Legislature(2021 - 2022)BUTROVICH 205

04/26/2022 01:30 PM Senate HEALTH & SOCIAL SERVICES

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* first hearing in first committee of referral
+ teleconferenced
= bill was previously heard/scheduled
+= HB 62 MARRIAGE: WITNESSES/SOLEMNIZATION/CONSENT TELECONFERENCED
Moved SCS CSHB 62(HSS) Out of Committee
+= SB 242 EXEMPTIONS FOR FOOD PRODUCTS TELECONFERENCED
Heard & Held
*+ SB 183 HOME AND COMMUNITY-BASED SERVICES TELECONFERENCED
Heard & Held
-- Invited & Public Testimony --
+ Bills Previously Heard/Scheduled TELECONFERENCED
                      ALASKA STATE LEGISLATURE                                                                                
        SENATE HEALTH AND SOCIAL SERVICES STANDING COMMITTEE                                                                  
                           April 26, 2022                                                                                       
                             1:35 p.m.                                                                                          
                                                                                                                                
                                                                                                                                
MEMBERS PRESENT                                                                                                               
                                                                                                                                
Senator David Wilson, Chair                                                                                                     
Senator Shelley Hughes, Vice Chair                                                                                              
Senator Lora Reinbold                                                                                                           
Senator Tom Begich                                                                                                              
                                                                                                                                
MEMBERS ABSENT                                                                                                                
                                                                                                                                
Senator Mia Costello                                                                                                            
                                                                                                                                
COMMITTEE CALENDAR                                                                                                            
                                                                                                                                
COMMITTEE SUBSTITUTE FOR HOUSE BILL NO. 62(JUD) AM                                                                              
"An Act relating to the Legislative Ethics Act; relating to                                                                     
solemnization of marriage; and relating to consent to marriage."                                                                
                                                                                                                                
     - MOVED SCS CSHB 62(HSS) OUT OF COMMITTEE                                                                                  
                                                                                                                                
SENATE BILL NO. 242                                                                                                             
"An Act relating to exemptions for the purchase and sale of                                                                     
certain food products for home consumption under the Alaska Food                                                                
Freedom Act."                                                                                                                   
                                                                                                                                
     - HEARD & HELD                                                                                                             
                                                                                                                                
SENATE BILL NO. 183                                                                                                             
"An Act relating to home and community-based services; and                                                                      
providing for an effective date."                                                                                               
                                                                                                                                
     - HEARD & HELD                                                                                                             
                                                                                                                                
PREVIOUS COMMITTEE ACTION                                                                                                     
                                                                                                                                
BILL: HB  62                                                                                                                  
SHORT TITLE: MARRIAGE: WITNESSES/SOLEMNIZATION/CONSENT                                                                          
SPONSOR(s): REPRESENTATIVE(s) CLAMAN                                                                                            
                                                                                                                                
02/18/21        (H)        PREFILE RELEASED 1/15/21                                                                             
02/18/21        (H)        READ THE FIRST TIME - REFERRALS                                                                      
02/18/21        (H)        STA, JUD                                                                                             
02/25/21        (H)        STA AT  3:00 PM GRUENBERG  120                                                                       
02/25/21        (H)        -- MEETING CANCELED --                                                                               
03/04/21        (H)        STA AT  3:00 PM GRUENBERG  120                                                                       
03/04/21        (H)        Heard  & Held                                                                                        
03/04/21        (H)        MINUTE(STA)                                                                                          
03/09/21        (H)        STA AT  3:00 PM GRUENBERG  120                                                                       
03/09/21        (H)        Heard  & Held                                                                                        
03/09/21        (H)        MINUTE(STA)                                                                                          
03/11/21        (H)        STA AT  3:00 PM GRUENBERG  120                                                                       
03/11/21        (H)        Moved  HB 62 Out of  Committee                                                                       
03/11/21        (H)        MINUTE(STA)                                                                                          
03/12/21        (H)        STA RPT 4DP 2DNP 1AM                                                                                 
03/12/21        (H)        DP: CLAMAN, STORY, TARR, KREISS-TOMKINS                                                              
03/12/21        (H)        DNP: EASTMAN, VANCE                                                                                  
03/12/21        (H)        AM: KAUFMAN                                                                                          
03/19/21        (H)        JUD AT  1:30 PM GRUENBERG  120                                                                       
03/19/21        (H)        <Bill Hearing Canceled>                                                                              
03/24/21        (H)        JUD AT  1:30 PM GRUENBERG  120                                                                       
03/24/21        (H)        Heard  & Held                                                                                        
03/24/21        (H)        MINUTE(JUD)                                                                                          
03/29/21        (H)        JUD AT  1:00 PM GRUENBERG  120                                                                       
03/29/21        (H)        <Bill Hearing Canceled>                                                                              
03/31/21        (H)        JUD AT  1:00 PM GRUENBERG  120                                                                       
03/31/21        (H)        Moved CSHB 62(JUD) Out of Committee                                                                  
03/31/21        (H)        MINUTE(JUD)                                                                                          
04/05/21        (H)        JUD RPT CS(JUD) NEW TITLE 4DP 3DNP                                                                   
04/05/21        (H)        DP: DRUMMOND, KREISS-TOMKINS, SNYDER,                                                                
                           CLAMAN                                                                                               
04/05/21        (H)        DNP: EASTMAN, VANCE, KURKA                                                                           
03/09/22        (H)        SUSTAINED RULING OF CHAIR Y21 N14 E4 A1                                                              
03/11/22        (H)        TECHNICAL SESSION 3/11 - ON 3/14                                                                     
                           CALENDAR                                                                                             
03/16/22        (H)        TRANSMITTED TO (S)                                                                                   
03/16/22        (H)        VERSION: CSHB 62(JUD) AM                                                                             
03/18/22        (S)        READ THE FIRST TIME - REFERRALS                                                                      
03/18/22        (S)        HSS, JUD                                                                                             
04/05/22        (S)        HSS AT  1:30 PM BUTROVICH  205                                                                       
04/05/22        (S)        Heard  & Held                                                                                        
04/05/22        (S)        MINUTE(HSS)                                                                                          
04/19/22        (S)        HSS AT  1:30 PM BUTROVICH  205                                                                       
04/19/22        (S)        Heard  & Held                                                                                        
04/19/22        (S)        MINUTE(HSS)                                                                                          
04/26/22        (S)        HSS AT  1:30 PM BUTROVICH  205                                                                       
                                                                                                                                
BILL: SB 242                                                                                                                  
SHORT TITLE: EXEMPTIONS FOR FOOD PRODUCTS                                                                                       
SPONSOR(s): RULES BY REQUEST OF THE GOVERNOR                                                                                    
                                                                                                                                
04/08/22        (S)        READ THE FIRST TIME - REFERRALS                                                                      
04/08/22        (S)        HSS, FIN                                                                                             
04/19/22        (S)        HSS AT 1:30 PM BUTROVICH 205                                                                         
04/19/22        (S)        Heard & Held                                                                                         
04/19/22        (S)        MINUTE(HSS)                                                                                          
04/26/22        (S)        HSS AT 1:30 PM BUTROVICH 205                                                                         
                                                                                                                                
BILL: SB 183                                                                                                                  
SHORT TITLE: HOME AND COMMUNITY-BASED SERVICES                                                                                  
SPONSOR(s): GRAY-JACKSON                                                                                                        
                                                                                                                                
02/08/22        (S)        READ THE FIRST TIME - REFERRALS                                                                      
02/08/22        (S)        HSS, FIN                                                                                             
04/26/22        (S)        HSS AT 1:30 PM BUTROVICH 205                                                                         
                                                                                                                                
