Legislature(2021 - 2022)SENATE FINANCE 532
03/29/2021 01:00 PM Senate FINANCE
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| Audio | Topic |
|---|---|
| Start | |
| SB56 || HB76 | |
| Adjourn |
* first hearing in first committee of referral
+ teleconferenced
= bill was previously heard/scheduled
+ teleconferenced
= bill was previously heard/scheduled
| += | SB 56 | TELECONFERENCED | |
| + | HB 76 | TELECONFERENCED | |
| + | TELECONFERENCED |
SENATE FINANCE COMMITTEE
March 29, 2021
1:01 p.m.
1:01:26 PM
CALL TO ORDER
Co-Chair Bishop called the Senate Finance Committee meeting
to order at 1:01 p.m.
MEMBERS PRESENT
Senator Click Bishop, Co-Chair
Senator Bert Stedman, Co-Chair
Senator Lyman Hoffman
Senator Bill Wielechowski
Senator David Wilson
MEMBERS ABSENT
Senator Donny Olson
Senator Natasha von Imhof
ALSO PRESENT
Suzanne Cunningham, Legislative Liaison, Department of
Health and Social Services.
PRESENT VIA TELECONFERENCE
Albert Wall, Deputy Commissioner, Department of Health and
Social Services; Dr. Anne Zink, Chief Medical Officer,
Department of Health and Social Services; Dr. Joe
McLaughlin, Chief Epidemiologist, Department of Health and
Social Services; Sara Chambers, Director, Division of
Corporations, Business and Professional Licensing,
Department of Commerce, Community and Economic Development;
Stacie Kraly, Chief Assistant Attorney General, Department
of Law; Heidi Teshner, Director, Finance and Support
Services, Department of Education and Early Development;
Adam Crum, Commissioner, Department of Health and Social
Services.
SUMMARY
SB 56 EXTENDING COVID 19 DISASTER EMERGENCY
SB 56 was HEARD and HELD in committee for further
consideration.
CSHB 76(FIN)am
EXTENDING COVID 19 DISASTER EMERGENCY
CSHB 76(FIN)am was HEARD and HELD in committee
for further consideration.
SENATE BILL NO. 56
"An Act extending the January 15, 2021, governor's
declaration of a public health disaster emergency in
response to the novel coronavirus disease (COVID-19)
pandemic; providing for a financing plan; making
temporary changes to state law in response to the
COVID-19 outbreak in the following areas: occupational
and professional licensing, practice, and billing;
telehealth; fingerprinting requirements for health
care providers; charitable gaming and online ticket
sales; access to federal stabilization funds; wills;
unfair or deceptive trade practices; and meetings of
shareholders; and providing for an effective date."
CS FOR HOUSE BILL NO. 76(FIN) am
"An Act extending the January 15, 2021, governor's
declaration of a public health disaster emergency in
response to the novel coronavirus disease (COVID-19)
pandemic; approving and ratifying declarations of a
public health disaster emergency; providing for a
financing plan; making temporary changes to state law
in response to the COVID- 19 outbreak in the following
areas: occupational and professional licensing,
practice, and billing; telehealth; fingerprinting
requirements for health care providers; charitable
gaming and online ticket sales; access to federal
stabilization funds; wills; unfair or deceptive trade
practices; meetings of shareholders; and school
operating funds; relating to informed consent for
COVID-19 vaccines; relating to personal objections to
the administration of COVID-19 vaccines; providing
immunity from liability and disciplinary action for
occupational licensees for exposure of clients to
COVID-19; providing immunity from liability for
persons engaging in business and their employees for
exposure of customers to COVID-19; and providing for
an effective date."
1:02:17 PM
Co-Chair Bishop relayed that HB 76 was a companion bill for
SB 56, and the bills would be considered together. It was
the first hearing for HB 76. His intention was to hear and
hold HB 76 and SB 56. He mentioned the names of invited
testimony and individuals available for questions.
1:03:38 PM
SUZANNE CUNNINGHAM, LEGISLATIVE LIAISON, DEPARTMENT OF
HEALTH AND SOCIAL SERVICES, discussed a Sectional Analysis
of version W.A of the bill (copy on file):
Section 1: Findings
Establishes legislative findings pertaining to COVID-
19. The Legislature finds that it is in the best
interest of the state to take appropriate steps to
continue to contain the spread of COVID-19; to
distribute COVID-19 vaccines statewide; and to take
appropriate steps to limit further harm to the state's
economy, enable displaced workers in the state to
return to work, and to allow students to rejoin in-
person classes.
Ms. Cunningham continued to address the Sectional Analysis:
Section 2: Approval, Ratification, and Extension of
Disaster Emergency
Approves and ratifies the declarations of a public
health disaster emergency issued on November 15, 2020,
December 15, 2020, and January 15, 2021. Extends the
Public Health Disaster Emergency issued on January 15,
2021 to September 30, 2021. Provides that the
Commissioner of the Department of Health & Social
Services (DHSS) may certify to the Governor that there
is no longer a present outbreak of COVID-19, or a
credible threat of an imminent outbreak. Upon
receiving this certification, the Governor shall
submit a proclamation to the Legislature that
indicates that the public health disaster emergency no
longer exists.
