02/25/2025 03:30 PM Senate HEALTH & SOCIAL SERVICES
| Audio | Topic |
|---|---|
| Start | |
| SB9 | |
| SB83 | |
| Adjourn |
+ teleconferenced
= bill was previously heard/scheduled
| += | SB 9 | TELECONFERENCED | |
| += | SB 83 | TELECONFERENCED | |
ALASKA STATE LEGISLATURE
SENATE HEALTH AND SOCIAL SERVICES STANDING COMMITTEE
February 25, 2025
3:31 p.m.
MEMBERS PRESENT
Senator Forrest Dunbar, Chair
Senator Cathy Giessel, Vice Chair
Senator Matt Claman
Senator Löki Tobin
Senator Shelley Hughes
MEMBERS ABSENT
All members present
COMMITTEE CALENDAR
SENATE BILL NO. 9
"An Act relating to the surrender of infants; and providing for
an effective date."
- HEARD & HELD
SENATE BILL NO. 83
"An Act relating to health care insurance; relating to insurance
reimbursement for health care services provided through
telehealth; and providing for an effective date."
- HEARD & HELD
PREVIOUS COMMITTEE ACTION
BILL: SB 9
SHORT TITLE: SURRENDER OF INFANTS; INF. SAFETY DEVICE
SPONSOR(s): SENATOR(s) MYERS
01/10/25 (S) PREFILE RELEASED 1/10/25
01/22/25 (S) READ THE FIRST TIME - REFERRALS
01/22/25 (S) HSS, JUD
02/20/25 (S) HSS AT 3:30 PM BUTROVICH 205
02/20/25 (S) -- MEETING CANCELED --
02/25/25 (S) HSS AT 3:30 PM BUTROVICH 205
BILL: SB 83
SHORT TITLE: TELEHEALTH REIMBURSEMENT RATES
SPONSOR(s): SENATOR(s) CLAMAN
01/31/25 (S) READ THE FIRST TIME - REFERRALS
01/31/25 (S) HSS, FIN
02/11/25 (S) HSS AT 3:30 PM BUTROVICH 205
02/11/25 (S) Heard & Held
02/11/25 (S) MINUTE(HSS)
02/25/25 (S) HSS AT 3:30 PM BUTROVICH 205
WITNESS REGISTER
SENATOR ROBERT MYERS, District Q
Alaska State Legislature
Juneau, Alaska
POSITION STATEMENT: Sponsor of SB 9.
CARLA ERICKSON, Chief Assistant
Child Protection
Civil Division
Department of Law
Anchorage, Alaska
POSITION STATEMENT: Answered questions on SB 9.
THERESA WOLSTAD, Staff
Senator Robert Myers
Alaska State Legislature
Juneau, Alaska
POSITION STATEMENT: Provided the sectional analysis for SB 9.
DOUGLAS SCHRAGE, Chief
Anchorage Fire Department
Anchorage, Alaska
POSITION STATEMENT: Testified by invitation on SB 9.
JULIE CONDELL, Lead Dispatcher
Anchorage Fire Department
Anchorage, Alaska
POSITION STATEMENT: Testified by invitation on SB 9.
LONNY MARLEY, Council Member
City of Fairbanks
Fairbanks, Alaska
POSITION STATEMENT: Testified by invitation on SB 9.
PAMELA SAMASH, representing self
Nenana, Alaska
POSITION STATEMENT: Testified in support of SB 9.
KEN SPIERS, representing self
Fairbanks, Alaska
POSITION STATEMENT: Testified in support of SB 9.
ARIELLE WIGGIN, Staff
Senator Forrest Dunbar
Alaska State Legislature
Juneau, Alaska
POSITION STATEMENT: Provided the summary of changes for SB 83
from version N to I.
HEATHER CARPENTER, Deputy Director
Division of Insurance
Department of Commerce, Community, and Economic Development
Juneau, Alaska
POSITION STATEMENT: Answered questions on SB 83.
ACTION NARRATIVE
3:31:47 PM
CHAIR DUNBAR called the Senate Health and Social Services
Standing Committee meeting to order at 3:31 p.m. Present at the
call to order were Senators Hughes, Claman, Tobin, Giessel, and
Chair Dunbar.