WITNESS REGISTER                                                                                                              
                                                                                                                                
JASMIN MARTIN, Staff                                                                                                            
Senator David Wilson                                                                                                            
Alaska State Legislature                                                                                                        
Juneau, Alaska                                                                                                                  
POSITION STATEMENT: Answered questions on SB 242.                                                                             
                                                                                                                                
CHRISTINA CARPENTER, Director                                                                                                   
Division of Environmental Health                                                                                                
Department of Environmental Conservation                                                                                        
Anchorage, Alaska                                                                                                               
POSITION STATEMENT: Answered questions on SB 242.                                                                             
                                                                                                                                
EMMA POKON, Deputy Commissioner                                                                                                 
Department of Environmental Conservation                                                                                        
Juneau, Alaska                                                                                                                  
POSITION STATEMENT: Answered questions on SB 242                                                                              
                                                                                                                                
DAVID RHODES, Chief Assistant Attorney;                                                                                         
Statewide Section Supervisor                                                                                                    
Special Litigation and Consumer Protection                                                                                      
Civil Division                                                                                                                  
Department of Law                                                                                                               
Anchorage, Alaska                                                                                                               
POSITION STATEMENT: Answered questions on SB 242                                                                              
                                                                                                                                
SENATOR ELVI GRAY-JACKSON                                                                                                       
Alaska State Legislature                                                                                                        
Juneau, Alaska                                                                                                                  
POSITION STATEMENT: Sponsor of SB 183.                                                                                        
                                                                                                                                
BESSE ODOM, Staff                                                                                                               
Senator Elvi Gray-Jackson                                                                                                       
Alaska State Legislature                                                                                                        
Juneau, Alaska                                                                                                                  
POSITION STATEMENT: Presented the sectional analysis for SB 183.                                                              
                                                                                                                                
JOHN LEE, Director                                                                                                              
Division of Senior and Disability Services                                                                                      
Department of Health and Social Services (DHSS)                                                                                 
Anchorage, Alaska                                                                                                               
POSITION STATEMENT: Answered questions on SB 183.                                                                             
                                                                                                                                
KATHERINE BACON, representing self                                                                                              
Palmer, Alaska                                                                                                                  
POSITION STATEMENT: Testified by invitation on SB 183.                                                                        
                                                                                                                                
DEBBIE MULHOLLAND, representing self                                                                                            
Anchorage, Alaska                                                                                                               
POSITION STATEMENT: Testified by invitation on SB 183.                                                                        
                                                                                                                                
MARIANA MORANTE, Research and Policy Manager                                                                                    
Service Employees International Union (SEIU) 775                                                                                
Seattle, Alaska                                                                                                                 
POSITION STATEMENT: Testified in support of SB 183.                                                                           
                                                                                                                                
ACTION NARRATIVE                                                                                                              
                                                                                                                                
1:35:41 PM                                                                                                                    
CHAIR  DAVID WILSON  called  the  Senate  Health and  Social  Services                                                        
Standing  Committee  meeting  to order  at  1:35 p.m.  Present  at the                                                          
call  to order  were  Senators  Hughes,  Reinbold,  Begich  and  Chair                                                          
Wilson.                                                                                                                         
                                                                                                                                
          HB  62-MARRIAGE: WITNESSES/SOLEMNIZATION/CONSENT                                                                  
                                                                                                                                
1:36:39 PM                                                                                                                    
CHAIR  WILSON  announced  the  consideration   of  CS FOR  HOUSE  BILL                                                          
NO.  62(JUD)  am "An  Act  relating  to the  Legislative  Ethics  Act;                                                          
relating  to  solemnization  of  marriage;  and  relating  to  consent                                                          
to marriage."                                                                                                                   
                                                                                                                                
[The committee adopted SCS CSHB 62(HSS) 4/19/22 hearing.]                                                                       
                                                                                                                                
SENATOR  BEGICH  asked  for  confirmation  that  under  the Senate  CS                                                          
an emancipated minor would retain the right to marry.                                                                           
                                                                                                                                
CHAIR  WILSON   said  it   was  stated   on  the  record   during  the                                                          
previous   hearing   and  the  memorandum   from   Legislative   Legal                                                          
Services  was discussed.  He  noted that  nobody  from Legal  Services                                                          
was  online  to respond  to  the  question  today,  but  he would  ask                                                          
for   a  response   during   hearings   in  the   next  committee   of                                                          
referral.                                                                                                                       
                                                                                                                                
1:36:53  PM                                                                                                                   
SENATOR  BEGICH  said he  knows  the memorandum  effectively   says an                                                          
emancipated   youth  is  considered  an  adult  for  purposes  of  the                                                          
contract  of  marriage  and  he  appreciates   the chair's   assurance                                                          
and the discussion that's on the record.                                                                                        
                                                                                                                                
SENATOR  REINBOLD   asked  whether   the  committee   would  hear  the                                                          
amendments from Senator Costello.                                                                                               
                                                                                                                                
1:38:18  PM                                                                                                                   
At ease.                                                                                                                        
                                                                                                                                
1:40:20  PM                                                                                                                   
CHAIR  WILSON  reconvened  the meeting.  Finding  no  final  questions                                                          
for the sponsor, he solicited a motion.                                                                                         
                                                                                                                                
1:40:34  PM                                                                                                                   
SENATOR  HUGHES  moved to  report the  [Senate  Committee  Substitute]                                                          
for   HB   62,  work   order   32-LS0272\I,    from   committee   with                                                          
individual recommendations and attached fiscal note(s).                                                                         
                                                                                                                                
CHAIR WILSON asked if there was objection.                                                                                      
                                                                                                                                
1:40:48  PM                                                                                                                   
At ease.                                                                                                                        
                                                                                                                                
1:40:58  PM                                                                                                                   
CHAIR WILSON reconvened the meeting.                                                                                            
                                                                                                                                
1:41:01  PM                                                                                                                   
CHAIR   WILSON  found   no  objection   and   SCS  CSHB  62(HSS)   was                                                          
reported  from   the  Senate  Health  and  Social  Services   Standing                                                          
Committee.                                                                                                                      
                                                                                                                                
1:41:06  PM                                                                                                                   
At ease.                                                                                                                        
                                                                                                                                
                SB 242-EXEMPTIONS FOR FOOD PRODUCTS                                                                         
                                                                                                                                
1:44:27 PM                                                                                                                    
CHAIR   WILSON    reconvened    the   meeting   and    announced   the                                                          
consideration   of   SENATE  BILL   NO.  242   "An  Act  relating   to                                                          
exemptions  for  the  purchase  and  sale  of  certain  food  products                                                          
for home consumption under the Alaska Food Freedom Act."                                                                        
                                                                                                                                
He asked whether the department had any comments before the                                                                     
committee moved into the amendment process.                                                                                     
                                                                                                                                
1:44:55 PM                                                                                                                    
CHRISTINA CARPENTER, Director, Division of Environmental Health,                                                                
Department of Environmental Conservation, Anchorage, Alaska,                                                                    
stated that the department has no comments at this time.                                                                        
                                                                                                                                
1:45:12 PM                                                                                                                    
CHAIR WILSON moved to adopt Amendment 1, work order 32-                                                                         
GS2521\A.1.                                                                                                                     
                                                                                                                                
                                                     32-GS2521\A.1                                                              
                                                          Bullard                                                               
                                                          4/25/22                                                               
                                                                                                                                
