the  Senate  Finance  Committee   meeting                                                              
to order at 9:02 a.m.                                                                                                           
                                                                                                                                
MEMBERS PRESENT                                                                                                               
                                                                                                                                
Senator Donny Olson, Co-Chair                                                                                                   
Senator Lyman Hoffman, Co-Chair                                                                                                 
Senator Jesse Kiehl                                                                                                             
Senator Kelly Merrick                                                                                                           
Senator David Wilson                                                                                                            
                                                                                                                                
MEMBERS ABSENT                                                                                                                
                                                                                                                                
Senator Bert Stedman, Co-Chair                                                                                                  
Senator Click Bishop                                                                                                            
                                                                                                                                
ALSO PRESENT                                                                                                                  
                                                                                                                                
Emily   Ricci,  Deputy   Commissioner,   Department    of  Health;                                                              
Valerie  Rose,  Fiscal  Analyst,  Legislative   Finance  Division;                                                              
Senator   Bill  Wielechowski,   Sponsor;   Kali  Spencer,   Staff,                                                              
Senator   Wielechowski;   Sylvan  Robb,   Director,   Division  of                                                              
Corporations,     Business     and    Professional     Licensing,                                                               
Department  of  Commerce,  Community  and  Economic  Development;                                                               
Kris Curtis, Legislative Auditor, Juneau;                                                                                       
                                                                                                                                
PRESENT VIA TELECONFERENCE                                                                                                    
                                                                                                                                
Dr.  Anne Zink,  Chief  Medical  Officer,  Department  of  Health,                                                              
Palmer;  Dr.  Mishelle  Nace,  Pediatric   Physician,  Fairbanks;                                                               
Brooke   Ivy,   Alaska   Children's   Trust,    Anchorage;   Jamie                                                              
Morgan,   Government  Relations,   American   Heart  Association,                                                               
Sacramento; Antonia Leonard, Self, Eagle River;                                                                                 
                                                                                                                                
SUMMARY                                                                                                                       
                                                                                                                                
SB 38      INTERFERENCE WITH EMERGENCY SERVICES                                                                                 
                                                                                                                                
           SB  38 was  REPORTED  out of  committee  with  and with                                                              
           three  do pass  and  one no  recommendation;   and with                                                              
           two  new  zero fiscal  notes  from  the  Department  of                                                              
           Administration,   and  three   zero  fiscal  notes:  FN                                                              
           3(COR), FN 4(LAW), FN 5(DPS).                                                                                        
                                                                                                                                
SB 55      EXTEND STATE MEDICAL BOARD                                                                                           
                                                                                                                                
           SB 55 was HEARD and HELD in committee for further                                                                    
           consideration.                                                                                                       
                                                                                                                                
SB 58      MEDICAID ELIGIBILITY: POSTPARTUM MOTHERS                                                                             
                                                                                                                                
           SB 58 was HEARD and HELD in committee for further                                                                    
           consideration.                                                                                                       
                                                                                                                                
SENATE BILL NO. 58                                                                                                            
                                                                                                                                
      "An  Act  relating   to  Medicaid  eligibility;    expanding                                                              
      eligibility   for  postpartum  mothers;   conditioning   the                                                              
      expansion  of   eligibility   on  approval   by  the  United                                                              
      States  Department   of  Health  and  Human  Services;   and                                                              
      providing for an effective date."                                                                                         
                                                                                                                                
9:04:24 AM                                                                                                                    
                                                                                                                                
EMILY RICCI, DEPUTY COMMISSIONER, DEPARTMENT OF HEALTH,                                                                         
introduced herself. She displayed the presentation, "SB 58:                                                                     
Postpartum Medicaid Extension" (copy on file).                                                                                  
                                                                                                                                
9:04:55 AM                                                                                                                    
                                                                                                                                
DR. ANNE ZINK, CHIEF MEDICAL OFFICER, DEPARTMENT OF HEALTH,                                                                     
PALMER (via teleconference), pointed to slide 3, "What is                                                                       
Postpartum Medicaid Extension:                                                                                                  
                                                                                                                                