Co-Chair Bishop relayed that the committee had learned the
previous week that the emergency allotment Supplemental
Nutrition Assistance Program (SNAP) funding was authorized
by the federal government until December 21, 2021. He
queried if the state would we eligible for emergency
allotment SNAP benefits for October, November, and December
if the state kept the extension date of September 30, 2021,
as proposed in HB 76.
1:06:24 PM
ALBERT WALL, DEPUTY COMMISSIONER, DEPARTMENT OF HEALTH AND
SOCIAL SERVICES (via teleconference), explained that the
emergency declaration had to be in place in the month in
which the emergency allotment SNAP benefits were paid. The
benefits were applied for on a month-to-month basis.
Co-Chair Stedman asked for clarity regarding when the
federal disaster declaration ended.
Co-Chair Bishop thought Co-Chair Stedman was referencing
Section 2.
Ms. Cunningham informed that the federal public health
emergency had to be renewed every 30 days, and the last
renewal was January 19, 2021. She continued that the Biden
Administration had indicated it intended to continue the
federal public health emergency through the duration of
calendar year 2021. The Major Disaster Declaration, in
place via the United States Stafford Act, would remain in
place until it was withdrawn.
Co-Chair Bishop asked what would cause a state or federal
agency to determine that there was no longer a present
outbreak of the COVID-19 disease, or a credible threat of a
COVID-19 outbreak. He asked if the state had met the
threshold already.
1:09:22 PM
DR. ANNE ZINK, CHIEF MEDICAL OFFICER, DEPARTMENT OF HEALTH
AND SOCIAL SERVICES (via teleconference), relayed that her
job, and that of the state's epidemiologist, was to promote
the health and wellbeing of Alaskans. She thought the
state's epidemiologist could best answer Co-Chair Bishop's
question.
1:10:50 PM
AT EASE
1:11:23 PM
RECONVENED
Co-Chair Bishop repeated his question. He asked what would
cause a federal or state agency to determine there was no
longer a present outbreak of COVID-19 or an imminent
outbreak, and if the state had met the threshold.
Dr. Zink stated that there were different definitions of
outbreak or pandemic. She explained that the disaster
declaration was more of a statutory condition rather than
being a public health definition and was a tool for having
additional resources.
1:13:14 PM
DR. JOE MCLAUGHLIN, CHIEF EPIDEMIOLOGIST, DEPARTMENT OF
HEALTH AND SOCIAL SERVICES (via teleconference), discussed
basic definitions for terminology surrounding the emergency
and disaster declarations. He explained that an epidemic
referred to an increase in the number of cases of a
particular disease above what was normally expected in a
population. There were a number of diseases that were
endemic in the population and had an established baseline
rate. Once there was a sudden increase in the number of
cases over time, it was possible to see epidemics emerge.
An emerging unknown infection disease such as the COVID-19
virus would be considered to be an outbreak when there were
three or more cases. An outbreak carried the same
definition as an epidemic but was often used for a more
limited geographic area and sometimes smaller numbers.
Dr. McLaughlin continued to address Co-Chair Bishop's
question. He explained that a pandemic referenced an
epidemic that was spread over several countries or
continents, usually affecting a large number of people. A
situation became a public health emergency when the health
consequences of an outbreak had the potential to overwhelm
routine community capabilities to address them.
Dr. McLaughlin discussed disasters, which were considered
as sudden, large-scale events which were often chaotic
because of acute onset. He used examples of earthquakes and
wildfires. The end result of a disaster typically involved
significant physical, social, psychological, and
environmental harm. He relayed that some states had only
public health emergency declaration capacity, some only had
disaster declaration capacity, and some had both.
1:16:51 PM
Senator Wielechowski thought the crux of the issue was that
Section 2 of the bill indicated that if the commissioner of
the Department of Health and Social Services certified to
the governor that there was no longer a present outbreak of
coronavirus or a credible threat of an imminent outbreak,
the governor could end the disaster declaration. He wanted
to see the issue depoliticized. He asked for an estimate of
when there would no longer be a present outbreak or
credible threat of an outbreak of the coronavirus.
Dr. McLaughlin answered, "not in the foreseeable future."
He qualified that there was no way of knowing how long the
pandemic would continue. He thought the outcome was
dependent upon the rate of vaccination as well as emerging
variants. He cited that there were 5 variants of COVID-19
reported by the Centers for Disease Control (CDC) that were
of concern. He thought most of the variants appeared to be
responding to vaccines but considered that there could be
new variants that emerged and showed a great degree of
resistance to vaccine-induced immunity. He summarized that
presently there was no end in sight in the near future.
Senator Hoffman asked if there was a level of herd immunity
(such as 80 percent) that would help mitigate the effect of
variants. He had heard that once a person received the
immunization, there would not be transmission of variants.
He used the example of a community that had a 90 percent
vaccination rate. He thought if there was a benchmark,
there could be a realistic way to look at progress. He
acknowledged the complexity of the question.
1:21:01 PM
Dr. McLaughlin did not know for sure what the herd immunity
threshold was for the COVID-19 virus. He explained that
many variants had become more transmissible because of
genetic mutations that had occurred, which could make it
difficult to determine an immunity threshold. He estimated
that the herd immunity threshold could be between 70
percent and 80 percent.