                            AMENDMENT 1                                                                                     
                                                                                                                                
                                                                                                                                
    OFFERED IN THE SENATE                     BY SENATOR WILSON                                                                 
        TO:  SB 242                                                                                                             
                                                                                                                                
                                                                                                                                
     Page 2, lines 9 - 10:                                                                                                      
        Delete "non-potentially hazardous"                                                                                      
        Insert "nonhazardous"                                                                                                   
                                                                                                                                
     Page 2, line 26:                                                                                                           
        Delete "non-potentially hazardous"                                                                                      
        Insert "nonhazardous"                                                                                                   
                                                                                                                                
     Page 2, lines 27 - 29:                                                                                                     
        Delete "A retail space selling a homemade food                                                                          
     product   under   this   section   shall  inform   the   end                                                               
     consumer   that the  product  has  not  been  inspected  and                                                               
     shall  display  a  sign  indicating  that  the  product  has                                                               
     not been inspected."                                                                                                       
                                                                                                                                
     Page 3, line 9:                                                                                                            
        Delete "non-potentially hazardous"                                                                                      
        Insert "nonhazardous"                                                                                                   
                                                                                                                                
     Page 3, lines 10 - 12:                                                                                                     
        Delete   "shall  be  clearly  and   prominently  labeled                                                                
     with  the  following  language:  "This  food was  made in  a                                                               
     home  kitchen,   is not  regulated   or  inspected  and  may                                                               
     contain  allergens."   The non-potentially   hazardous  food                                                               
     for sale at the retail location or grocery store"                                                                          
                                                                                                                                
     Page 3, line 17:                                                                                                           
        Delete "non-potentially hazardous"                                                                                      
        Insert "nonhazardous"                                                                                                   
                                                                                                                                
     Page 3, line 20:                                                                                                           
        Delete ";"                                                                                                              
        Insert "."                                                                                                              
                                                                                                                                
     Page 3, lines 21 - 24:                                                                                                     
        Delete all material and insert:                                                                                         
           "(g)  A producer or other seller of eggs or a                                                                        
        nonhazardous    food  product    under  AS  17.20.331   -                                                               
        17.20.339   shall  include  a  clearly  visible  warning                                                                
        stating  "This  food  is  not  regulated  or  inspected,                                                                
        and may contain allergens"                                                                                              
              (1)  on a label attached to the packaging of                                                                      
           the eggs or nonhazardous food product; or                                                                            
              (2)  if the eggs or nonhazardous food product                                                                     
        do  not have  packaging  or  cannot  be easily  labeled,                                                                
        on   signage   in   the   area    where   the   eggs   or                                                               
        nonhazardous food product are sold.                                                                                     
           (h)  A producer of a potentially hazardous food                                                                      
        product,   except   for  eggs,   under   AS 17.20.331   -                                                               
        17.20.339   shall  include  a  clearly  visible  warning                                                                
        stating  "This food  is not  regulated  or inspected  and                                                               
        may contain allergens. It is not for resale"                                                                            
              (1)  on a label attached to the packaging of                                                                      
        the potentially hazardous food product; or                                                                              
              (2)  if the potentially hazardous food product                                                                    
        does  not have  packaging or  cannot be  easily labeled,                                                                
        on  signage   in  the  area  where  the  hazardous   food                                                               
        product is sold."                                                                                                       
                                                                                                                                
     Page 6, line 29:                                                                                                           
        Delete "non-potentially hazardous"                                                                                      
        Insert "nonhazardous"                                                                                                   
                                                                                                                                
     Page 7, line 1:                                                                                                            
        Delete "non-potentially hazardous"                                                                                      
        Insert "nonhazardous"                                                                                                   
                                                                                                                                
1:45:15 PM                                                                                                                    
SENATOR HUGHES objected for purposes of discussion.                                                                             
                                                                                                                                
1:45:19 PM                                                                                                                    
CHAIR WILSON provided the following explanation of Amendment 1:                                                                 
                                                                                                                                
     This  amendment  requires   labeling  on food  sold  from  a                                                               
     producer  to  the end  customer.  That brings  labeling  and                                                               
     food  requirements  for  food  sold through  a  third  party                                                               
     in  line  with  food  directly   sold  to  the  producer  to                                                               
     customer.   It requires  that  hazardous   food is  sold  by                                                               
     the  producer   directly  to  the  consumer   to  either  be                                                               
     clearly   labeled,   "This   food   is  not   regulated   or                                                               
     inspected   and may  contain  allergens,  and it's  not  for                                                               
     resale,    or  the  food  does  not  have  packaging   label                                                               
     that  can be  affixed  to it like  farmer market  that  they                                                               
     have  clear  signage on  the food  letting  folks know  that                                                               
     this  food  is not regulated  or  inspected  or may contain                                                                
     allergens and is not for resale type of purposes.                                                                          
                                                                                                                                
     [The  amendment]  also  requires  nonhazardous  foods to  be                                                               
     sold  by  the  producer  and  a third  party  to  be  either                                                               
     clearly   labeled  with  the same  thing     "This  food  is                                                               
     not  regulated  or  inspected  and  may contain  allergens,                                                                
     and  it's  not for  resale,"  or  this  food does  not  have                                                               
     the  packaging  that  can be  easily  affixed  to and  there                                                               
     must  be  clear signage,  again,  where  the food  is  sold.                                                               
     And   it   also   replaces    the   term   "non-potentially                                                                
     hazardous" with the term "nonhazardous."                                                                                   
                                                                                                                                
1:46:33 PM                                                                                                                    
SENATOR REINBOLD asked if he knew what it would cost for                                                                        
somebody to comply with the labeling and signage requirements.                                                                  
                                                                                                                                
CHAIR WILSON said he didn't know, but producers he spoke with                                                                   
said nobody had ever asked whether the product was made in a                                                                    
safe and sanitary kitchen.                                                                                                      
                                                                                                                                
1:47:48 PM                                                                                                                    
SENATOR BEGICH he has done home labeling and it doesn't cost                                                                    
very much and isn't difficult.                                                                                                  
                                                                                                                                
SENATOR  REINBOLD  asked  why the  term  "non-potentially   hazardous"                                                          
is replaced  with  the term  "nonhazardous."  She  said it  seems like                                                          
a very  high standard  and  she was  concerned about  exposing  people                                                          
to liability.                                                                                                                   
                                                                                                                                
1:49:03 PM                                                                                                                    
JASMIN   MARTIN,   Staff,   Senator   David   Wilson,   Alaska   State                                                          
Legislature,   Juneau,  Alaska,   explained  that  Legislative   Legal                                                          
Services  decided   to  correct  that  term   when  it  made  drafting                                                          
changes to comply with legislative drafting standards.                                                                          
                                                                                                                                
SENATOR  REINBOLD  commented  that  she  didn't  know  of any  product                                                          
that was required to say on the label that it was nonhazardous.                                                                 
                                                                                                                                
MS.  MARTIN  said the  amendment  does  not require  that  term  to be                                                          
on   the  label;   it's   a  term   that   is  used   throughout   the                                                          
legislation and is in the definitions section.                                                                                  
                                                                                                                                
SENATOR   HUGHES  recalled   that  an  initial   presentation   talked                                                          
about  classifying  foods and that  one category  was nonhazardous.                                                             
                                                                                                                                
1:50:49 PM                                                                                                                    
MS. MARTIN  said  that's correct  and  the department  could  speak to                                                          
that.  She   pointed  out   that  the  amendment   only   changes  the                                                          
terminology;   it  does  not  change  the  definition   of  hazardous,                                                          
non-potentially hazardous, or nonhazardous.                                                                                     
                                                                                                                                