      .notdef SB 58 extends postpartum Medicaid coverage  for  new                                                            
      mothers from 60  days to 12 months.                                                                                       
                                                                                                                                
      .notdef The original 60 days postpartum period for  Medicaid                                                            
      came  from  Congress     in  1986.   The  data   are  clear:                                                              
    postpartum health issues occur far beyond 60  days.                                                                         
                                                                                                                                
      .notdef SB 58 is an evidence-based   action  that   supports                                                            
      growing  families   and  will    improve   maternal   health                                                              
      outcomes for Alaskans.                                                                                                    
                                                                                                                                
      .notdef Continued health care coverage is  associated   with                                                            
      detection and early  intervention which improve long-                                                                     
      term maternal and child health  outcomes.                                                                                 
                                                                                                                                
Dr. Zink pointed to slide 4, "What Are the Stakes?                                                                              
                                                                                                                                
      The United  States  is  the  only developed   country  where                                                              
      maternal mortality rates are worsening.                                                                                   
                                                                                                                                
Dr. Zink looked at slide 5, "What Are the Stakes?                                                                               
                                                                                                                                
      .notdef Pregnancy-related deaths occur well beyond  the  60-                                                            
      day  postpartum period.                                                                                                   
                                                                                                                                
      .notdef 29 percent of pregnancy-related deaths in the U.S.                                                              
      not  including   those  caused  by   accidents,  homicides,                                                               
      and suicides  occur 43 to 365  days postpartum.                                                                           
                                                                                                                                
      .notdef For every pregnancy-related death, there  are  70 to                                                            
      80 cases  of   severe  maternal  illness  and  morbidity  in                                                              
      the postpartum period.                                                                                                    
                                                                                                                                
      .notdef Medicaid-enrolled women are especially vulnerable to                                                            
      pregnancy-  related   death  as  they  are  more  likely  to                                                              
      experience  chronic   conditions,   pre-term  or low-weight                                                               
      births, and severe maternal morbidity.                                                                                    
                                                                                                                                
Dr. Zink addressed slide 6, "Pregnancy-Associated Deaths in                                                                     
Alaska:                                                                                                                         
                                                                                                                                
                                                                                                                                
      .notdef In 2021, Alaska's overall pregnancyassociated  death                                                            
      rate  exceeded   the    previous   5-year  average   by  109                                                              
      percent                                                                                                                   
                                                                                                                                
      .notdef Among deaths in 2015-2019: 73 percent   occurred  >6                                                            
      weeks post-delivery                                                                                                       
                                                                                                                                
      .notdef Among deaths reviewed by Alaska's Maternal and Child                                                            
      Death  Review  (MCDR)    committee   during  2016-2022,   88                                                              
      percent  were   potentially   preventable,  and  44  percent                                                              
    were associated with barriers to health care access                                                                         
                                                                                                                                
Dr. Zink looked at slide 7, "What can Alaska do about it?                                                                       
                                                                                                                                
      Section  9812  of  the  American  Rescue   Plan  Act  (ARPA)                                                              
      added  the  time-limited  option   for  allowing  states  to                                                              
      extend postpartum coverage from the required 60 days                                                                      
      to 12 months for eligible beneficiaries through March                                                                     
      1, 2027.                                                                                                                  
                                                                                                                                
      The Consolidated Appropriations Act of 2023 (CAA-2023)                                                                    
      revised ARPA to make the optional coverage extension                                                                      
      permanent.                                                                                                                
                                                                                                                                
Co-Chair  Hoffman  looked  at slide  6,  and noted  the number  of                                                              
deaths  per  100,000  was twice  in  rural  Alaska  than in  urban                                                              
Alaska  in  2020   and  2021.  He  remarked   that  in  the  Yukon                                                              
Kuskokwim  Delta,  there  was  a  prematernal  home  which  housed                                                              
pregnant   people    from   outlying   villages   for   the   last                                                              
trimester.   He  wondered   whether   there  was  any  indication                                                               
that  the mortality   rate  for the  region  was  reduced  because                                                              
of that expectant mother requirement.                                                                                           
                                                                                                                                