SB 9-SURRENDER OF INFANTS; INF. SAFETY DEVICE
3:32:33 PM
CHAIR DUNBAR announced the consideration of SENATE BILL NO. 9
"An Act relating to the surrender of infants; and providing for
an effective date."
3:32:46 PM
SENATOR ROBERT MYERS, District Q, Alaska State Legislature,
Juneau, Alaska, sponsor of SB 9 paraphrased the following
statement:
[Original punctuation provided.]
SB 9 - Sponsor Statement
SURRENDER OF INFANTS; INF. SAFETY DEVICE
"An Act relating to the surrender of infants; and
providing for an effective date."
In 2008 Alaska enacted its safe surrender law to
ensure that surrendered infants receive immediate care
for their safety and provide protections for the
relinquishing parent, thereby reduce potential infant
death due to illegal abandonment. While nine infants
have been surrendered since the safe surrender statute
was enacted, the state of Alaska has recently had
several instances of infants being illegally
abandoned, sometimes leading to death. Traditional
safe surrender laws require a parent to directly
relinquish an infant to another individual. Yet shame,
fear, and potential recognition may pose potential
barriers for a parent in crisis to utilize the safe
surrender law as it still requires the surrender to be
made in person.
Infant safety devices offer a possible solution to
protect both relinquishing parents and infants. Infant
safety devices allow a parent to surrender an infant
anonymously through a climate-controlled device at a
designated facility. Currently, twenty-two states
authorize infant safety devices. Senate Bill Nine
would authorize the use of infant safety devices as an
additional method of infant relinquishment under the
safe surrender laws. These devices would safely hold
an infant with an automatic lock and constant video
surveillance while immediately alerting appropriate
personnel of the surrender. Infant safety devices
would be placed in conspicuous areas with appropriate
signage as determined by the Department of Family and
Community Services (DFCS). An infant safety device may
be located at hospital, emergency department,
freestanding birth center, office of a private
physician, rural health clinic, municipal police
department, state trooper post, fire department, or
other facility designated by the DFCS commissioner.
The ability to relinquish an infant to a safe location
rather than an individual allows additional anonymity
for the relinquishing parent while still ensuring that
surrendered infants receive immediate medical care.
Thus, SB 9 preserve the protection of surrendered
infants while also addressing the potential barriers
of shame, fear, and potential recognition of a
relinquishing parent during a time of crisis.
SENATOR MYER stated facility consent is required for
installation and payment for the devices is through private
funding. He stated his office did not work with any particular
group in the drafting of SB 9. It mirrors Maryland legislation
that was unanimously passed last year.
3:35:46 PM
SENATOR CLAMAN asked for the names of a few other states that
have passed similar legislation.
3:35:59 PM
SENATOR MYERS replied that the list of states with similar
legislation is in the bill packet.
CHAIR DUNBAR stated Alabama, Idaho, and Indiana are among the
states listed.
SENATOR MYERS offered to provide the direct research from the
National Conference of State Legislatures (NCSL).
CHAIR DUNBAR expressed approval of the shortened summary.
SENATOR CLAMAN stated he would like to see the NCSL analysis.
SENATOR MYERS said he would provide it.
3:36:49 PM
SENATOR GIESSEL expressed appreciation for the immediate
emergency medical services (EMS) response when a child is placed
in the device. She asked whether there is a provision in place
for situations where the child is already deceased and there is
evidence of child abuse.
3:37:20 PM
SENATOR MYERS stated that current law permits safe surrender
only when there are no indications of abuse, and SB 9 does not
change that standard. He clarified that the basic provisions of
the safe surrender law remain intact. SB 9 simply introduces an
additional method for safe surrender. He added that if there is
evidence of abuse, it could still lead to criminal charges
against the parent.
3:37:45 PM
SENATOR GIESSEL asked whether video surveillance could be used
as a tool to identify the perpetrator.
3:37:58 PM
SENATOR MYERS stated that the video surveillance is limited to
the inside of the box and does not capture the person
approaching it. He explained that the intent is to preserve the
anonymity of the surrendering parent, which is a key factor in
encouraging safe surrenders.
3:38:25 PM
SENATOR TOBIN asked how authorities can confirm that the person
surrendering the infant is actually the parent.
SENATOR MYERS stated that under the current safe surrender law,
no proof is required to verify that the person surrendering the
child is the parent, and SB 9 does not change that provision. He
suggested the Department of Family and Community Services
address the question.