1:51:09 PM                                                                                                                    
CHRISTINA  CARPENTER,  Director,  Division  of  Environmental  Health,                                                          
Department    of  Environmental    Conservation,    stated   that   as                                                          
originally  drafted,  the bill  defined  potentially  hazardous  foods                                                          
as  those  that  require  time  and temperature   control  to  prevent                                                          
the  risk  of foodborne   illness.  Non-potentially   hazardous  foods                                                          
don't  need that  time  and temperature   control.  The original  bill                                                          
also   had   different   labeling    requirements    for   potentially                                                          
hazardous  foods  and  non-potentially  hazardous  foods.  She  agreed                                                          
with  Ms. Martin  that Amendment  1 does  not require  the food  to be                                                          
labeled  to identify  it  as potentially  hazardous,  non-potentially                                                           
hazardous, or [nonhazardous].                                                                                                   
                                                                                                                                
SENATOR  HUGHES  said  she didn't  want  to  suggest  anything  on the                                                          
fly,  but  she  was  thinking  about  other  points   where  consumers                                                          
should be informed.                                                                                                             
                                                                                                                                
SENATOR  REINBOLD   asked  if  these  foods  needed  to  have  signage                                                          
about  their hazard  level but it  didn't need  to be on the  label.                                                            
                                                                                                                                
1:54:46 PM                                                                                                                    
CHAIR  WILSON  asked  if  she  was  asking  about  the  products  that                                                          
would need a label versus those that would not.                                                                                 
                                                                                                                                
SENATOR  REINBOLD  said  that's  part  of it  but  she  was trying  to                                                          
understand   the  difference  between  the  requirement   for  signage                                                          
versus labels.                                                                                                                  
                                                                                                                                
CHAIR  WILSON  explained  that  a jar  of  jam would  have  to  have a                                                          
label  affixed,  but a  head of  lettuce  would have  signage  because                                                          
a label could not readily be affixed.                                                                                           
                                                                                                                                
1:55:19 PM                                                                                                                    
SENATOR  BEGICH  said  the  only things  that  have  to  be signed  or                                                          
labeled  are those  identified  in the  phrases:  "This food  was made                                                          
in  a  home  kitchen,   is  not  regulated   or  inspected,   and  may                                                          
contain   allergens.";   and   "This   food   is  not   regulated   or                                                          
inspected  and  may  contain  allergens."   The language   on page  2,                                                          
line  20 clarifies  that  the food  is not  for resale.  The  language                                                          
on page  2, lines  11-12 and  lines 19-20  is part  of that.  He asked                                                          
Ms. Martin if she agreed.                                                                                                       
                                                                                                                                
MS. MARTIN said that is correct.                                                                                                
                                                                                                                                
CHAIR WILSON asked if there was further debate on Amendment 1.                                                                  
                                                                                                                                
1:56:35 PM                                                                                                                    
EMMA  POKON,   Deputy  Commissioner,   Department   of  Environmental                                                           
Conservation    (DEC),   Juneau,   Alaska,   stated   that   DEC   was                                                          
comfortable with the amendment.                                                                                                 
                                                                                                                                
1:56:50 PM                                                                                                                    
SENATOR HUGHES removed her objection.                                                                                           
                                                                                                                                
1:556 PM                                                                                                                      
CHAIR  WILSON  found  no  further   objection,  and  Amendment  1  was                                                          
adopted.                                                                                                                        
                                                                                                                                
1:57:00 PM                                                                                                                    
SENATOR HUGHES moved to adopt Amendment 2, work order 32-GS2521\A.2.                                                            
                                                                                                                                
                                                       32-GS2521\A.2                                                            
                                                            Bullard                                                             
                                                            4/25/22                                                             
                                                                                                                                
                                                                                                                                
                            AMENDMENT 2                                                                                       
                                                                                                                                
                                                                                                                                
     OFFERED IN THE SENATE                       BY SENATOR HUGHES                                                              
                                                                                                                                
                                                                                                                                
     Page 7, line 12, following "property;":                                                                                    
        Insert "and"                                                                                                            
                                                                                                                                
     Page 7, lines 14 - 16:                                                                                                     
        Delete "and                                                                                                             
              (C)  does not exceed two hundred fifty thousand                                                                   
        dollars in gross revenue annually from the food                                                                         
        products;"                                                                                                              
                                                                                                                                
1:57:02 PM                                                                                                                    
CHAIR WILSON objected for purposes of discussion.                                                                               
                                                                                                                                
1:57:05 PM                                                                                                                    
SENATOR  HUGHES   explained  that  Amendment   2  removes  the  annual                                                          
$250,000  sales  cap.  Feedback   from  the industry   indicates  that                                                          
this  would  be helpful  for  startup  businesses.  This  will  likely                                                          
stimulate more interest, which may help with food security.                                                                     
                                                                                                                                
1:58:04 PM                                                                                                                    
SENATOR  BEGICH  expressed  concern  that removing  the  cap  would be                                                          
an  open  invitation   for  large   producers  to  potentially   avoid                                                          
inspection. He asked for the departments view.                                                                                  
                                                                                                                                
MS  POKON said  the  amendment  is  responsive  to the  concerns  that                                                          
stakeholders  expressed   when  the bill  was  first  introduced.  DEC                                                          
would  retain the  ability  to address  any concerns  about  foodborne                                                          
illnesses if they should arise.                                                                                                 
                                                                                                                                
SENATOR  BEGICH  pointed  out  that any  follow  up on  illness  would                                                          
be after the fact.                                                                                                              
                                                                                                                                
2:00:09 PM                                                                                                                    
MS. POKON confirmed that was correct.                                                                                           
                                                                                                                                
SENATOR   BEGICH  said  perhaps   a  higher  cap  is  appropriate   to                                                          
recognize  startup   costs,  but  he  was  not  comfortable  with  the                                                          
department   abrogating    its   responsibility    for  environmental                                                           
safety  to  ensure  there  are no  foodborne  illnesses.   He said  he                                                          
could support a higher cap but he could not support no cap.                                                                     
                                                                                                                                
2:01:21  PM                                                                                                                   
CHAIR  WILSON  said  paragraph   (14)  still  has  the  two  items  in                                                          
subparagraphs  (A)  and (B)  that  talk about  what it  means  to be a                                                          
producer.  The  individual  may  not  produce  more than  two  hundred                                                          
fifty  thousand  individual  food  products  each year  and they  must                                                          
grow,  harvest,  prepare,  process,   or make  and  package  the  food                                                          
product  on  land they  own  or  lease. He  opined  that  (A)  and (B)                                                          
would eliminate commercial entities.                                                                                            
                                                                                                                                
SENATOR   HUGHES  asked,   should   the  amendment   pass,   would  an                                                          
illness  need  to  occur  or could  the  department  intervene   if an                                                          
end consumer reported a problem.                                                                                                
                                                                                                                                
2:02:42  PM                                                                                                                   
MS. POKON  directed  attention  to the  exceptions  listed on  page 4.                                                          
She read  that  nothing prevents  the  department  from conducting  an                                                          
inspection   based   on  a  report   of  foodborne   illness,   unsafe                                                          
sanitary   practices,   or  misbranded   or  adulterated   food.  That                                                          
authorizes the department to respond to such complaints.                                                                        
                                                                                                                                
SENATOR   HUGHES   expressed    satisfaction   with   the   level   of                                                          
protection to the end consumer.                                                                                                 
                                                                                                                                
SENATOR BEGICH said he was uncomfortable but he wouldn't object.                                                                
                                                                                                                                