Dr.  Zink agreed  to  provide  that information.   She noted  that                                                              
the  numbers were  quite  low,  so it was  difficult  to  pull out                                                              
each region.                                                                                                                    
                                                                                                                                
9:10:54 AM                                                                                                                    
                                                                                                                                
Co-Chair   Olson  noted  that   72  percent  of  deaths   occurred                                                              
after  six  weeks   post-delivery.   He  wondered  whether   those                                                              
were deaths of the children or deaths of the mother.                                                                            
                                                                                                                                
Dr. Zink replied that those were death of the mother.                                                                           
                                                                                                                                
Co-Chair  Olson   looked  at  slide  4,  and  queried  the  reason                                                              
for the higher mortality rate in the United States.                                                                             
                                                                                                                                
Dr.  Zink replied   that access  to  health  care  coverage  was a                                                              
major   challenge   in   Alaska   and   the  other   states.   She                                                              
remarked   that  there  were  many   factors  that   affected  the                                                              
mother  such  as  substance  abuse  and  depression.   She  agreed                                                              
to provide additional details.                                                                                                  
                                                                                                                                
Senator  Kiehl  asked  about  the services   that  the bill  would                                                              
enable the state to provide to lead to better outcomes.                                                                         
                                                                                                                                
Dr.  Zink remarked  that  72 percent  of  the maternal   mortality                                                              
rates  from  2012  to  2021  were  related  to  substance,   drug,                                                              
and  alcohol   abuse   disorder,   which  would   be  put  into  a                                                              
category  of  potentially  preventable.   She  shared  a story  of                                                              
a patient  who  was sober  during  her  pregnancy,  but after  the                                                              
birth  she  became  depressed   and started   using  drugs  again.                                                              
She  did not  have health  insurance  to  get treatment   options.                                                              
She  stated  that the  woman  reenrolled   in Medicaid  to  obtain                                                              
access to treatment.                                                                                                            
                                                                                                                                
Co-Chair  Olson  wondered  whether   a person  from  rural  Alaska                                                              
who  gave  birth  in an  urban  hospital  would  be  considered  a                                                              
rural or urban death.                                                                                                           
                                                                                                                                
Dr.  Zink  replied   believed  that  it  would   be  considered  a                                                              
rural   death,   because   it   was  based   on   residency.   She                                                              
deferred to Ms. Nace.                                                                                                           
                                                                                                                                
9:15:05 AM                                                                                                                    
                                                                                                                                
DR.   MISHELLE   NACE,  PEDIATRIC    PHYSICIAN,   FAIRBANKS   (via                                                              
teleconference),   stated  that  she  would  need to  confirm  the                                                              
statistics in determining the differentiation.                                                                                  
                                                                                                                                
9:15:52 AM                                                                                                                    
                                                                                                                                
Ms. Ricci pointed to slide 8, "Why a Bill?                                                                                      
                                                                                                                                
      .notdef The Legislature must approve all optional groups for                                                            
      Medicaid coverage in statute AS 47.07.020                                                                                 
                                                                                                                                
      .notdef Women who are eligible for Medicaid in Alaska based                                                             
      on their pregnancy currently only receive coverage for                                                                    
      60 days postpartum                                                                                                        
                                                                                                                                
      .notdef In Alaska, 51 percent of births are covered by                                                                  
      Medicaid                                                                                                                  
                                                                                                                                
Senator  Wilson  wondered   how long  it  would  be  for the  bill                                                              
to be enacted after its passage.                                                                                                
                                                                                                                                
Ms. Ricci replied that it would take effect by July 2024.                                                                       
                                                                                                                                