3:39:32 PM
SENATOR TOBIN explained that she asked the question because she
was raised by her grandparents and understands that there are
situations where an infant may be surrendered by a family member
who is not the parent but also cannot provide care. She said
gaining clarity on how the process works would help her better
understand the implications.
3:39:51 PM
CHAIR DUNBAR called on Ms. Erikson to address the question and
for Senator Tobin to repeat the question.
3:40:07 PM
SENATOR TOBIN asked whether, under the current bill draft and
related statutes, there is any process through which the
department or another system confirms that the individual
surrendering the child is the parent or legal guardian.
3:40:31 PM
CARLA ERICKSON, Chief Assistant, Child Protection, Civil
Division, Department of Law, Anchorage, Alaska, answered that
confirmation of who surrendered the child is only possible if
the individual's identity is known. In cases of complete
anonymity and without external surveillance, the Department of
Family and Community Services would treat the situation as an
abandoned child and proceed with efforts to establish
permanency. She stated her understanding of the process is there
would likely be attempts to identify and contact other family
members and that would be the extent of the current process.
3:41:16 PM
SENATOR TOBIN stated that she did not want to focus on worst-
case scenarios but explained that she often considers situations
involving separated parents or caregivers who can no longer
provide care. She expressed concern that if the surrender
process remains fully anonymous with no way to confirm the
identity of the person surrendering the child, there is a real
risk that a loving family willing to care for the child might
never be contacted. She said this is a personal consideration
she takes into account when reviewing the legislation.
3:42:09 PM
SENATOR HUGHES stated that the 2008 law granted immunity from
prosecution to a parent who surrendered a child to another
person. Regarding the nine cases where infants were surrendered,
she asked whether information about the parent was provided to
the Department of Family and Community Services (DFCS). She
expressed concern that under the current proposal, that
information may no longer be available.
3:42:57 PM
SENATOR MYERS deferred the question.
3:43:25 PM
MS. ERICKSON stated that in her experience with the Department
of Law, the agency has been aware of the identity of the parent
in safe surrender cases. She clarified that she was not aware of
any case involving a fully anonymous or "clean, safe surrender"
where the parent left the child and walked away without
providing any information. She emphasized her understanding that
the department had identifying information.
3:43:50 PM
SENATOR HUGHES sought to address Senator Tobin's concern by
stating that the intent behind safe surrender options is to
account for factors like fear and embarrassment that a parent
may experience. She questioned whether requiring a parent to
fill out and sign a form affirming their identity and placing it
with the baby in the device would discourage use. She noted that
although the act remains private, adding a signed document might
still feel intrusive.
3:44:41 PM
SENATOR MYERS stated that SB 9 aims to provide an opportunity
for parents to voluntarily include identifying and medical
information when surrendering a child, which is the ideal
outcome. He emphasized, however, that the priority remains
preserving the child's life. He acknowledged that while
additional information is valuable, the first and most critical
step is ensuring the child survives. He concluded that this
focus guided the direction of the SB 9.
3:45:36 PM
THERESA WOLSTAD, Staff, Senator Robert Myers, Alaska State
Legislature, Juneau, Alaska, provided the sectional analysis for
SB 9:
[Original punctuation provided.]
SB 9 ver. I Sectional Analysis
SURRENDER OF INFANTS; INF. SAFETY DEVICE
"An Act relating to the surrender of infants; and
providing for an effective date."
Section 1: AS 47.10.013 (c) Page 1, Lines 3-15 Page 2,
Lines 1-18.
This section authorizes an infant safety device as a
location a parent may safely surrender an infant.
Establishes appropriate locations for infant safety
devices and authorizes the Commissioner of Family and
Community Services to designate other appropriate
facilities and locations.
Section 2: AS 47.10.013(d) Page 2, Line 19-31, Page 3,
Lines 1-2.
Amends AS 47.10.013(d) with conforming statutory
references as made in section one.
Section 3: AS 47.10.013(e) Page 3, Line 3-6.
Amends AS 47.10.013(e) with conforming language which
adds "designated" to authorized facilities.