2:04:26  PM                                                                                                                   
CHAIR   WILSON    removed   his   objection.    Finding   no   further                                                          
objection, Amendment 2 was adopted.                                                                                             
                                                                                                                                
2:05:02  PM                                                                                                                   
At ease.                                                                                                                        
                                                                                                                                
2:05:31  PM                                                                                                                   
CHAIR  WILSON  reconvened  the meeting  and  noted  that David  Rhodes                                                          
was  available  to  respond  to questions  that  were  asked  earlier.                                                          
He asked Senator Hughes to restate her question.                                                                                
                                                                                                                                
2:05:53  PM                                                                                                                   
SENATOR  HUGHES  asked whether  the signage  and  labeling called  for                                                          
in  Amendment  1 would  relieve  a  producer  of liability  should  an                                                          
end consumer get sick from that producer's product.                                                                             
                                                                                                                                
2:06:35  PM                                                                                                                   
DAVID   RHODES,   Chief   Assistant   Attorney    General;   Statewide                                                          
Section Supervisor, Special Litigation and Consumer Protection,                                                                 
Civil  Division  Department  of Law,  Anchorage,  Alaska, stated  that                                                          
the  bill  does  not  create  or  eliminate   any  new  liability  for                                                          
manufacturers.                                                                                                                  
                                                                                                                                
2:07:07 PM                                                                                                                    
SENATOR  HUGHES  noted that  no new liability  assumes  there  already                                                          
is some  liability.  She  asked  if there  were any  protections  that                                                          
could  be  put  into  the  law so  that  producers   or manufacturers                                                           
that  are contributing  to  food  security  would be  less subject  to                                                          
debilitating lawsuits.                                                                                                          
                                                                                                                                
MR.  RHODES said  he'd  defer the  discussion  to the  agency,  but he                                                          
believes  there  are options  for  the legislature   to consider  that                                                          
would reduce liability.                                                                                                         
                                                                                                                                
SENATOR  HUGHES  asked  whether  the  department  could  suggest  ways                                                          
to reduce liability for producers.                                                                                              
                                                                                                                                
2:08:30 PM                                                                                                                    
CHAIR  WILSON   asked  Deputy   Director   Pokon  to  work   with  the                                                          
Department   of  Law  on  suggested  options   for  the  committee  to                                                          
consider.  The  information  could  be  forwarded  to  his office  for                                                          
distribution to the members.                                                                                                    
                                                                                                                                
2:08:44 PM                                                                                                                    
MS.  POKON  stated  that if  it  was the  will  of  policymakers,  DEC                                                          
would  be  happy  to have  those  discussions.   She agreed  with  Mr.                                                          
Rhodes  that  the  bill,  as written,  does  not  affect  the  current                                                          
landscape regarding liability for producers.                                                                                    
                                                                                                                                
2:09:13 PM                                                                                                                    
CHAIR  WILSON  stated  that he  would  hold SB  242  in committee  for                                                          
future consideration.                                                                                                           
                                                                                                                                
2:09:41 PM                                                                                                                    
At ease                                                                                                                         
                                                                                                                                
              SB 183-HOME AND COMMUNITY-BASED SERVICES                                                                      
                                                                                                                                
2:13:02 PM                                                                                                                    
CHAIR   WILSON    reconvened    the   meeting   and    announced   the                                                          
consideration   of SENATE  BILL  NO.  183  "An Act  relating  to  home                                                          
and  community-based   services;   and  providing   for  an  effective                                                          
date."                                                                                                                          
                                                                                                                                
2:13:33 PM                                                                                                                    
SENATOR ELVI GRAY-JACKSON, Alaska State Legislature, Juneau,                                                                    
Alaska, sponsor of SB 183, introduced the bill by reading                                                                       
sponsor statement:                                                                                                              
                                                                                                                                
     Alaska  has  recently seen  an increased  demand  for  home-                                                               
     care   services  from  our  senior   population   and  those                                                               
     with   disabilities  due  to  both  growth   in  our  senior                                                               
     population   and  increasing   waiting  periods   to  access                                                               
     home  and  community-based   services.   Currently,  we  are                                                               
     unable   to  meet   these   demands.  We   have  seen   many                                                               
     individuals   who  qualify  for  Home  and  Community-Based                                                                
     Services   (HCBS)   waivers  and  Community   First   Choice                                                               
     Medicaid   State Plan  (K)  have  service  levels  cut,  get                                                               
     stuck  on  waiting  lists  for  long  periods  of  time,  or                                                               
     unable  to  hire caregivers   of their  choice.  There is  a                                                               
     high   need   for   caregivers    yet   hourly   wages   for                                                               
     caregivers has declined over the past decade.                                                                              
                                                                                                                                
     This   harms   Alaskans  everywhere.   Without   access   to                                                               
     home-care   services,   many  Alaskans  either  go  without                                                                
     the  care   they  need,  rely  exclusively   on  unpaid  and                                                               
     untrained  friends  and  family members,  or  are forced  to                                                               
     move  thousands  of  miles  away from  their  community  and                                                               
     support systems to receive institutional care.                                                                             
                                                                                                                                
     SB  183  takes  steps  to  ensure  that  Alaskans  who  need                                                               
     in-home  care  receive  it, so they  may live  with dignity                                                                
     and   independence    at   home,   while   providing    more                                                               
     stability   to  caregivers.   This   bill  will  raise   the                                                               
     threshold   for  reduction   of  benefits,  ensure  benefit                                                                
     recipients    are  notified   of   eligibility   assessment                                                                
     results   and  their  options  for  appeal,  and  allow  for                                                               
     re-assessment   of eligibility  for  those whose  levels  of                                                               
     service  have  been  reduced  over the  past two  years.  It                                                               
     will  make  it easier  for  eligible  caregivers  to  become                                                               
     Personal   Care  Assistants  under   HCBS  waivers  and  the                                                               
     Community First Choice Medical State Plan (K).                                                                             
                                                                                                                                
     Passing   SB  183  helps  Alaska   meet  the  in-home   care                                                               
     needs   of  seniors   and  people  with   disabilities.   It                                                               
     ensures   more  Alaskans   can  stay  in  their  homes   and                                                               
     communities     and    maintain     their    dignity     and                                                               
     independence.   It  also provides  improved   stability  for                                                               
     the  direct-care   workforce.  I  hope  you'll  join  me  in                                                               
     supporting SB 183.                                                                                                         
                                                                                                                                
2:16:00 PM                                                                                                                    
BESSE ODOM, Staff, Senator Elvi Gray-Jackson, Alaska State                                                                      
Legislature, Juneau, Alaska, presented the sectional analysis                                                                   
for SB 183 reading the following:                                                                                               
                                                                                                                                
     Sec.   1:  Amends  AS  47.07.045(a)   Home  and  community-                                                              
     based  services  for  provisions  in  the section  to  apply                                                               
     also  to  Community  First  Choice  and  Medicaid  personal                                                                
     care services programs.                                                                                                    
                                                                                                                                
     Sec.   2:  Amends  AS  47.07.045(a)   Home  and  community-                                                              
     based services by:                                                                                                         
     ?  Introducing  a  process  in statute  for  reducing  hours                                                               
     or   payment   for  home   and   community-based   services                                                                
     provided  under  1915(k)  state  plan  option  and Medicaid                                                                
     personal   care  services  that  mirrors   the  process  for                                                               
     terminating services.                                                                                                      
     ?  Adding  "and  live  independently"  as  a  condition  for                                                               
     terminating services.                                                                                                      
         Requiring   the   department   to  continue   following                                                                
     notice requirements provided in later sections.                                                                            
                                                                                                                                