Dr. McLaughlin addressed the concept of herd immunity
through an anecdotal group of 1,000 people. He postulated
that once 80 percent of people were vaccinated, in the
absence of any other mitigation activities, the virus'
trajectory started to go down. He referenced the rapid
acceleration phase, and then there had been a decline
attributed to work done with non-pharmaceutical
interventions such as masking, social distancing, and
handwashing. With a high level of herd immunity, even
without masking and herd immunity there would be a decline
of the disease trajectory, to eventually reach a baseline.
He hoped the state would see herd immunity level from
vaccination reach the 70 to 80 percent range in the next
couple of months, which would result in a low-level
percolation of the virus.
Dr. McLaughlin addressed the question of how to know if the
state's population was reaching herd immunity and argued
that the best way was to assess vaccination rates. He noted
the difficulty of assessing the level of immunity a person
had through prior infection. He cited that the CDC said
that if an individual had been infected with COVID-19,
there was a robust immunity level for 90 days, after which
re-exposure would require quarantine. He summarized that
the durability of immunity from infection was not as strong
and robust as the immunity a person incurred after
vaccination.
1:26:00 PM
Dr. Zink added that it was possible to see a benefit even
before reaching herd immunity and cited a decrease in
hospitalizations. She mentioned the issue of hospitals
becoming overwhelmed and emphasized the importance of
vaccinations.
Senator Hoffman asked if the 70 to 80 percent herd immunity
calculation included only those 16 and over that could
receive the vaccine.
Dr. McLaughlin explained that from a public health
perception the calculation included the entire population
and the desired outcome was 70 to 80 percent immunity. He
noted that the disease severity was the worst for older
adults. He mentioned that it was still possible for
children to get severely ill from the virus. He hoped there
would be a vaccine licensed for kids younger than 16 by the
summer. He summarized that ultimately it was desirable to
get 70 to 80 percent of the entire population.
1:29:01 PM
Senator Wilson was confused about some messaging he had
heard in the past week. He thought he had heard that Dr.
McLaughlin did not see an end to the outbreak and did not
see an end to the threat; but had also thought the doctor
had indicated that there would be a "flattening of the
curve" in a couple of months. He recounted that couple of
weeks previously, he had heard Dr. McLaughlin state in a
call with the legislature that people with COVID-19
exposure could have more than a 90-day immunity and the CDC
could be revising its statement. He thought he had been
receiving mixed messages from the department. He commented
that the administration was not willing to extend the
emergency declaration without legislative action. He
thought it was confusing for himself as well as the general
public in understanding when the danger to the public might
end and when the state could get back to "normal."
Dr. McLaughlin addressed the question about his prior
answer about when we might see COVID-19 come to an end. He
thought COVID-19 would be with the global population for
years to come, and the virus would likely become a
routinely circulating coronaviruses. He did not think the
virus would go away for the foreseeable future.
Senator Wilson asked how long the department expected the
current situation would continue to the degree that a
disaster declaration was needed.
Dr. McLaughlin deferred the question to others.
Dr. Zink stated that the department did not believe all the
authorities granted in the disaster declaration were not
needed to address the pandemic, but considered that limited
authority was needed to continually respond to the changing
pandemic. She emphasized that the department would continue
to work for the public health for Alaskans. She affirmed
that COVID-19 was going to be present for a long time. She
commented that the state had built up its resources and
ability to respond to the pandemic, and the department no
longer had as much of a concern about overwhelming the
healthcare infrastructure as a year ago.
Co-Chair Bishop asked if Senator Wilson was satisfied with
the answer to his question.
Senator Wilson was satisfied.
1:34:11 PM
Ms. Cunningham continued to address the Sectional Analysis:
Section 3: Financing Plan
1. Appropriations made in Section 8 of HB 206 (Ch.2,
SLA 2020)
2. Appropriations made in Section 10 of HB 234 (Ch. 7,
SLA 2020)
3. Appropriations made in Section 28 of HB 205 (Ch. 8,
SLA 2020) of federal receipts received during FY
2021 for Medicaid Services and federal receipts
received for responding to the public health disaster
emergency
4. Appropriations made in Section 38 of HB 205 (Ch. 8,
SLA 2020) to the Disaster Relief Fund
5. Appropriations made in Section 37(a) of HB 205 (Ch.
8, SLA 2020) - excess federal receipts received during
FY 2021
6. The authorization for expenditure of federal CARES
Act receipts that were ratified in HB 313 (Ch. 32, SLA
2020)
7. Federal receipts received by any state agency for
purposes of mitigating the public health disaster
emergency that may be requested to include in an
appropriation bill if the Legislature is in session,
or using the process under AS 26.23.020(k)(2) if the
Legislature is not in session
8. Any future appropriations made for FY 2021 and FY
2022
9. The Governor may not spend more than $10 million
from the Disaster Relief Fund for the emergency
declared on January 15, 2021 and extended to September
30, 2021
Senator Wielechowski asked about Section 3 (a) 6. He asked
about excess federal receipts received and if there was any
indication of how many funds would be generated for the
governor to use.
Ms. Cunningham asked to consult with the Office of
Management and Budget (OMB) and provide the information in
writing.
Senator Wielechowski was curious about why the funds were
not included in SB 241, the financing plan from the
previous year.