Section 4: AS 47.10.013 Page 3, Lines 7-31, Page 4,
Lines 1. This section requires a designated facility
to notify the nearest office of the Department of
Family and Community Services that the infant has been
surrendered. The Department may provide training to
employees of a designated facility regarding
implementation and compliance with Alaska safe
surrender laws.
This section further establishes requirements for
infant safety devices including:
1. Located within a conspicuous location that is
visible to designated facility employees.
2. Climate-controlled.
3. Clearly marked with appropriate signage.
4. Equipped with an automatic 911 emergency system
dispatch request for emergency medical response
to the device location, a 24-hour video
surveillance system, and automatic security lock
after deposit.
Section 5: Page 4, Line 2.
This section establishes an effective date for the
bill of July 1 st, 2026.
3:47:48 PM
CHAIR DUNBAR announced invited testimony on SB 9.
3:48:03 PM
DOUGLAS SCHRAGE, Chief, Anchorage Fire Department, Anchorage,
Alaska, testified by invitation on SB 9 expressing strong
support for the bill. He noted that Alaska's current safe haven
law, like those in all 50 states, provides immunity from
prosecution for a parent who surrenders a newborn to a
designated professional. He explained that while the Anchorage
Fire Department has received infants under this law, there have
also been tragic cases of unsafe abandonment. He identified the
face-to-face handoff requirement as a significant barrier due to
stigma and fear, and stated that safe haven baby boxes offer a
safer, anonymous alternative.
MR. SCHRAGE clarified that there is no legal requirement to
collect identifying information during a live handoff, though
officials use a voluntary questionnaire to request medical or
background information. He stated that the same voluntary
approach would apply to baby boxes, with signage encouraging
completion of the form but no obligation to do so. He explained
that baby boxes are typically installed in fire stations due to
their 24-hour staffing, and are funded by donations.
MR. SCHRAGE emphasized that SB 9 is necessary to amend AS
47.10.013, which currently requires a live handoff and does not
account for the use of anonymous baby boxes. He concluded that
the bill would allow for safe, anonymous surrender and provide
legal immunity, which he believes is a positive and necessary
development.
3:53:45 PM
SENATOR CLAMAN congratulated Mr. Schrage on the birth of his
granddaughter and becoming "Grandpa Schrage."
3:54:01 PM
SENATOR HUGHES asked about the cost of an infant safe surrender
device. She also inquired how public awareness would be handled
if one or more of these devices were installed in a community.
3:54:29 PM
MR. SCRAGE stated that he did not know the exact cost of the
infant safe surrender boxes but estimated them to be in the tens
of thousands of dollars. He explained that installation requires
building modifications for alarms, lighting, electrical systems,
and environmental controls to meet safety standards.
MR. SCHRAGE said boxes would be placed in strategic, accessible
locations near main transportation routes. He described how
signage, public education campaigns, and media coverage, such as
news stories and social media, would inform the public. He added
that flyers could be distributed at shelters, high-density
housing, and other locations where individuals needing the
service might be reached.
3:56:09 PM
SENATOR HUGHES asked whether the cost of the infant surrender
boxes would be covered by the municipality or if nonprofits
would be expected to raise funds. She inquired if any
consideration had been given to how the funding would be
handled.
MR. SCHRAGE stated that fundraising efforts have been
significant, and he believed enough money had been raised to
install at least one safe surrender box in Anchorage, though he
was not certain. He clarified that there is no current plan for
the municipality to fund the boxes directly. However, he noted
that if a fire station were to be newly built or remodeled, it
would be reasonable to include the cost of a surrender box as
part of the construction project.
3:57:29 PM
JULIE CONDELL, Lead Dispatcher, Anchorage Fire Department,
Anchorage, Alaska, testified by invitation on SB 9. She said she
has 18 years of experience handling 911 emergencies. She spoke
in strong support of SB 9 stating the bill adds another
surrender option without removing existing legal avenues and
highlighted the value of anonymity, which confidentiality alone
does not provide. She stressed that many child abandonment cases
stem from fear of being identified and described infant
abandonment as a preventable form of trauma. She shared multiple
real incidents, including a 2013 case in Eagle River where a
baby was abandoned in a park and later found deceased, and a
2021 case in Fairbanks where a baby was left in a box in one-
degree weather. She also cited a 2024 case in Anchorage where a
baby was found deceased just one block from a fire station. She
concluded that the ability to offer anonymity through safe
surrender boxes could prevent such tragedies and save lives,
reinforcing that protecting life should remain the top priority.