Co-Chair   Olson  wondered   if  all  of  the  requirements   were                                                              
federally mandated before the bill could take effect.                                                                           
                                                                                                                                
Ms.   Ricci    replied   that   the    regulations    were   state                                                              
requirements, but there was one federal requirement.                                                                            
                                                                                                                                
9:20:00 AM                                                                                                                    
                                                                                                                                
Dr. Zink looked at slide 9, "Benefits to Alaskans                                                                               
                                                                                                                                
      .notdef Improves maternal health outcomes                                                                               
           .notdef Prevents gaps in  health  care   coverage   and                                                            
           improves health care access                                                                                          
      .notdef Improves maternal mental health                                                                                 
           .notdef Mental health conditions  contributed    to  31                                                            
           percent of pregnancy-associated deaths in Alaska                                                                     
           between 2014 and 2018                                                                                                
           .notdef 14 percent of Alaskan mothers who had a baby in                                                            
           2020 had symptoms of postpartum                                                                                      
           depression                                                                                                           
 .notdef Addresses disparities in maternal health outcomes                                                                    
           .notdef Medicaid plays a  vital  role   in  addressing                                                             
           disparities   in  maternal   mortality  and   morbidity                                                              
           rates                                                                                                                
      .notdef Improves child health outcomes                                                                                  
           .notdef Parental enrollment in Medicaid  is associated                                                             
           with  a   29    percent  higher   probability   that  a                                                              
           child will receive an annual well-child visit                                                                        
                                                                                                                                
Dr. Zink pointed to slide 10, Cost Savings:                                                                                     
                                                                                                                                
      .notdef The costs for providing Medicaid  coverage  for  new                                                            
      mothers  who would  have  otherwise  lost  or experienced  a                                                              
      gap in  coverage   have  been  estimated  using  historical                                                               
      Medicaid  claims  data, but  these  costs do  not take  into                                                              
     account potential savings and offsetting factors.                                                                          
                                                                                                                                
      .notdef Savings from averted severe   maternal   morbidity:                                                             
      Medicaid-enrolled   pregnant  women  with  severe   maternal                                                              
      morbidity  cost an  average  of $10,134   annually  compared                                                              
      to $6,894 for those without.                                                                                              
                                                                                                                                
      .notdef Savings from prevention: Preventing gaps in coverage                                                            
      ensures   access    to   primary   and   preventive    care,                                                              
      including    management    of   chronic    conditions    and                                                              
      screening  for mental  health  conditions,   substance  use,                                                              
      and intimate partner violence.                                                                                            
                                                                                                                                
Co-Chair Hoffman wondered how the bill applied to those                                                                         
hospitals by Alaska Native health corporations.                                                                                 
                                                                                                                                
Dr. Zink replied that the bill would apply to anyone who                                                                        
was covered by pregnancy Medicaid coverage, both tribal and                                                                     
non-tribal.                                                                                                                     
                                                                                                                                
Dr. Zink looked at slide 11, Alaska Supports SB 58:                                                                             
                                                                                                                                
      Extending Postpartum Medicaid Coverage is supported                                                                       
      by:                                                                                                                       
                                                                                                                                
      -   The    American    College    of   Obstetricians     and                                                              
      Gynecologists (ACOG)                                                                                                      
      - The American Medical Association                                                                                        
      - The American Academy of Pediatrics                                                                                      
      - The Society for Maternal-Fetal Medicine                                                                                 
      - The American College of Physicians                                                                                      
      - The American Academy of Family Physicians                                                                               
      - The American Hospital Association                                                                                       
      - The American Psychiatric Association                                                                                    
      - The American College of Cardiology                                                                                      
      - The American Osteopathic Association                                                                                    
      - The March of Dimes                                                                                                      
                                                                                                                                
Co-Chair   Olson  asked  for  an   example  of  extreme   maternal                                                              
morbidity, and the costs associated with that.                                                                                  
                                                                                                                                