Ms. Cunningham asked if Senator Wielechowski was referring
to Item 6.
Senator Wielechowski answered "yes."
Ms. Cunningham affirmed that DHSS had received federal
receipt authority in one of the appropriation bills, and
offered to follow up in writing to clarify.
1:36:58 PM
Senator Wilson asked about Section 3 on page 5, line 18,
which indicated the governor could not expend a cumulative
amount greater than $10 million. He noted the act expired
February 15, 2020 and asked about the total amount the
governor had spent during the month.
Ms. Cunningham offered to provide the information at a
later time after consulting with OMB and the Department of
Military and Veterans' Affairs. She noted the governor did
not have the authority to extend the disaster declaration
from January 15 to February 14. She agreed to verify the
information in writing.
Senator Wilson assumed that the declaration was extended.
He thought about the authority time frame and how the funds
were expended. He mentioned the Disaster Relief Fund.
Ms. Cunningham noted that in Subsection (b) on page 5,
lines 18-21, there was additional authority to spend from
the Disaster Relief Fund rather than the original authority
under SB 241 from the previous year.
Co-Chair Bishop asked if the $10 million authorized on page
4, line 26 of the bill was in addition to the $20 million
in authorization.
Ms. Cunningham noted that page 4, line 26 signified the
authority to transfer up to $20 million between all
appropriations made in DHSS and was separate from
appropriations made to or expenditures from the Disaster
Relief Fund, which was the subject of subsection (b) on
page 5, lines 18-21 of the bill. She noted that there was
$10 million authorized for expenditure from the Disaster
Relief Fund in SB 241.
Senator Wielechowski looked at Section 3 (a) 6 and thought
the funds in the section were addressed through the Revised
Program Legislative (RPL) process from the text of HB 205.
He was curious about the interplay of HB 76 and HB 205. He
asked if the state was still working under the RPL process.
1:40:42 PM
AT EASE
1:43:17 PM
RECONVENED
Co-Chair Bishop thought that Section 3 generated many
questions from the committee. He thought that the committee
would probably have the Legislative Finance Division to
speak on the section. He thought some of the funds in
question had already been encumbered.
Co-Chair Bishop asked to address Section 4.
1:43:59 PM
Ms. Cunningham continued to address the Sectional Analysis:
Section 4: Report to the Legislature
Requires the Office of Management and Budget to submit
a monthly report to the Legislative Finance Division
that lists the total expenditures incurred by the
State in its response to the public health emergency
disaster including expenditures aimed at mitigating,
preventing, and controlling COVID-19.
The report will include cumulative expenses incurred
since March 11, 2020, the date the Governor issued an
initial declaration of a public health disaster
emergency. This section further provides for a final
report due to the Legislative Finance Division no
later than November 30, 2021 or 60 days after the
Governor determines that a public health disaster
emergency no longer exists, whichever is earlier.
Ms. Cunningham noted that OMB had been providing the
reports mentioned, and the March report should be available
shortly for members consideration.
Co-Chair Bishop thought Ms. Cunningham had stated that OMB
had been adhering to reporting requirements even though the
state had not been under a disaster declaration for some
weeks.
Ms. Cunningham agreed.
Ms. Cunningham continued to address the Sectional Analysis:
Section 5: Professional and Occupational Licensing
Provides that a professional or occupational licensing
board, or the Director of Corporations, Business and
Professional Licensing (CBPL):
1. May not increase licensing fees during the public
health disaster emergency declaration;
2. May grant a license, permit or certificate on an
expedited basis, if an individual holds a
corresponding license, permit, or certificate in good
standing in another jurisdiction. A license expedited
under this section, expires September 30, 2021 or on
the date that the Governor determines a public health
disaster emergency no longer exists;
3. May temporarily waive or modify continuing
education requirements for licensees who need to renew
a professional license permit or certificate in
calendar year 2021;
4. May require an individual who receives a license,
permit, or certificate under this section to arrange
and agree to supervision by an individual who holds a
license, permit or certificate in good standing for an
applicable profession or by an administrator of
facility licensed under AS 47.32.
This section provides that a licensed professional
seeking or holding an expedited license, permit or
certificate under this section who travels to Alaska
from outside of Alaska, must comply with travel
restriction orders or guidelines recommended by the
Centers for Disease Control and Prevention (CDC), the
US Health and Human Services, and that are in effect
when the individual travels.
1:46:08 PM
Co-Chair Bishop asked if Section 5 was still needed or if
the department had found a way to accomplish the
alternative licensing.
SARA CHAMBERS, DIRECTOR, DIVISION OF CORPORATIONS, BUSINESS
AND PROFESSIONAL LICENSING, DEPARTMENT OF COMMERCE,
COMMUNITY AND ECONOMIC DEVELOPMENT (via teleconference),
reported that boards had worked hard in the previous year
to try and move the regulatory tools forward. She stated
that the division had made considerable headway since there
had been time to adopt regulations to address some of the
problems. The request in the bill went further than the
tools proposed in the bill, and the division supported the
governor's request.
Co-Chair Bishop asked how far along the division was with
the regulation packages Ms. Chambers mentioned.