4:01:18 PM
LONNY MARLEY, Council Member, City of Fairbanks, Fairbanks,
Alaska, testified by invitation on SB 9. He stated that he has
been an advocate for infant safe surrender options since
December 31, 2021, when a baby was found in a cardboard box on
the side of the road on Chena Pump Road. He said SB 9 is a clear
and necessary step. He shared that, based on his research
through a firm in Florida, the cost of a baby box is
approximately $22,000, with an additional annual fee for
maintenance and certification. He mentioned that the Knights of
Columbus, although not present in Fairbanks, have funded boxes.
He identified three possible locations for installation in
Fairbanks. He expressed concern that the fire station may be
unstaffed at times due to emergency calls and emphasized the
importance of choosing a staffed, accessible location. He
concluded by referencing recent child abuse cases, including the
bludgeoning deaths of two toddlers, and questioned whether those
tragedies could have been prevented if baby boxes had been
available as an early intervention option.
4:03:48 PM
CHAIR DUNBAR concluded invited testimony on SB 9.
4:03:55 PM
CHAIR DUNBAR opened public testimony on SB 9.
4:04:11 PM
PAMELA SAMASH, representing self, Nenana, Alaska, testified in
support of SB 9. She stated that she and others have waited
years for the passage of SB 9 and expressed strong support on
behalf of Right to Life Interior Alaska. She described the bill
as an answer to prayer and shared that a fire official in Nenana
also supports the bill and wants a baby box in that community.
She emphasized the urgency of safe surrender options in Alaska
due to extreme cold, noting that other, warmer states already
have baby boxes in place. She shared a confidential account of a
mother who, due to lifelong trauma, would not have surrendered
her baby face to facehighlighting the importance of anonymous
options. She said funding is not a barrier, as Interior Right to
Life is ready to organize fundraisers in Fairbanks, and
representatives from the Knights of Columbus have participated
in past events and could help as well. She concluded by urging
the committee to move forward so the community can act.
4:06:43 PM
SENATOR GIESSEL clarified that the Knights of Columbus is a very
active organization within the Catholic Church and has a
presence anywhere a Catholic Church exists in Alaska.
4:07:19 PM
KEN SPIERS, representing self, Fairbanks, Alaska, testified in
support of SB 9 by stating he agrees with others who have
testified in support of the bill. He also noted his affiliation
with Interior Right to Life.
4:08:05 PM
CHAIR DUNBAR closed public testimony on SB 9.
4:08:15 PM
SENATOR TOBIN stated that she had questions about the bill's
language but began by raising concerns she encountered online
regarding opposition from tribal communities in other states.
She noted that some tribal groups strongly oppose anonymous
infant surrender due to concerns about maintaining tribal
connections for surrendered children. She asked whether any
conversations had taken place with tribal communities in Alaska
to address these concerns.
4:08:49 PM
SENATOR MYERS stated that no direct conversations had taken
place with tribal communities regarding SB 9. However, he
confirmed discussions with the Department of Law and the Office
of Children's Services (OCS), recognizing that tribal connection
is a significant concern. He explained that under the existing
safe surrender law, OCS has policies to contact tribes when a
child appears to be a tribal member. He acknowledged the
challenge of confirming identity without a name and noted that
one of the departments could provide more detail on those
procedures.
4:09:48 PM
MS. ERICKSON stated that the Indian Child Welfare Act (ICWA)
applies to any child who enters state custody under AS 47.10,
including through the proposed statutory change under AS
47.10.011. She explained that a child surrendered anonymously
would trigger a child-in-need-of-aid proceeding, which requires
efforts to identify the child's parents. She noted that, in her
experience, OCS has never begun a case without at least some
information about the child or one parent. She acknowledged she
could not speak to the exact procedures OCS would follow in a
case with no identifying information but confirmed that existing
policies and laws already require notification and involvement
of tribes in accordance with ICWA.
4:10:51 PM
CHAIR DUNBAR asked whether the list of authorized safe surrender
locations in SB 9, page 2, line 8 should be expanded to include
additional tribal facilities. He pointed out that AS 47.32.900
defines "rural health clinic," but some tribal and community
health centers in urban areas, such as Anchorage, may not fall
under that definition. He noted that while hospitals would
likely include facilities like the Alaska Native Medical Center
(ANMC), there may be other tribal health centers that are not
classified as rural clinics or hospitals and asked whether those
should be explicitly included in the legislation.