     Sec.   3:  Amends  AS  47.07.045(d)   Home  and  community-                                                              
     based services by:                                                                                                         
     ?  Moving  definitions  for "independent   qualified  health                                                               
     care  professional"   and  "independent  qualified  waiver"                                                                
     to   this   section.    It   does   not   create   any   new                                                               
     definitions.                                                                                                               
     ?  "Independent  qualified  health  care professional"   for                                                               
     an  intellectual  or  developmental   disability  waiver  is                                                               
     defined    as   a   qualified    intellectual    disability                                                                
     professional under 42 C.F.R. 483.430.                                                                                      
     ?  For   other  allowable   waivers,   "Independent   health                                                               
     care   professional"   is  defined  as  a  person   who  can                                                               
     provide  personal  care  services  under the  1915(k)  state                                                               
     plan     or    a   registered     nurse    with    specific                                                                
     qualifications relevant to the waivers.                                                                                    
                                                                                                                                
     Sec.  4: Adds  a new  subsection  to AS 47.07.045  Home  and                                                             
     community-based services that:                                                                                             
     ?  Establishes   that  once  the  department  receives   the                                                               
     results  of  an assessment  they  have  10 days  to notify,                                                                
     in  writing,  the  recipients   or individuals   with  legal                                                               
     authority   to  act  on  the   recipient's  behalf   of  the                                                               
     assessment results.                                                                                                        
     ?  Establishes   that  after   the  department  decides   if                                                               
     there   will  be  a   change  in  levels   of  services   or                                                               
     payments   for  services,  they  have   10 days   after  the                                                               
     decision    is   made   to    notify   the   recipient    or                                                               
     individuals    with   legal   authority   to  act   on   the                                                               
     recipient's   behalf  of  the decision.   This  notice  must                                                               
     be   done   in  writing   and  30   days  before   the   new                                                               
     determination   goes  into   effect.  The  department   must                                                               
     also   inform  them  they   have  a  right  to  appeal   the                                                               
     decision.                                                                                                                  
     ?   Allows   legally   responsible    persons   to  provide                                                                
     personal   care  services  to an  individual   eligible  for                                                               
     home    and    community-based    services    waivers    and                                                               
     Community First Choice.                                                                                                    
                                                                                                                                
     Sec.  5:  Adds  a  new  section  that  creates  a  path  for                                                             
     hours  to be  restored  through  the proposed  reassessment                                                                
     process   for   recipients   of  care  whose   payment   for                                                               
     services   were  reduced   between   January  1,  2019   and                                                               
     January 1, 2022.                                                                                                           
                                                                                                                                
     Sec.  6:  Adds a  new section  to  instruct  the Department                                                              
     of  Health  and  Social  Services  to  amend  and  submit  a                                                               
     state   plan  for  medical  services   to the  Centers   for                                                               
     Medicare and Medicaid Services (CMS).                                                                                      
                                                                                                                                
     Sec.   7:  Makes  section   5  retroactive  to  January   1,                                                             
     2019.                                                                                                                      
                                                                                                                                
     Sec.  8: Establishes  the  act will  take effect  only  upon                                                             
     federal   approval    of  the   state   plan   for  medical                                                                
     assistance,   and that  if  approved,  the Commissioner   of                                                               
     the   Department   of  Health  and   Social  Services   must                                                               
     notify  the  revisor  of  statute  not later  than  30  days                                                               
     after receiving notice.                                                                                                    
                                                                                                                                
     Sec. 9-10: Create two effective dates:                                                                                   
     ?  For  sections  1   4,  effective  date  will  be the  day                                                               
     after   the  revisor  of  statutes   receives  notification                                                                
     from  the Commissioner   of Health  and Social  Services  of                                                               
     federal approval of state plan amendments.                                                                                 
     ?   Sections   5  and  7  take   effect   immediately   upon                                                               
     passage.                                                                                                                   
                                                                                                                                
2:20:42 PM                                                                                                                    
CHAIR WILSON listed the individuals available to answer                                                                         
questions.                                                                                                                      
                                                                                                                                
2:21:00 PM                                                                                                                    
SENATOR  BEGICH  mentioned a  memorandum  he received  that  discusses                                                          
the  incentive   mechanism  the  [Department   of  Health  and  Social                                                          
Services   (DHSS)]   uses   and   the   concern   it   has  with   the                                                          
legislation  that  there  is  an expectation   that  individuals  gain                                                          
skills  to take  better care  of themselves.  He  said his concern  is                                                          
that  some people  are never  going to  gain new  skills because  they                                                          
are  permanently   disabled.   He  called  the  requirement   to  show                                                          
continued  progress  when it's  not possible  a loophole  in  the law.                                                          
He asked whether the bill rectified that conundrum.                                                                             
                                                                                                                                
2:23:19 PM                                                                                                                    
SENATOR  GRAY-JACKSON   answered   that  she  believes   SB  183  does                                                          
rectify  that  situation  because  it  allows  a repeal  process.  She                                                          
suggested   that   the  department   could   give   a  more   in-depth                                                          
response.                                                                                                                       
                                                                                                                                
2:23:41 PM                                                                                                                    
JOHN  LEE, Director,  Division   of Senior  and  Disability  Services,                                                          
Department   of  Health   and  Social  Services   (DHSS),   Anchorage,                                                          
Alaska,  said  he  believes  the  discussion  is  about  a Center  for                                                          
Medicare  and  Medicaid  Services  (CMS) concept  called  fading  that                                                          
applies   to  individuals  who   have  the  capacity   to  obtain  new                                                          
skills  or competencies  to  perform  certain tasks.  He acknowledged                                                           
that   this   isn't  available    for  many   individuals   that   the                                                          
department   supports   because   their   conditions   will   not  get                                                          
better.   However,   for  supportive   employment   there   is  a  CMS                                                          
requirement  that  as  skills  and  competencies  are  developed,  the                                                          
supportive process in place will fade.                                                                                          
                                                                                                                                
SENATOR  BEGICH   referenced  page  4  of  the  memorandum   from  the                                                          
department  that  indicates   that  SB  183 would  negatively   affect                                                          
the federal policy called fading.                                                                                               
                                                                                                                                
2:25:42 PM                                                                                                                    
MR. LEE  answered  yes; the  department  would need  federal  approval                                                          
to  remove   the   requirement   for  fading   to   be  part   of  the                                                          
department's program.                                                                                                           
                                                                                                                                
SENATOR  BEGICH  noted  that  the  memorandum  said,  "The  department                                                          
is eager  to  work with  the sponsor  to  better understand   the goal                                                          
of  the bill."  He asked  Mr.  Lee if  he'd  met with  the sponsor  to                                                          
discuss the concern.                                                                                                            
                                                                                                                                
MR.  LEE  answered   yes  and  he  appreciated   that   Senator  Gray-                                                          
Jackson  participated   in  the  dialog  and  was  open  to  potential                                                          
changes.  The  department  also  met with  the  sponsor  of the  House                                                          
companion   bill   who   agreed   to  some   positive   changes.   The                                                          
department  looks  forward   to continuing   conversations  with  both                                                          
sponsors   to  improve  the  legislation   and  reduce   the  concerns                                                          
articulated in the fiscal note.                                                                                                 
                                                                                                                                