Dr.  Zink  replied   that  an  example   would  be  someone   with                                                              
chronic  hypertension,    or someone   with  a  development   of a                                                              
clot.  She  stated  that once  the  coverage  was  lost, a  person                                                              
was  less  likely   to  have  follow   up  care  or  preventative                                                               
care.                                                                                                                           
                                                                                                                                
9:25:51 AM                                                                                                                    
                                                                                                                                
Co-Chair  Olson  wondered  how  often eclamptic   or preeclamptic                                                               
symptoms were seen post-partum.                                                                                                 
                                                                                                                                
Dr.  Zink responded  that  those  only would  apply  to the  first                                                              
six  weeks  post-delivery,   however   women  could  have  chronic                                                              
hypertension   that  can  be  exacerbated  during   pregnancy  and                                                              
require long term coverage. She deferred to Dr. Nace.                                                                           
                                                                                                                                
Dr.  Nace stated  that  about  one  quarter  to one  third  of the                                                              
conditions   would  happen   in  the  62  day  to  one  year  post                                                              
delivery time period.                                                                                                           
                                                                                                                                
Co-Chair Olson stressed that it was a significant number.                                                                       
                                                                                                                                
Ms.  Ricci  continued  to discuss   slide  11. She  stressed  that                                                              
there  was  an  initial   upfront   cost  of  approximately   $2.6                                                              
million  in UGF  associated  with the  bill on  an annual  basis.                                                               
                                                                                                                                
Dr.   Zink    pointed    to   slide    12,    "Healthy    Families                                                              
Initiative.    She  stated  that  the  slide  showed  the  overall                                                              
life impacts of the mother and baby. She stressed the                                                                           
significant impact of untreated mental health.                                                                                  
                                                                                                                                
9:31:12 AM                                                                                                                    
                                                                                                                                
Dr. Zink discussed slide 13, "Healthy Families Initiative:                                                                      
                                                                                                                                
      Strong   families   are   the  foundation    of  a   healthy                                                              
      society and a vibrant economy.                                                                                            
                                                                                                                                
      .notdef 4-year statewide investments in  the   health    and                                                            
      well-being of Alaskan families                                                                                            
      .notdef Governor Dunleavy proposed $9.5M (UGF)   in   FY  24                                                            
      operating   budget   for  Healthy   Families     activities                                                               
      within DOH:                                                                                                               
           .notdef Postpartum Medicaid extension                                                                              
           .notdef Office of Health Savings                                                                                   
       .notdef TB and congenital syphilis mitigation                                                                          
           .notdef Fresh Start Campaign                                                                                       
                                                                                                                                
Dr. Zink pointed to slide 15, "Section 1:                                                                                       
                                                                                                                                
      Adds  a new  section   (o)  to  AS  47.07.020,  authorizing                                                               
      the department  to  implement  an  extension  of postpartum                                                               
      Medicaid  coverage  up  to the  maximum  period  authorized                                                               
      under federal law.                                                                                                        
                                                                                                                                
Co-Chair Olson asked whether the current congenital                                                                             
syphilis trend was increasing or decreasing.                                                                                    
                                                                                                                                
Dr. Zink replied that syphilis was rapidly on the rise.                                                                         
                                                                                                                                
9:35:06 AM                                                                                                                    
                                                                                                                                
Ms. Ricci pointed to slide 17, "Section 3:                                                                                      
                                                                                                                                
      Amends the  uncodified  law  to establish   the requirement                                                               
      that  the commissioner   of  health  notifies   the  revisor                                                              
      of statutes  within  30  days  of federal  approval   of the                                                              
      state plan amendment.                                                                                                     
                                                                                                                                
Ms. Ricci addressed slide 18, "Section 4:                                                                                       
                                                                                                                                
      Establishes  that  the postpartum   extension  takes  effect                                                              
      on the  day  after   the  date  the  commissioner   notifies                                                              
      the revisor of statutes as described above.                                                                               
                                                                                                                                
Co-Chair    Olson    queried    the    anticipated    number    of                                                              
participants in the program.                                                                                                    
                                                                                                                                