4:12:09 PM
SENATOR MYERS responded by referencing the Chief Andrew Isaac
Health Center (CAIHC) in Fairbanks as an example of a tribal
facility that is not a full hospital but located near one. He
acknowledged that it is not currently covered under the listed
definitions and agreed that the question was valid, although the
issue had not been specifically addressed during bill drafting.
He stated that, based on national patterns, most communities in
Alaska, except Anchorage, would likely only install one baby
box, making it unlikely for both Fairbanks Memorial Hospital and
CAIHC to each have one. He clarified that the term "rural health
clinic" is defined under AS 47.32.900 and includes certain
health care facilities in rural areas but excludes
rehabilitation and mental health treatment centers. He expressed
openness to the idea of including more facility types but noted
uncertainty about how often such an addition would be used. He
suggested that the bill already grants the commissioner
authority to designate additional approved sites, which could
include the kinds of tribal health centers in question. He added
that the current list is modeled after Maryland's law and was
meant to serve as a general framework, not a limit.
4:14:00 PM
CHAIR DUNBAR emphasized the significant role tribal entities
play in Alaska's healthcare system, public safety, and other
areas. He expressed a preference for explicitly including tribal
health facilities in the list of authorized locations for safe
surrender devices. He noted that some clinics in Anchorage are
neither hospitals nor classified as rural health clinics and may
be unnecessarily excluded under the current language. He
acknowledged the bill's provision allowing the commissioner to
approve additional sites but stated that tribal facilities
should not have to seek special permission to be included. He
suggested further discussion with the Department of Law on the
matter.
4:14:57 PM
SENATOR HUGHES stated that many urban and rural clinics are not
open 24 hours, making it necessary to have an on-call health
care provider if a clinic were to have a device. She asked why
an optional form for a parent to fill out was not included on
page 3, line 11 of SB 9.
4:16:42 PM
SENATOR MYERS replied that the DFCS has a form that is
distributed to police and fire departments so that a parent
surrendering an infant can choose whether to provide the
information. He said he has no objection to including language
in SB 9 stating that forms are placed inside the safe surrender
devices.
4:17:52 PM
SENATOR CLAMAN asked how often the identity of a surrendering
parent remains unknown.
4:19:12 PM
MS. ERICKSON replied that, in her experience, the identity of at
least one parent is known. She said that when someone surrenders
a child, it is to the state, which begins the child-in-need-of-
aid proceeding. There is nothing in the language of AS 47.13
that relieves the state of the obligation to initiate the
proceeding, which by definition means the state needs to try to
identify the parent and offer services or another path, such as
relinquishment, where tribes are notified. The statute shields a
parent from criminal prosecution but not necessarily from other
processes that could make the parent's identity known.
4:20:26 PM
SENATOR CLAMAN contrasted the child-in-need-of-aid process to
the anonymity offered when providing rape test kits, stating
that even though a person may attempt to deliver a child
anonymously, as a practical matter, their name is brought into
the child-in-need-of-aid proceeding, where they provide their
perspective before the court rules on adoption.
4:21:16 PM
MS. ERICKSON replied that is correct.
4:21:26 PM
SENATOR CLAMAN commented that the process has a lot of merit.
4:21:38 PM
SENATOR TOBIN said many countries have phased out the use of the
device due to the United Nations' stance that a child has a
right to know their identity. The United Nations fears there was
misuse of the devices, such as surrendering larger children. She
asked if there is a definition for "infant" in statute and
whether there are restrictions on the size of the device.
4:22:35 PM
SENATOR MYERS replied that current statute defines an infant as
21 days old or younger, which is not altered in SB 9. The
definition of "infant" in other states ranges from 7 days to 60
days. He said that while he is not averse to a change in
definition, his understanding is that if a child is
significantly larger than the defined age, the provision for
safe surrender no longer applies, making criminal prosecution
possible.
4:23:51 PM
SENATOR TOBIN responded that her frustration with SB 9 and
anonymous surrender is the inability to identify a parent in the
event an older child is surrendered. She asked whether the
device is large enough to hold an older child and if there are
constraints on the device that would prevent a larger child from
being placed in it.
