04/29/2025 03:30 PM Senate HEALTH & SOCIAL SERVICES
| Audio | Topic |
|---|---|
| Start | |
| SB178 | |
| SB45 | |
| SB147 | |
| Adjourn |
+ teleconferenced
= bill was previously heard/scheduled
| += | SB 45 | TELECONFERENCED | |
| *+ | SB 178 | TELECONFERENCED | |
| += | SB 147 | TELECONFERENCED | |
ALASKA STATE LEGISLATURE
SENATE HEALTH AND SOCIAL SERVICES STANDING COMMITTEE
April 29, 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. 178
"An Act relating to early intervention services for certain
children; relating to optional services under the medical
assistance program; and providing for an effective date."
- HEARD & HELD
SENATE BILL NO. 45
"An Act relating to medical assistance services; relating to
parity in mental health and substance use disorder coverage in
the state medical assistance program; and providing for an
effective date."
- HEARD & HELD
SENATE BILL NO. 147
"An Act relating to the prescription and administration of drugs
and devices by pharmacists; relating to reciprocity for
pharmacists; and providing for an effective date."
- MOVED SB 147 OUT OF COMMITTEE
PREVIOUS COMMITTEE ACTION
BILL: SB 178
SHORT TITLE: EXPAND EARLY INTERVENTION SERVICES
SPONSOR(s): HEALTH & SOCIAL SERVICES
04/22/25 (S) READ THE FIRST TIME - REFERRALS
04/22/25 (S) HSS, FIN
04/29/25 (S) HSS AT 3:30 PM BUTROVICH 205
BILL: SB 45
SHORT TITLE: MEDICAID MENTAL HEALTH PARITY
SPONSOR(s): DUNBAR
01/22/25 (S) PREFILE RELEASED 1/17/25
01/22/25 (S) READ THE FIRST TIME - REFERRALS
01/22/25 (S) HSS, FIN
01/28/25 (S) HSS AT 3:30 PM BUTROVICH 205
01/28/25 (S) Heard & Held
01/28/25 (S) MINUTE(HSS)
04/03/25 (S) HSS AT 3:30 PM BUTROVICH 205
04/03/25 (S) <Bill Hearing Canceled>
04/10/25 (S) HSS AT 3:30 PM BUTROVICH 205
04/10/25 (S) Scheduled but Not Heard
04/24/25 (S) HSS AT 3:30 PM BUTROVICH 205
04/24/25 (S) Heard & Held
04/24/25 (S) MINUTE(HSS)
04/29/25 (S) HSS AT 3:30 PM BUTROVICH 205
BILL: SB 147
SHORT TITLE: PHARMACIST PRESCRIPTION AUTHORITY
SPONSOR(s): GIESSEL BY REQUEST
03/26/25 (S) READ THE FIRST TIME - REFERRALS
03/26/25 (S) HSS, L&C
04/15/25 (S) HSS AT 3:30 PM BUTROVICH 205
04/15/25 (S) Heard & Held
04/15/25 (S) MINUTE(HSS)
04/22/25 (S) HSS AT 3:30 PM BUTROVICH 205
04/22/25 (S) Heard & Held
04/22/25 (S) MINUTE(HSS)
04/29/25 (S) HSS AT 3:30 PM BUTROVICH 205
WITNESS REGISTER
ARIELLE WIGGIN, Staff
Senator Forrest Dunbar
Alaska State Legislator
Juneau, Alaska
POSITION STATEMENT: Introduced SB 178 on behalf of the sponsor
and provided the sectional analysis.
AMY SIMPSON, Executive Director
Program for Infants and Children
Anchorage, Alaska
POSITION STATEMENT: Testified by invitation on SB 178.
RICHARD SAVILLE, Program Coordinator
Governor's Council on Disabilities and Special Education
Department of Health
Anchorage, Alaska
POSITION STATEMENT: Testified by invitation on SB 178.
CHERYL WELCOME, representing self
Palmer, Alaska
POSITION STATEMENT: Testified in support of SB 178.
YULIA SMITH, representing self
Anchorage, Alaska
POSITION STATEMENT: Testified in support of SB 178.
LAURA NORTON-CRUZ, representing self
Anchorage, Alaska
POSITION STATEMENT: Testified in support of SB 178.
ACTION NARRATIVE
3:31:48 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 Giessel, Claman, Tobin, Hughes, and
Chair Dunbar.
SB 178-EXPAND EARLY INTERVENTION SERVICES
3:32:32 PM
CHAIR DUNBAR announced the consideration of SENATE BILL NO. 178
"An Act relating to early intervention services for certain
children; relating to optional services under the medical
assistance program; and providing for an effective date."