Ms.   Ricci   replied   that   she   estimated   at   least   1556                                                              
participants   that  would   have  lost  coverage  entirely,   and                                                              
another 2300 that would have had gaps in coverage.                                                                              
                                                                                                                                
9:38:06 AM                                                                                                                    
                                                                                                                                
VALERIE  ROSE,  FISCAL  ANALYST,  LEGISLATIVE   FINANCE  DIVISION,                                                              
(LFD) addressed the bill's fiscal note.                                                                                         
                                                                                                                                
Co-Chair  Olson  queried  the limit  of  federal  funding  for the                                                              
bill.                                                                                                                           
                                                                                                                                
Ms.  Rose  replied  approximately   $6.4  million  was  needed  in                                                              
additional federal authority for the department.                                                                                
                                                                                                                                
9:40:50 AM                                                                                                                    
                                                                                                                                
Co-Chair  Hoffman  wondered  whether  the  implementation   of the                                                              
fiscal  note  would  follow  the  same  process  for  the  initial                                                              
60 days.                                                                                                                        
                                                                                                                                
Ms. Rose deferred to the department.                                                                                            
                                                                                                                                
Co-Chair  Hoffman  wondered  whether  there  would  be additional                                                               
requirements to access those funds statewide.                                                                                   
                                                                                                                                
Ms. Rose deferred to the department.                                                                                            
                                                                                                                                
Co-Chair Hoffman said he would accept a written response.                                                                       
                                                                                                                                
Co-Chair Olson OPENED public testimony.                                                                                         
                                                                                                                                
9:42:42 AM                                                                                                                    
                                                                                                                                
BROOKE   IVY,    ALASKA   CHILDREN'S    TRUST,   ANCHORAGE    (via                                                              
teleconference), spoke in support of the bill.                                                                                  
                                                                                                                                
9:44:54 AM                                                                                                                    
                                                                                                                                
JAMIE    MORGAN,    GOVERNMENT    RELATIONS,     AMERICAN    HEART                                                              
ASSOCIATION,   SACRAMENTO   (via teleconference),    testified  in                                                              
support of the legislation.                                                                                                     
                                                                                                                                
Co-Chair   Olson   queried    the   specific   types   of   cardio                                                              
myopathies.                                                                                                                     
                                                                                                                                
9:47:32 AM                                                                                                                    
                                                                                                                                
ANTONIA   LEONARD,  SELF,   EAGLE  RIVER   (via  teleconference),                                                               
expressed concern about state-funded medical coverage.                                                                          
                                                                                                                                
Co-Chair Olson CLOSED public testimony.                                                                                         
                                                                                                                                
9:50:57 AM                                                                                                                    
                                                                                                                                
Ms.  Zink   addressed   the  question   about   the  question   of                                                              
maternal  death  related  to COVID-19   vaccinations.  She  stated                                                              
that  an  internal  maternal  death   review  board  reviewed  all                                                              
maternal   deaths    by  exploring    all   factors   that   would                                                              
contribute  to  the death.  She  noted  that seven  were  suicide,                                                              
seven  were  drug  and alcohol  overdoses,   eight  were  homicide                                                              
and  assault,  eight were  injury,  nine  were  pregnancy  related                                                              
medical   causes,  and  nine  were   other  medical   causes.  She                                                              
stated  that  the medical  causes  were  primarily  heart  disease                                                              
and diabetes.                                                                                                                   
                                                                                                                                
Ms. Ricci thanked the committee.                                                                                                
                                                                                                                                
SB   58  was   HEARD   and   HELD   in   committee   for   further                                                              
consideration.                                                                                                                  
                                                                                                                                
SENATE BILL NO. 55                                                                                                            
                                                                                                                                
      "An Act extending the termination date of the State                                                                       
      Medical Board; and providing for an effective date."                                                                      
                                                                                                                                