SENATOR MYERS said his office found three companies that make
the devices and obtained the specifications for one of them. He
said that while a 45-day-old infant might fit, there is not
enough space for a larger child, such as a three-year-old.
4:25:59 PM
SENATOR TOBIN requested that future dialog on SB 9 include size
restrictions to deter negative actions.
CHAIR DUNBAR asked if people put pets in the devices.
4:26:45 PM
SENATOR MYERS replied that he has heard of that happening, as
the devices are in public locations. As with many things, there
is the possibility for abuse.
4:27:19 PM
CHAIR DUNBAR held SB 9 in committee.
4:27:45 PM
At ease.
SB 83-TELEHEALTH REIMBURSEMENT RATES
4:30:31 PM
CHAIR DUNBAR reconvened the meeting and announced the
consideration of SENATE BILL NO. 83 "An Act relating to health
care insurance; relating to insurance reimbursement for health
care services provided through telehealth; and providing for an
effective date."
4:32:01 PM
CHAIR DUNBAR solicited a motion.
4:32:04 PM
SENATOR GIESSEL moved to adopt the committee substitute (CS) for
SB 83, work order 34-LS0413\I, as the working document.
4:32:15 PM
CHAIR DUNBAR objected for purposes of discussion.
4:32:24 PM
ARIELLE WIGGIN, Staff, Senator Forrest Dunbar, Alaska State
Legislature, Juneau, Alaska, provided the summary of changes for
SB 83 from version N to I.
[Original punctuation provided.]
Senate Bill 83
Explanation of Changes Version N to Version I (CS-
SHSS)
This version of SB 83 moves multiple sections that had
been added to or referred to a new section in Version
N (AS 21.42.450) into the existing statute covering
telehealth (AS 21.42.422) and makes conforming
changes. This version adds a requirement for health
care insurers to equally apply reimbursement rates for
each health care provider.
Title Change
Expanded to include "relating to health care insurance
reimbursement rates" on account of new language in
Section 3.
Section 1 (new section)
AS 21.42.422(b). Coverage for telehealth.
Adds new paragraph (3) to reference the definition of
"health care provider" as given in AS 21.07.250.
Section 2
Prior version Section 1 language is moved from AS
21.42.450 to existing statutes covering telehealth, AS
21.42.422.
Prior version Section 2 removed: referenced definition
of "telehealth" as given in AS 47.05.270.
Section 3 (new section)
AS 21.54.190. Reimbursement rates.
Requires health care insurers to equally apply
reimbursement rates for each health care provider.
Section 4 (prior version Section 3)
Section 5 (prior version Section 4; updates telehealth
reference AS 21.42.422)
Section 6 (prior version Section 5; updates telehealth
reference AS 21.42.422)
Section 7 (prior version Section 6; updates telehealth
reference AS 21.42.422)
Prior version Section 7 removed: repealed definition
of "telehealth" in AS 21.42.422
Section 8 (no change)
4:34:55 PM
SENATOR GIESSEL said Section 3 of CSSB 83 was her amendment
requiring uniform and equal pay for health care providers under
Current Procedural Terminology (CPT) codes, so if the service is
the same, the pay is equitable and uniform. She stated this
results in no change to the zero fiscal notes.
4:35:35 PM
CHAIR DUNBAR sought confirmation that the change achieves the
intended purpose.
SENATOR GIESSEL replied yes.
4:35:42 PM
CHAIR DUNBAR removed his objection, found no further objection
and CSSB 83 was adopted as the working document.
4:36:08 PM
SENATOR HUGHES said that, according to Ms. Wing-Heier, insurance
companies are paying parity. She stated her understanding that
during COVID, under Medicaid laws, parity was provided with a
sunset date in 2030, and insurance companies typically follow
Medicaid's model. She referenced a provider who testified she
only received 60 percent of what she would for an in-person
[visit], which conflicted with Ms. Wing-Heier's testimony. She
asked for an update on whether insurance companies are already
paying parity and, if so, expressed reservations about the
mandate. She said she viewed telehealth as a way to reduce
health care costs. She acknowledged the sponsor's point that
frequent provider visits can improve patient outcomes and reduce
long-term costs, however, she suggested compromise is needed.