3:32:52 PM
At ease.
3:33:17 PM
CHAIR DUNBAR reconvened the meeting.
3:33:24 PM
ARIELLE WIGGIN, Staff, Senator Forrest Dunbar, Alaska State
Legislator, Juneau, Alaska, introduced SB 178 on behalf of the
sponsor and provided the sectional analysis. She said SB 178
makes three primary changes: it allows the Infinite Learning
Program to access additional federal Medicaid funding, reducing
reliance on state general funds; requires the Department of
Health to review and recommend updates to qualifying disability
conditions and submit a report to the legislature by July 1,
2029. She said SB 178 expands access to the program by lowering
developmental delay eligibility from 50 percent to a 25 percent.
The eligibility change, based on recommendations from the
Department of Health's Interagency Coordinating Council and
stakeholder input, aims to reduce provider hesitation and
improve access for children and families.
3:35:47 PM
CHAIR DUNBAR announced a presentation on SB 178.
3:35:59 PM
AMY SIMPSON, Executive Director, Program for Infants and
Children, Anchorage, Alaska, testified by invitation on SB 178.
She thanked the committee for hearing the presentation.
3:36:41 PM
MS. SIMPSON moved to slide 2, Alaska ILP Network, and stated
that the Infant Learning Program (ILP) serves children
statewide, ensuring that any baby born in the state is eligible
to receive high-quality services for infants and toddlers with
disabilities.
3:37:01 PM
MS. SIMPSON moved to slides 4-5, Highlighting Changes in SB 178
and Why Expand Eligibility, and stated that the bill updates the
Infant Learning Program by allowing Medicaid billing for all
Part C services, reducing reliance on state funds for special
instruction and developmental therapies. SB 178 removes
discretionary inclusion for at-risk children, clarifies the
definition of developmental delay, eliminates an obsolete
paraprofessional training program, requires reviewing qualifying
conditions every five years, and aligns Part C eligibility with
Part B by lowering the delay threshold from 50 percent to 25
percent, expanding early intervention access and potentially
reducing future special education costs.
3:41:58 PM
MS. WIGGIN gave the following sectional analysis for SB 178.
[Original punctuation provided.]
Section 1 Amends AS 47.07.030 (b) to add early
intervention services for children with developmental
delays to the medical services provided by the Alaska
Department of Health.
Section 2 Amends AS 47.20.060 to delete the
discretionary authority of the department to serve
children under the age of three who are at risk of
developmental delays or disabilities. AS 47.20.060 is
the statute governing the department's authority to
provide quality learning and related early
intervention family support services to eligible
children under the age of three with developmental
delays.
Section 3 Amends AS 47.20.070 (c), which is the
statute governing the establishment of the early
intervention services program, to delete the mandate
for the Department of Health to establish a training
program for paraprofessionals who provide services to
children under the age of three with developmental
delays and disabilities.
Section 3 adds a new subsection (8) requiring the
Department of Health to review the conditions that
qualify as a disability and make recommendations to
the Alaska State Legislature on updating those
conditions. The review must be conducted at least
every five years, in consultation with medical
professionals and the Department of Health's
Interagency Coordinating Council.
Section 4 Amends AS 47.20.080 (a), the statute
governing eligibility for early intervention services,
to stipulate that a child and the child's family are
eligible for services if the child is experiencing
developmental delay or disability.
Section 5 Amends AS 47.20.100, the statute governing
individualized family service plans, to remove the
right of the Department of Health to eliminate
coverage for services if there is insufficient funding
to provide services to all eligible persons.
3:43:47 PM
MS. WIGGIN continued with the sectional analysis for SB 178:
Section 6 Amends AS 47.20.290 (4) to change the
definition of "developmentally delayed" to align with
the federal Individuals with Disabilities in Education
Act and to expand eligibility to those children with a
developmental delay of at least 25 percent below a
chronological or corrected age or equivalent standard
deviation below age-appropriate norms in one of the
identified areas listed in the definition of
"developmentally delayed." The standard is 20 percent
for children in two or more of the areas listed.
Section 7 Repeals and reenacts AS 47.20.290 (6) to
list the services that qualify as early intervention
services. Qualified services include:
- Audiology services
- Health services
- Medical services
- Nursing services
- Nutrition services
- Occupational therapy
- Psychological services
- Special Instruction
- Transportation and related costs
- Vision
- Vision services.
Section 8 Repeals three sections of state law.
AS 47.20.080 (b) allows the Department to eliminate
coverage if there is insufficient funding
AS 47.20.290 (1) is the definition of "additional
early intervention services." The definition is no
longer necessary because early intervention services
are detailed in Section 7 of this act.