SENATOR  HUGHES  asked if  CMS would  have  to issue  a formal  waiver                                                          
to eliminate  the  requirement  for a  person to  be developing  their                                                          
skills  to  progress  towards  employment.   She  also  asked  whether                                                          
individuals   who   lose  eligibility    because   their  skills   and                                                          
competencies   aren't  improving   are  eligible   for  help  under  a                                                          
different type of funding.                                                                                                      
                                                                                                                                
2:28:18 PM                                                                                                                    
MR.  LEE  said  the  bill  affects  the  department's   Personal  Care                                                          
Services   Program   and  the   Home   and  Community   Based   waiver                                                          
programs.  To  implement   the  changes  the  bill  calls  for,  these                                                          
three  programs would  have  to make  changes to  the regulations  and                                                          
potentially   get   approval  from   the  Center   for  Medicare   and                                                          
Medicaid   Services.  The  department   is  currently   receiving  the                                                          
American  Rescue  Plan enhanced  federal  match for  HCBS and  because                                                          
some  of  the  provisions  in  the  proposed  statute  would  be  more                                                          
restrictive,   it  may   be  necessary   to  delay  implementing   the                                                          
changes   until  after   March  31,  2024.   To  the  question   about                                                          
funding,  he said  the  lack of  progress  toward  employment  doesn't                                                          
typically   trigger  the   loss  of  that   aspect  of  the   person's                                                          
waiver.  He  asked  if  she  could  give  specific  examples  of  that                                                          
happening so he could give a more precise response.                                                                             
                                                                                                                                
2:30:04 PM                                                                                                                    
SENATOR   HUGHES  suggested   he   follow  up   with  the   Governor's                                                          
Council   on  Disabilities    and  Special   Education   because   she                                                          
recalled  testimony  from people  with  severe disabilities   who have                                                          
lost  services  because  they were  not progressing.   She also  asked                                                          
whether  the  regulation  changes  he mentioned  earlier  referred  to                                                          
state or federal regulations.                                                                                                   
                                                                                                                                
MR. LEE  answered  that the  waiver and  state plan  amendments  would                                                          
require  approval  from  CMS, but  he  saw no  need  to change  either                                                          
federal statutes or federal regulations.                                                                                        
                                                                                                                                
SENATOR  HUGHES  shared  her  personal   experience  when  her  father                                                          
was  in  a recovery  center   receiving  therapy  after  hip  surgery.                                                          
For Medicare  to  pay, he had  to show  he was  making progress.  When                                                          
he  stopped  making  progress,   he  lost  the  therapy  and  declined                                                          
rapidly.  She offered  her  belief that  the requirement  to  continue                                                          
to show  progress  to stay  on a program  needs  to be revisited  with                                                          
CMS.                                                                                                                            
                                                                                                                                
2:33:48 PM                                                                                                                    
SENATOR  BEGICH  asked if  the two  retroactive  clauses  were  due to                                                          
COVID-19.                                                                                                                       
                                                                                                                                
SENATOR GRAY-JACKSON deferred to Ms. Odom.                                                                                      
                                                                                                                                
MS. ODOM answered yes.                                                                                                          
                                                                                                                                
SENATOR  BEGICH  elaborated  that  it returns  to the  standard  prior                                                          
to the COVID-19 pandemic.                                                                                                       
                                                                                                                                
SENATOR GRAY-JACKSON agreed.                                                                                                    
                                                                                                                                
SENATOR  REINBOLD  asked for  further  clarification  because  January                                                          
1, 2019 was before the pandemic.                                                                                                
                                                                                                                                
SENATOR  BEGICH  said  it's set  for  the beginning   of the  calendar                                                          
year. He suggested the department comment.                                                                                      
                                                                                                                                
CHAIR  WILSON  noted that  the department   declined  to comment  on a                                                          
policy call.                                                                                                                    
                                                                                                                                
2:36:20 PM                                                                                                                    
CHAIR WILSON turned to invited testimony.                                                                                       
                                                                                                                                
2:36:37 PM                                                                                                                    
KATHERINE  BACON,  representing  self,  Palmer,  Alaska,  stated  that                                                          
she  has  been a  special  needs  caregiver  for  25  years,  starting                                                          
with  her medically  fragile  granddaughter.  She  is now the  primary                                                          
caregiver   to  her  late  husband's   grandson   Michael  who  has  a                                                          
traumatic  brain  injury.  Countless  caregivers  have  come  and gone                                                          
because  the pay  isn't  very good.  She is  fortunate  to be  paid to                                                          
care  for Michael,  but  the  process  to get  qualified  to retain  a                                                          
caregiver   let  alone   to  qualify   to  be   a  caregiver   is  too                                                          
difficult  for  a  lot  of families.   Many  of the  paid  and  unpaid                                                          
people  doing  this work  are struggling   and reaching  the  breaking                                                          
point.                                                                                                                          
                                                                                                                                
MS.  BACON described   SB 183  as the  first  small  step towards  the                                                          
urgently  needed  repair  of  a broken  system  by  reducing  barriers                                                          
to access  to  care and  restoring  client  hours.  These two  changes                                                          
will help keep vulnerable Alaskans like Michael safer.                                                                          
                                                                                                                                
2:41:09 PM                                                                                                                    
DEBBIE  MULHOLLAND,  representing   self,  Anchorage,  Alaska,  stated                                                          
that  she  has been  a  caregiver  for  nearly  10  years.  SB  183 is                                                          
important  to her  clients,  most  of whom  are seniors.  They  are in                                                          
need  of care  and  often  can't  get  it. She  shared  the  following                                                          
story from her prepared testimony:                                                                                              
                                                                                                                                
     I  have  one client  who  is bed  ridden  and  his daughter                                                                
     has  been taking  care  of him. I  only see  him five  hours                                                               
     per  day, four  days per  week. I  can see  that it is  very                                                               
     hard   on  her  mental  and  physical   health  because   of                                                               
     physical   abuse   due  to   her  father's   dementia.   She                                                               
     doesn't  get  any  breaks  or  help from  other  caregivers                                                                
     besides    me.   It  worries    me  that   caregivers    are                                                               
     experiencing   these kinds  of hardships  on  a daily  basis                                                               
     because   there   is   simply   not   enough   funding   for                                                               
     caregiving.                                                                                                                
                                                                                                                                
MS.  MULHOLLAND   stressed  that   families  are  struggling   because                                                          
they  can't find  caregivers  and caregivers  are  struggling  because                                                          
their  clients  only qualify  for  two  hours of  care  per day  a few                                                          
times  a week  so they  leave to  find  more stable  employment.  This                                                          
often   leaves   the   families   to   fill   the  gap.   [Audio   was                                                          
indiscernible.]                                                                                                                 
                                                                                                                                
CHAIR  WILSON   advised  that   the  committee  could   not  hear  the                                                          
testimony.                                                                                                                      
                                                                                                                                
2:43:33 PM                                                                                                                    
MS.  MULHOLLAND  stated  that  the  cuts  to  the caregiver   programs                                                          
have  gone too  far.  Some seniors  are  no longer  able  to  get help                                                          
for  their most  basic  needs.  She urged  the  committee  to  pass SB
183.                                                                                                                            
                                                                                                                                
2:45:29 PM                                                                                                                    
CHAIR WILSON opened public on SB 183.                                                                                           
                                                                                                                                
SENATOR  HUGHES  thanked the  caregivers  who gave  testimony  for the                                                          
work they do.                                                                                                                   
                                                                                                                                
CHAIR  WILSON   asked  Mariana  Morante   if  she  wanted  to  provide                                                          
testimony or comment on the bill and she declined.                                                                              
                                                                                                                                
2:46:55 PM                                                                                                                    
CHAIR WILSON closed public testimony on SB 183.                                                                                 
                                                                                                                                