4:38:25 PM
SENATOR CLAMAN deferred the question.
4:38:49 PM
HEATHER CARPENTER, Deputy Director, Division of Insurance,
Department of Commerce, Community, and Economic Development,
Juneau, Alaska, answered questions on SB 83, stated that the
Medicaid legislation referenced was House Bill 265, passed in
2022. She clarified that the 2030 sunset applied only to
Medicaid. She confirmed that insurers are generally paying at
parity. Moda reported paying at parity, and Premera stated it
follows Centers for Medicare and Medicaid Services (CMS)
guidelines, meaning payment depends on the patient's location,
which often results in parity, but not when the location is
somewhere other than the patient's home location.
4:40:11 PM
SENATOR HUGHES asked if the testimony from the provider who said
she only received 60 percent meant that payment was based on
location, even though the location was in-state.
4:40:30 PM
MS. CARPENTER replied that it depends on who the payor was. She
said the Division of Insurance only oversees about 15 percent of
the health insurance market.
4:41:26 PM
SENATOR HUGHES asked if SB 83 became law, would the federal
payors have to follow the law. She commented that 15 percent of
payors are currently paying at parity voluntarily. She asked
would the remaining 85 percent not regulated by the Division
have to comply if SB 83 became law.
MS. CARPENTER stated that SB 83 does not direct Medicaid or
Employee Retirement Income Security Act (ERISA) plans, except
that it does target AlaskaCare through SB 83, Sections 6 and 7.
She added that it also applies to two municipal plans under
Sections 4 and 5. SB 83 currently impacts the Division of
Insurance under AS 21. She directed the committee's attention to
Section 3, addressing Senator Giessel, and acknowledged
understanding her intent. However, she explained that the way
the drafter wrote it limits application to group insurance
coverage only, meaning it would not apply to all plans. It would
not affect plans in the individual market. She offered to
suggest alternatives to better achieve the intended policy
goals.
4:42:48 PM
SENATOR HUGHES asked if, based on the way SB 83 is drafted, it
covers the 15 percent regulated by the Division, AlaskaCare, and
any plans provided by municipalities in the state, but not the
85 percent outside the Division's authority.
4:43:04 PM
MS. CARPENTER replied that is the Division understanding.
4:43:15 PM
SENATOR HUGHES said that, for the provider who was reimbursed at
60 percent, it could be that the payer was one to which SB 83
would not apply. She reiterated her reservations regarding the
potential for telehealth to reduce health care costs and
expressed a preference for a compromise. However, she stated she
was not objecting to adopting the SB 83 and was fine with it
moving out.
4:43:47 PM
SENATOR GIESSEL said she believes everyone supports reducing the
cost of health care, but not at the expense of underfunding
providers who are trying to maintain clinics. She stated the
purpose of the amendment is to enforce parity of pay. Currently,
nurse practitioners and physician assistants are not reimbursed
at the same rate as physicians for the same CPT codes and
services.
4:44:24 PM
SENATOR HUGHES said she agreed with Senator Giessel and
clarified that her concern is the payment amount for a
telehealth visit compared to an in-person visit, noting that
seeing more patients reduces overhead costs. She stated that a
nurse practitioner providing the same service as a physician
should be reimbursed at the same rate.
4:45:02 PM
At ease.
4:46:03 PM
CHAIR DUNBAR reconvened the meeting and held SB 83 in committee.
4:46:32 PM
SENATOR CLAMAN stated that Senator Hughes raised interesting
points about the cost of care but stated his belief that her
analysis viewed the issue too narrowly, focusing only on the
cost comparison of a single telehealth and in-person visit. He
argued that a broader economic perspective, including overall
medical costs, shows that her analysis does not hold up. He
cited repeated evidence of cost savings and improved access
through telehealth. He added that the strongest indicator of
telehealth's value is the lack of opposition from insurance
companies, who support the legislation because it reduces
overall insurance costs. He concluded that while Senator
Hughes's view may be accurate within a narrow scope, the larger
picture shows telehealth improves access, keeps patients
healthier, and benefits both employers and insurers through
long-term savings.
4:48:42 PM
There being no further business to come before the committee,
Chair Dunbar adjourned the Senate Health and Social Services
Standing Committee meeting at 4:48 p.m.