Ms. Chambers stated that for the boards that had elected to
adopt regulations to establish emergency courtesy licenses,
emergency regulations had been completed and were being
adopted as permanent regulations. The division was issuing
the licenses currently.
Ms. Cunningham continued to address the Sectional Analysis:
Section 6: Telehealth and Telemedicine
Allows for a health care provider licensed, permitted
or certified in another jurisdiction to practice
telehealth in Alaska, without first conducting an in-
person physical examination or being licensed in
Alaska. The telehealth services provided must be
within a provider's authorized scope of practice. If
the provider determines that the encounter will extend
beyond the scope of practice or services, the provider
must notify the patient and recommend that the patient
contact a health care provider licensed in Alaska. The
health care provider cannot charge unreasonable fees
and the fees must be consistent with the ordinary fees
charged for that service and may not be more than 5%
above the ordinary fees typically charged.
Senator Wielechowski asked if Ms. Cunningham had sense of
how many telehealth providers had taken advantage of the
provision in Section 6.
Ms. Chambers stated that since the legislation bypassed
licensing in the state, the department did not have any way
to record or track people that were practicing under the
provision. She did not have a way to estimate how many
practitioners had taken advantage of the bill section.
Senator Wielechowski asked if the department had received
any complaints about outside telehealth or telemedicine
providers.
Ms. Chambers answered in the negative.
1:49:32 PM
Senator Wilson relayed that there was a similar bill moving
through the Senate, and public testimony from providers had
indicated there was concern about jurisdiction over and
tracking of providers. He mentioned concerns about
behavioral health and wondered if a definition was outlined
in the bill.
Co-Chair Bishop asked if Senator Wilson had two questions.
Senator Wilson stated that one comment was a statement of
concern about not knowing who was practicing medicine in
the state. He asked if the bill covered other healthcare
services such as behavioral health and dental health.
Ms. Chambers stated that the provision only applied to
physicians, physician's assistants, and nurses. There was
no provision for other healthcare providers to practice in
the same way under the proposed or previous legislation.
She stated that the department had been working with
committees on addressing Senator Wilson's concerns on
permanent policy. Since the proposal was for emergency
policy only, there was less concern about proposing
telemedicine for the next few months so people could
receive care. The administration was willing to continue
the practice in the near term but not for permanent policy
change.
1:52:57 PM
Co-Chair Bishop asked about Ms. Chambers last statement. He
had heard from constituents that people that were able to
take advantage of accessing telemedicine under the disaster
declaration were no longer able to do so. He thought Ms.
Chambers mentioned continuing telemedicine.
Ms. Chambers affirmed that the bill would allow physicians
and nurses that were not licensed in Alaska to continue to
see Alaskans unable to travel for care. The bill had a
deadline for the practice to end, at which time the
administration hoped people would be able to travel, or
there would be a new modified telemedicine policy in place.
She reiterated that the department was working on the new
policy with Senator Wilson and committees. She referenced a
courtesy license as an option.
Senator Wilson thought behavioral health services were
covered through telemedicine federally. He asked if the
state needed to add anything to the disaster declaration to
cover the need for behavioral health service in the state.
Ms. Chambers stated that the behavioral
health boards had done a good job in adopting emergency
licensing provisions in regulation. Her office had not
heard in the previous few months that there was an
outstanding need for providers not licensed in Alaska to be
able to provide services. The department had been able to
identify providers and point them toward emergency
licensure. Presently, the data did not support the need to
expand the provisions.
Senator Wilson was concerned about parity. He noted there
was only allowance for medical telehealth but no other type
of healthcare and thought many other providers were looking
for the same equality.
Ms. Chambers had not heard that other providers were
looking for the same accommodation. She thought it would be
helpful for the division to have the information to bring
the boards for consideration for regulation or permanent
legislative policy change. She noted that the department
was looking at the legislation as linked to an emergent
situation with an end date, trying to avoid price gouging.
She pondered that the addition of other providers could be
a policy change to consider and supported facilitating a
discussion with legislative offices and the boards.
1:57:16 PM
Ms. Cunningham continued to address the Sectional Analysis:
Section 7: Fingerprinting
Provides that the Department of Commerce, Community
and Economic Development shall coordinate with DHSS
and the Department of Public Safety to expedite the
process for certain license applicants to submit
fingerprints.
Co-Chair Bishop asked if the administration still felt that
the provision in Section 7 was needed.
Ms. Cunningham deferred to Director Chambers.
Ms. Chambers believed that the department had met its need
in Section 7 through working with the Department of Public
Safety. She did not see an anticipated need unless there
was an unanticipated spike that would shut down the ability
to get fingerprints rolled in person. She had not heard
from programs that required fingerprints that anyone was
having trouble accessing the resource.
Senator Wielechowski asked to go back to Section 6 to
discuss the fees. He asked if the wording referenced
services as provided in Alaska, or services provided
elsewhere outside the state. He noted that the state had
the most expensive healthcare in the world, and he did not
see how others should charge Alaska rates while charging
out of state clients with lower rates.
Ms. Chambers stated that the division had not heard any
complaints or concerns from individuals that had been
charged an extraordinary amount. She thought Senator
Wielechowski's question was a good question for the bill
drafter. She had not contemplated the subject.