9:54:05 AM                                                                                                                    
                                                                                                                                
SENATOR BILL WIELECHOWSKI, SPONSOR, introduced himself.                                                                         
                                                                                                                                
9:54:39 AM                                                                                                                    
                                                                                                                                
KALI  SPENCER,  STAFF,   SENATOR  WIELECHOWSKI,   stated  that  SB
55 extended   the termination   date of  the State  Medical  Board                                                              
to  June  30, 2031.  She  stated  that  the  recommendation   came                                                              
from an audit performed by Legislative Audit.                                                                                   
                                                                                                                                
9:57:43 AM                                                                                                                    
                                                                                                                                
SYLVAN  ROBB,   DIRECTOR,  DIVISION   OF  CORPORATIONS,   BUSINESS                                                              
AND   PROFESSIONAL     LICENSING,    DEPARTMENT    OF    COMMERCE,                                                              
COMMUNITY  AND  ECONOMIC  DEVELOPMENT,  stated  that  there  was a                                                              
small  fiscal  note that  reflected  the  continued  costs  to the                                                              
State Medical Board.                                                                                                            
                                                                                                                                
Co-Chair   Olson  asked  about   the  significance   and  cost  of                                                              
investigations.                                                                                                                 
                                                                                                                                
Ms.  Robb responded  that  investigation   costs  were not  within                                                              
the  fiscal   note.  She   stated  that   the  governors    budget                                                              
proposed changing the investigation fund source.                                                                                
                                                                                                                                
Co-Chair   Olson  spoke   of  the  cost   of  investigations.   He                                                              
asked about the current number of investigations.                                                                               
                                                                                                                                
Ms.  Robb  said  that  the  fiscal  note  reflected  the  cost  of                                                              
running the board.                                                                                                              
                                                                                                                                
10:00:07 AM                                                                                                                   
                                                                                                                                
KRIS  CURTIS,   LEGISLATIVE    AUDITOR,   JUNEAU,  spoke   to  the                                                              
sunset audit of the board.                                                                                                      
                                                                                                                                
10:04:17 AM                                                                                                                   
AT EASE                                                                                                                         
                                                                                                                                
10:04:56 AM                                                                                                                   
RECONVENED                                                                                                                      
                                                                                                                                
Co-Chair Olson OPENED and CLOSED public testimony.                                                                              
                                                                                                                                
Senator  Wielechowski   stated   that  he  did  not  have  further                                                              
comments.                                                                                                                       
                                                                                                                                
Ms. Spencer thanked the committee.                                                                                              
                                                                                                                                
10:05:41 AM                                                                                                                   
                                                                                                                                
Senator  Wilson  recalled  that  there was  a new  cost shift  for                                                              
investigations   and wondered  whether  a  percentage  of  the fee                                                              
could  be used  for investigations.   He  felt that  shifting  the                                                              
entire cost to UGF might be too great.                                                                                          
                                                                                                                                
Ms.  Robb  stated  that  the  investigative   fees  would  be  for                                                              
the   21  boards   that   were   covered   by  the   Division   of                                                              
Corporations,    Business,   and  Professional    Licensing.   She                                                              
shared  that  the  percentage  had  been  examined  in  the  past,                                                              
such  as the  Board  of  Midwives.  She  stressed  that  spreading                                                              
the   set  fee   for   every   licensee,   was   because   of  the                                                              
differential of the number of licensees.                                                                                        
                                                                                                                                
Senator   Wilson   felt   that   determining   a   fee  to   cover                                                              
investigations would not be impossible.                                                                                         
                                                                                                                                
Ms.  Robb replied   that she  could  examine  a way  to  determine                                                              
the fee.                                                                                                                        
                                                                                                                                
Senator  Wilson  felt  that maybe  there  could be  a nominal  fee                                                              
to offset that cost.                                                                                                            
                                                                                                                                
Co-Chair   Olson  wondered   whether   the  State  Medical   Board                                                              
still had a long wait period to receive a license.                                                                              
                                                                                                                                