SENATOR  GRAY-JACKSON  suggested   Ms. Morante  address  the  concerns                                                          
DHSS articulated.                                                                                                               
                                                                                                                                
2:47:36 PM                                                                                                                    
MARIANA  MORANTE,   Research  &  Policy  Manager,  Service   Employees                                                          
International  Union  (SEIU)  775, Seattle,  Washington,  stated  that                                                          
SB  183  seeks  to  prevent   caregiver  hours   from  being  cut  for                                                          
clients  who  need  those services.   The bill  mirrors  the  existing                                                          
process  for  terminating  services.   That  involves  an  independent                                                          
health  provider   conducting   an  assessment   to  verify  that  the                                                          
client   would   be   able   to   function   in   a  home   and   live                                                          
independently.    The  bill   ensures   that   what   the   caregivers                                                          
provided   in  testimony   today   does   not  happen,   so   everyone                                                          
receives  the level  of care  needed to  function  in a home  and live                                                          
independently.                                                                                                                  
                                                                                                                                
CHAIR  WILSON offered  his  view on indeterminate   fiscal notes,  and                                                          
asked  Mr. Lee  to  discuss how  the  bill would  work,  how  it would                                                          
be implemented, and what it would cost the state.                                                                               
                                                                                                                                
2:49:32 PM                                                                                                                    
MR.  LEE  stated  that  SB  183  would  fundamentally   change  nearly                                                          
every   aspect   of   processing   and   managing   the  department's                                                           
portfolio   of   businesses.   It   would   also   require   extensive                                                          
consultation  with  CMS on  how to implement  the  bill. He  justified                                                          
the   indeterminate   fiscal   note   saying   that   the  number   of                                                          
processes   that  would  need   to  be  changed  and   the  number  of                                                          
additional   staff  that  would  be  needed  and  managed  would  vary                                                          
depending  on  whether  the  Senate  or  House  version  of  the  bill                                                          
passed.  He  opined that  it  would  take weeks  of  concerted  effort                                                          
with  the entire  leadership   team to  provide  a guestimate   of the                                                          
actual  costs  to  hire  additional  staff,  to  contract  for  third-                                                          
party   reviews,  and   to  determine   what   assessments   would  be                                                          
required  and  when.  A final  determination   would likely  be  after                                                          
public comment and consultation with CSM.                                                                                       
                                                                                                                                
2:51:41 PM                                                                                                                    
CHAIR  WILSON  said  he  appreciates  that  but  legislators  rely  on                                                          
good  faith   estimates  from   the  departments   to  make  the  best                                                          
decisions possible.                                                                                                             
                                                                                                                                
CHAIR  WILSON  asked  if  the bill  could  be  implemented  given  the                                                          
changes  the  federal  government  has  made  to Medicaid,   including                                                          
the moratorium on enrollment.                                                                                                   
                                                                                                                                
MR.  LEE   opined  that   certain  aspects   of  the  bill   would  be                                                          
problematic  and  need to  be delayed  given  that  the department  is                                                          
taking  advantage   of  the  American  Rescue  American   Rescue  Plan                                                          
enhanced  federal  match  for  certain  programs.  There  may  also be                                                          
required  assessments   that  aren't  currently   required  and  those                                                          
would need to be delayed until after March 31, 2024.                                                                            
                                                                                                                                
SENATOR  HUGHES  pointed  out  that the  department  would  also  need                                                          
to get  any  waiver applications   approved  by CMS.  She asked  if he                                                          
agreed that it's more involved than simply passing the bill.                                                                    
                                                                                                                                
2:53:57 PM                                                                                                                    
MR. LEE said that's correct.                                                                                                    
                                                                                                                                
SENATOR  BEGICH  commented  that he  was pleased  that  the Chair  was                                                          
on the  Finance  Committee  because  the  questions  about the  fiscal                                                          
note  will  be  significantly   more  difficult   to  answer  in  that                                                          
venue.  He also  observed  that  the administration   appears  to have                                                          
no  interest  in this  legislation  moving  forward.  He  asked  if he                                                          
was hearing that correctly.                                                                                                     
                                                                                                                                
MR.  LEE  responded  that  the department   has  worked  hard and  has                                                          
had  multiple  meetings  with  the sponsors  of  both  the Senate  and                                                          
House  bills.   He  apologized   for  giving  the  impression   of  no                                                          
interest  because   that  was  not the  intent.   There  is  a lot  of                                                          
interest in making a better bill, he said.                                                                                      
                                                                                                                                
SENATOR   REINBOLD  commented   that   she  doesn't  have   a  lot  of                                                          
compassion  for  a  department   that can't   come up  with  a  fiscal                                                          
note  when it's  now two departments   with addition  staff.  She said                                                          
this  is  an important   issue  for  the people  who  need  care,  the                                                          
families,  and  the  caregivers.  She  added  that  her  problem  with                                                          
public  assistance   relates  to  the  expansion   of  Medicaid.  It's                                                          
made the budget too large.                                                                                                      
                                                                                                                                
2:57:52 PM                                                                                                                    
SENATOR  GRAY-JACKSON  stated  that this  bill is  very important  and                                                          
she  appreciates  the  support.  She  also  agreed  with  the  comment                                                          
about  the two  departments  and the  indeterminate  fiscal  note, and                                                          
expressed appreciation for Senator Begich's comments.                                                                           
                                                                                                                                
CHAIR WILSON asked the sponsor if she had any closing comments.                                                                 
                                                                                                                                
SENATOR  GRAY-JACKSON   thanked  the  committee  for  considering  the                                                          
bill                                                                                                                            
                                                                                                                                
2:59:27 PM                                                                                                                    
CHAIR WILSON held SB 183 in committee.                                                                                          
                                                                                                                                
3:00:14 PM                                                                                                                    
There being no further business to come before the committee,                                                                   
Chair Wilson adjourned the Senate Health and Social Services                                                                    
Standing Committee meeting at 3:00 p.m.                                                                                         

Document Name Date/Time Subjects
SB 183, Version A – Supporting Document (Guardianship Overview).pdf SHSS 4/26/2022 1:30:00 PM
SB 183
SB 183, Version A – Supporting Document (One Pager).pdf SHSS 4/26/2022 1:30:00 PM
SB 183
SB 183, Version A - Sponsor Statement.pdf SHSS 4/26/2022 1:30:00 PM
SB 183
SB 183, Version A – Supporting Document (Personal Care Services).pdf SHSS 4/26/2022 1:30:00 PM
SB 183
SB 183, version A.PDF SHSS 4/26/2022 1:30:00 PM
SB 183
Additional Letters of Support.pdf SHSS 4/26/2022 1:30:00 PM
SB 183
GCDSE Letter of Support 3.14.22.pdf SHSS 4/26/2022 1:30:00 PM
SB 183
SB 183, Version A - Sectional Analysis.pdf SHSS 4/26/2022 1:30:00 PM
SB 183
SB 183 FN DOH MS 4.22.22.pdf SHSS 4/26/2022 1:30:00 PM
SB 183
SB 183 FN DOH SDSA 4.22.22.pdf SHSS 4/26/2022 1:30:00 PM
SB 183
SB 242 Ammendments 4.26.22.pdf SHSS 4/26/2022 1:30:00 PM
SB 242
SB 242 Letter- Delta 4.20.pdf SHSS 4/26/2022 1:30:00 PM
SB 242
SB 242 A1 Memo Wilson 4.25.pdf SHSS 4/26/2022 1:30:00 PM
SB 242