2:00:22 PM
Ms. Cunningham continued to discuss the Sectional Analysis:
Section 8: Meeting of Shareholders; Notice of
Shareholder Meetings
Allows for meetings of shareholders, shareholders of
Native corporations, and members of a nonprofit
corporation, to be held by electronic communication,
in compliance with guidelines adopted by each of the
type of entities board of directors.
Ms. Cunningham noted that SB 24 [allowing corporate
shareholder meetings and nonprofit member meetings to be
held via remote communications] had been transmitted to the
governor after the Senate concurred with the changes made
in the other body the previous week. The action of the
governor would determine if Section 8 was necessary.
Senator Wilson asked about Section 6, and whether licensed
advanced nurse practitioners could practice telehealth
under the bill.
Ms. Cunningham specified that Section 6 pertained to the
provisions of AS 08.64.170, the license to practice
medicine, podiatry, or osteopathy; as well as AS 08.68.160,
which pertained to registered advanced practice,
registered, or practical nurses in the state.
Senator Wielechowski asked about Section 6 (c), which gave
the commissioner the ability to waive any state laws or
regulations.
Ms. Cunningham answered "yes," and thought the provision
pertained to regulations that impacted Medicaid. She
thought most of the authorities to waive regulations were
provided for or allowed for under the public health
emergency and sections of the Social Security Act that the
Centers for Medicare & Medicaid Services (CMS) provided
waivers for the delivery of services. She offered to
provide a list of the specific regulations.
Co-Chair Bishop referenced Section 8 and asked if Ms.
Cunningham was aware of any meetings that were held after
February 15, 2021 and before the governor's plans to sign
SB 24 that would require a retroactivity clause.
Ms. Cunningham deferred to Senator Wilson.
Senator Wilson noted that SB 24 had a retroactivity clause
that covered the time period in question. The bill had been
back dated to the last retroactivity of the last
declaration to make sure there was no lapse of corporations
and boards that met during the time period mentioned by Co-
Chair Bishop. He hoped the governor would sign the bill in
the upcoming days.
2:04:00 PM
Ms. Cunningham continued to address the Sectional Analysis:
Section 9: Charitable Gaming Online Ticket Sales
Allows for certain charitable gaming activities to be
conducted online during the public health disaster
emergency declared by the Governor on January 15, 2021
and an extension granted by this Act. Permittees and
operators may sell tickets and draw the winning ticket
online for a raffle or lottery, dog mushers' contest,
derby, or a type of classic. The seller must verify
that the purchaser is of legal age to purchase,
physically present in Alaska, and not within an area
where charitable gaming is prohibited. The Department
of Revenue is responsible for establishing standards
for online ticket sales.
Section 10: Informed Consent for COVID-19 Vaccines
Provides that a health care provider may not
administer a COVID-19 vaccine to an individual without
first obtaining the informed consent of the
individual, or the parent or guardian of a minor
child.
Section 11: Personal Objections to the Administration
of COVID-19 Vaccines
Provides that an individual may object to the
administration of a COVID-19 vaccine based on
religious, medical, or other grounds. A parent or
guardian of a minor child may object to the
administration of the COVID-19 vaccine to the minor
child based on religious, medical, or other grounds.
This section further provides that a person may not be
required to provide justification or documentation to
support an individual's decision to decline to receive
the COVID-19 vaccine.
Senator Wilson asked if Section 11 were passed into law, if
the provision would allow an employer to mandate that
employees be vaccinated for COVID-19. He asked if
businesses or other entities could require the general
public to receive an emergency-authorized vaccine under
grounds of termination or other exclusionary purposes.
Ms. Cunningham deferred the question to the chief attorney
general.
Senator Wilson asked if Section 11 would prohibit "vaccine
passports," or if more language was needed to prevent a
business from mandating vaccination for COVID-19 for
employees. He asked if businesses would be allowed to
engage in exclusionary practices.
2:07:48 PM
STACIE KRALY, CHIEF ASSISTANT ATTORNEY GENERAL, DEPARTMENT
OF LAW (via teleconference), stated that the issue of a
"vaccine passport" was being discussed more commonly in
various circles relating to how the public could move
forward to get back to normalcy. She explained that
businesses and governmental agencies had the ability to
provide restrictions or rules about how individuals
accessed their services. She used the example of an airline
being able to potentially say that a person needed a
vaccine passport for purposes of travelling. She explained
that "vaccine passport" was a more global phrase that
contemplated the idea of having some sort of verification
of being fully vaccinated in order to access services,
enter business, or in some case have employment in a
governmental agency. The thought the ability of a business
or the government being able to limit an individual's
access or to participate would have to be evaluated through
a constitutional lens.
Ms. Kraly continued to address Senator Wilson's question.
She mentioned the Americans With Disabilities Act and
individuals that might not be able to receive a vaccine.
She mentioned conscientious objection to the vaccine, and a
religious exemption. She summarized that individuals could
be prohibited from participating, and could have some means
to be exclude from different services or processes; but she
though the question was about the standard of what was
allowed. She thought the idea that everyone must be
vaccinated to participate was overly broad. She discussed
an accommodation such as masking. She did not think the
provision precluded the idea of a vaccine passport and
pondered the question of how such a passport would be
applied. She thought further specific situational analysis
would be needed.