Ms.   Robb  replied   that   the  current   licensing    time  was                                                              
approximately eight to ten weeks.                                                                                               
                                                                                                                                
10:10:56 AM                                                                                                                   
                                                                                                                                
Co-Chair   Olson  wondered  whether   the  delay  was  related  to                                                              
podiatrists and physicians assistants.                                                                                          
                                                                                                                                
Ms. Robb agreed to provide that information.                                                                                    
                                                                                                                                
SB   55  was   HEARD   and   HELD   in   committee   for   further                                                              
consideration.                                                                                                                  
                                                                                                                                
SENATE BILL NO. 38                                                                                                            
                                                                                                                                
      "An Act establishing the crime of interference with                                                                       
      emergency communications."                                                                                                
                                                                                                                                
10:12:07 AM                                                                                                                   
                                                                                                                                
Senator   Wilson   thanked   the   committee   for   hearing   the                                                              
legislation.                                                                                                                    
                                                                                                                                
Co-Chair Olson noted that there were five fiscal notes.                                                                         
                                                                                                                                
Senator   Wilson   MOVED   to  REPORT   SB  38   with  individual                                                               
recommendations   and  attached   fiscal  notes.  There  being  NO                                                              
OBJECTION, it was so ordered.                                                                                                   
                                                                                                                                
SB  38 was  REPORTED  out  of committee  with  and  with three  do                                                              
pass  and   one  no  recommendation;    and  with   two  new  zero                                                              
fiscal   notes  from  the   Department   of  Administration,   and                                                              
three zero fiscal notes: FN 3(COR), FN 4(LAW), FN 5(DPS).                                                                       
                                                                                                                                
ADJOURNMENT                                                                                                                   
10:14:09 AM                                                                                                                   
                                                                                                                                
The meeting was adjourned at 10:14 a.m.                                                                                         
                                                                                                                                

Document Name Date/Time Subjects
SB 58 Medicaid Eligibility Postpartum Mothers Presentation 3.7.2023.pdf SFIN 3/7/2023 9:00:00 AM
SB 58
SB 58 Research Maternal Mortality 12.1.2022 .pdf SFIN 3/7/2023 9:00:00 AM
SHSS 2/9/2023 3:30:00 PM
SB 58
SB 58 Sectional Analysis Version A.pdf SFIN 3/7/2023 9:00:00 AM
SHSS 2/9/2023 3:30:00 PM
SB 58
SB 58 Sponsor Statement.pdf SFIN 3/7/2023 9:00:00 AM
SHSS 2/9/2023 3:30:00 PM
SB 58
SB 58 Summary Version A.pdf SFIN 3/7/2023 9:00:00 AM
SB 58
SB 55 Supporting Document - State Medical Board Audit, July 2022.pdf SFIN 3/7/2023 9:00:00 AM
SL&C 2/17/2023 1:30:00 PM
SB 55
SB 55 Sponsor Statement Version A.pdf SFIN 3/7/2023 9:00:00 AM
SL&C 2/17/2023 1:30:00 PM
SB 55
SB 55 Letter of Support - Alaska State Medical Association.pdf SFIN 3/7/2023 9:00:00 AM
SB 55
SB 58 Postpartum Medicaid SFIN Response questions.pdf SFIN 3/7/2023 9:00:00 AM
SB 58
SB 55 Follow-Up from DCCED-CBPL 3.9.23.pdf SFIN 3/7/2023 9:00:00 AM
SB 55
SB 58 MSHF Medicaid Postpartum LOS.pdf SFIN 3/7/2023 9:00:00 AM
SB 58
SB 58 AMHB.ABADA LOS.pdf SFIN 3/7/2023 9:00:00 AM
SB 58
SB 55- Extend State Medical Board- Letter of Support from AK Board of Pharmacy.pdf SFIN 3/7/2023 9:00:00 AM
SB 55
SB 58 Support Alaska Children's Trust.pdf SFIN 3/7/2023 9:00:00 AM
SB 58