2:11:39 PM
Senator Wilson asked if Ms. Kraly's answer included
emergency use order vaccines. He thought Ms. Kraly
indicated it would be necessary to include some type of
anti-discriminatory language to prohibit the vaccine
passport to be used in Alaska.
Ms. Kraly thought there should be language to indicate the
use of the vaccine passports was to be non-discriminatory,
but thought the concept was to some extent built into the
state and federal constitutions.
Senator Wilson mentioned emergency use ordered vaccines.
Ms. Kraly noted that the government was currently operating
under emergency use authorization for the COVID-19 vaccines
currently available. The question of whether the emergency
authorization for the use of the vaccination under a
vaccine passport was an open question. She continued that
ultimately the emergency use authorizations, because of the
number of vaccines being used nationwide, provided data
that supported the efficacy of the vaccines that would be
available, and eventually there would be enough core data
for a standard authorized vaccine. She summarized that the
use of emergency-use authorized vaccines had some limiting
factors with respect to vaccine passports, but ultimately
the emergency use authorization framework would end as
vaccine use increased and data showing vaccine efficacy was
gathered.
Ms. Cunningham continued to address the Sectional Analysis:
Section 12: School Operating Funds
Provides that a school district may retain an
unreserved portion of its year-end fund balance in its
school operating fund and the unreserved portion may
not be used to reduce the state aid for that school
district in the next fiscal year. Under current law, a
district may not accumulate an unreserved portion that
is greater than 10 percent of its expenditures for
that fiscal year.
Ms. Cunningham noted that Section 12 was an amendment
offered in the House Finance Committee. She noted that the
director of school finance was available to answer
questions.
Co-Chair Bishop noted that the current version of the bill
contemplated a repeal date of June 30, 2023. He asked if
Ms. Teshner thought the date was appropriate.
2:15:41 PM
HEIDI TESHNER, DIRECTOR, FINANCE AND SUPPORT SERVICES,
DEPARTMENT OF EDUCATION AND EARLY DEVELOPMENT (via
teleconference), believed the date was reasonable given the
amount of COVID-19 relief funds that school districts were
receiving, and it was reasonable to allow a couple of years
of flexibility for using state funds.
Senator Wilson asked about fund balances and maintenance of
effort.
Ms. Teshner explained that the maintenance of effort was
calculated on the year the state paid out. The provision in
the bill would have no effect on the maintenance of effort
calculation. The proportional amount the state would pay to
districts was separate from the provision.
Ms. Cunningham continued to address the Sectional Analysis:
Section 13: Licensee Liability for Client Exposure to
COVID-19
Adds a new section of law to AS 08.02 (Business and
Professions) that provides that a licensee under Title
8, is immune from disciplinary actions for the
sickness, death, economic loss, and other damages
suffered by a client due to exposure to COVID-19 if
the exposure occurred during the course of the
licensee's practice.
In order for the protection to apply, the licensee
must have been in substantial compliance with
applicable federal, state, and municipal laws and
health mandates in effect at the time of the client's
exposure. The immunity from disciplinary action does
not apply if the exposure of the client resulted from
gross negligence, recklessness, or intentional
misconduct of the licensee.
Section 14: Business and Employee Liability for
Customer Exposure to COVID-19
Adds a new section of law to AS 45.45 (Trade and
Commerce) that provides that a business owner and an
employee, while working in the business, are immune
from liability for sickness, death, economic loss, and
other damages suffered by a customer from exposure to
COVID-19 while the individual is patronizing the
business.
In order for the protection to apply, the business
owner must have been in substantial compliance with
applicable federal, state, and municipal laws and
health mandates that are in effect at the time the
customer was exposed to COVID-19. Immunity does not
apply to exposure to COVID-19 if the exposure was the
result of gross negligence, recklessness, or
intentional misconduct of the business owner or the
employee of the business.
Ms. Cunningham noted that Section 13 and Section 14 had a
different retroactivity clause than that of the bill and
would make the sections retroactive to exposure occurring
on or after February 14, 2021.
2:19:28 PM
Ms. Cunningham noted that Section 15 had been an amendment
that was offered on the House floor when the bill was in
second reading before the body. She continued to address
the Sectional Analysis:
Section 15: Use of CARES, CRSSA, or American Rescue
Plan Act Funds
Provides that no funds received by the State under the
Coronavirus Aid, Relief, and Economic Security Act
(CARES Act), the Coronavirus Response and Relief
Supplemental Appropriations Act (CRSSA), or the
American Rescue Act may be expended for an abortion
that is not mandatory under AS 47.07.030(a).
Provides that funds may only be expended for mandatory
services under Title XIX of the Social Security Act
and for optional services offered by the Alaska State
Medicaid Plan that has been approved the US Department
of Health and Human Services.
Co-Chair Bishop asked if there had been any COVID-19 state
or federal funds used for abortions in the state to date.
Ms. Cunningham had inquired about the question earlier and
had not received a response from the department. She
offered to provide the information in writing at a later
date.
Ms. Cunningham continued to address the Sectional Analysis:
Section 16: Amends Section 37, Chapter 10, SLA 2020
Repeals Section 29 (Purchase of Seafood for
Distribution) of SB 241 effective March 11, 2021.
Repeals Section 31 (Tolling of Office of
Administrative Hearings) of SB 241 effective March 11,
2021.
SB 241 provided a sunset date for these sections of
March 11, 2021.
Ms. Cunningham continued to address the Sectional Analysis:
Section 17: Repeals sections of SB 241
Repeals Section 25 (Witnessing of Will Signing by
Videoconference), Section 26 (Unfair or Deceptive
Trade Practices), and Section 28 (State Access to
Federal Education Stabilization Funds) of SB 241 on
September 30, 2021. SB 241 provided a sunset date for
these sections of March 11, 2021.
Section 18: Applicability Section
Provides that Section 13 (Licensee Liability Immunity)
and Section 14 (Business/Employee Liability Immunity)
apply to events of exposure to COVID-19 occurring on
or after February 15, 2021.
Section 19: Repeal Section
Sections 1 3 and Sections 5-11 are repealed on the
earlier of September 30, 2021 or when the Governor
determines a public health disaster emergency no
longer exists.
Section 12 (School Operating Funds) is repealed on
June 30, 2023.
Section 20: Retroactivity
Except for Section 2(a), the sections of this bill are
retroactive to February 14, 2021, if this Act takes
effect after February 14, 2021.
Section 2(a) is retroactive to November 15, 2020.
Section 21: Effective Date
This Act takes effect immediately under AS
01.10.070(c).
2:23:10 PM
Co-Chair Stedman asked to go back to Section 19. He wanted
more clarity regarding the different federal and state
dates. He wondered if the legislature would have to return
in the fall to take action.
Ms. Cunningham relayed that when the bill was originally
introduced in January, the date of September 30, 2021, was
chosen as the end of the federal fiscal year. At the time
of introduction, the Biden Administration had not extended
the federal public health emergency. Rather than having a
definitive answer, the end of the fiscal year had been
chosen as the date.
Co-Chair Stedman asked if there should be consideration
towards making the dates match up.
Ms. Cunningham stated that the administration was happy to
discuss the end date of any type of authority related to
the COVID-19 response.
Ms. Cunningham noted that Section 21 was an immediate
effective date clause.
Co-Chair Bishop conveyed that there was an amendment
deadline of April 1, 2021, at 5 o'clock p.m. He discussed
the agenda for the following day.
Senator Hoffman noted that HB 76 was much broader than the
previous bill that was considered. He asked if the
administration supported the broader bill.
Ms. Cunningham reiterated that the testimony of the DHSS
commissioner indicated that there had been certain
authorities that had been identified as important elements
to continued response to COVID-19 in the state, and the
administration supported a limited approach in providing
the authorities. The authorities were all-encompassing
under a disaster declaration.
2:27:02 PM
Senator Hoffman reminded that Commissioner Crum's comments
were made prior to the House taking action in the form of
HB 76. He asked if the administration had taken a different
position in light of the fact that the House had taken
action. He thought it seemed as though the issues the
commissioner addressed could be implemented under the House
version of the bill, but not necessarily utilizing all the
provisions of the bill. He asked if the administration felt
that it could accomplish what it wanted the way the bill
was currently written.
ADAM CRUM, COMMISSIONER, DEPARTMENT OF HEALTH AND SOCIAL
SERVICES (via teleconference), addressed Senator Hoffman's
question. He thought the topic needed to be considered in
conversation with the governor and legislative leadership
and wanted to get back to Senator Hoffman with a response
at a later time.
2:29:33 PM
Co-Chair Stedman asked how many states had emergency
declarations in place, and how many did not. He wondered if
the states without a disaster declaration in place had a
similar structure as Alaska. He asked about timelines for
expiration amongst the states that had declarations in
place.
Commissioner Crum relayed that he had an outstanding
inquiry with the National Governor's Association about the
current status across the nation. He cited that the
governor for the State of Michigan had lost the ability to
make a disaster declaration, but another state official had
the statutory authority to declare a public health
emergency. Most of the other states in the country had a
mechanism of one or both of a disaster declaration or
public health emergency in order to address federal
flexibilities. He offered to provide the information when
it became available.
Co-Chair Stedman understood that all states had the ability
to make a disaster declaration and thought Alaska would be
an anomaly without one. He hoped to get more information
within the next 48 hours as the committee worked on the
bill.
Co-Chair Bishop concurred with Co-Chair Stedman.
SB 56 was HEARD and HELD in committee for further
consideration.
HB 76 was HEARD and HELD in committee for further
consideration.
ADJOURNMENT
2:32:27 PM
The meeting was adjourned at 2:32 p.m.
| Document Name | Date/Time | Subjects |
|---|---|---|
| HB 76 Summary of Changes Version 32 GH 1011 W.A.pdf |
SFIN 3/29/2021 1:00:00 PM |
HB 76 |
| HB 76 Sectional Analysis Version 32-GH1011 W.A.pdf |
SFIN 3/29/2021 1:00:00 PM |
HB 76 |
| HB 76 Status of State COVID-19 Emergency Orders_Last Updated March 25 2021.xlsx |
SFIN 3/29/2021 1:00:00 PM |
HB 76 |
| HB 76 DHSS Follow Up Answers with Attachments.pdf |
SFIN 3/29/2021 1:00:00 PM |
HB 76 |