AS 47.20.290 (2) is the definition of "core early
intervention services." This definition is no longer
applicable because the act eliminates "core" services
in favor of a broader list of early intervention
services.
3:45:00 PM
MS. WIGGIN continued with the sectional analysis for SB 178:
Section 9 Adds a new section to uncodified law
requiring the Alaska Department of Health to submit a
report to the Alaska State Legislature by July 1,
2029, that includes details about how many children in
Alaska need early intervention services and the types
of services provided. The report must also include the
cost to the State of Alaska of providing services and
the amount of federal funding received by the state.
Additionally, the report must include recommendations
for further statutory changes to enhance and expand
early intervention services for eligible children
under the age of three who have developmental delays
or disabilities.
Section 10 Adds a new section to the uncodified law
requiring the Department of Health to amend and
resubmit for federal approval the state plan for
medical assistance coverage to align with the changes
made by this act.
Section 11 Adds a new section to the uncodified law
stipulating that the changes to early intervention
services only take effect if the U.S. Department of
Health and Human Services approves the amendment to
the state plan for medical assistance coverage or
determines that approval of the amendments to the
state plan is not necessary.
Section 12 Stipulates that section 1 of this act
takes effect on July 1, 2026, if the changes in early
intervention services included in this act are
approved by the U.S. Department of Health and Human
Services.
Section 13 Sets an effective date of July 1, 2026,
for this act.
3:46:34 PM
RICHARD SAVILLE, Program Coordinator, Governor's Council on
Disabilities and Special Education, Department of Health,
Anchorage, Alaska, testified by invitation on SB 178. He stated
that Alaska has the most stringent eligibility requirements for
Part C services in the nation, a fact that was surprising given
the state's strong history of supporting individuals with
developmental disabilities. Lowering eligibility to a 25 percent
delay would align Part C with Part B, promote equity, and
demonstrate the state's commitment to families and children.
Early intervention could reduce long-term special education
costs by up to $229,000 per child annually, potentially saving
more than $34 million per year overtime, while also yielding
broader community benefits such as reduced reliance on Medicaid
waivers, lower involvement with child welfare and justice
systems, increased workforce participation, and more students
graduating ready for work or post-secondary training.
3:50:15 PM
SENATOR TOBIN raised concerns about whether lowering the
eligibility benchmark would significantly increase the number of
eligible children, potentially requiring additional departmental
staff. She asked whether the anticipated need for two new full-
time positions is justified, given that the state already
conducts disability screenings.
3:51:30 PM
MR. SAVILLE replied that research indicates the program would
serve approximately 77 percent more children, and while the
state already performs much of the work, additional staff would
likely be needed to manage the increased workload.
MS. SIMPSON agreed with Mr. Saville. She replied that increased
Medicaid billing responsibilities would have an additional
impact of the state office. She said that requiring added
support would help programs statewide draw down federal funds
and offset state costs.
3:53:08 PM
CHAIR DUNBAR opened public testimony on SB 178.
3:53:46 PM
CHERYL WELCOME, representing self, Palmer, Alaska, testified in
support of SB 178. She emphasized a strong commitment to
Alaska's future through early childhood intervention. She noted
that while many families benefit from home-based services,
children with delays below the current 50 percent threshold are
often turned away. Without access to other services, these
families frequently return later with more severe delays,
resulting in lost opportunities during critical early years when
evidence-based interventions could have been most effective.
3:55:41 PM
YULIA SMITH, representing self, Anchorage, Alaska, testified in
support of SB 178. She shared a personal account of how early
intervention transformed her family's experience after her child
qualified for services due to a speech delay. She said
developmental specialists identified early signs of autism,
empowered her through parent coaching and tailored strategies,
and supported early intervention before a formal diagnosis. As a
result, her child is now a confident, high-functioning
kindergartener fully included in the classroom, with behavioral
challenges resolved and special education services no longer
needed.
3:59:16 PM
CHAIR DUNBAR confirmed that Ms. Smith is in support of the bill.
MS. SMITH replied yes, absolutely.
3:59:42 PM
LAURA NORTON-CRUZ, representing self, Anchorage, Alaska,
testified in support of SB 178. She stated that while filming a
documentary on the Infant Learning Program she witnessed
multiple instances where children with clear developmental risks
were denied or removed from services due to the 50 percent delay
requirement. Examples included infants prenatally exposed to
alcohol, NICU graduates, and premature newborns who could not
yet demonstrate sufficient delay despite high risk and critical
early brain development needs. She emphasized that SB 178 would
allow earlier intervention but would also require additional
funding, staffing, and contracted services to support expanded
eligibility.
4:02:39 PM
CHAIR DUNBAR closed public testimony on SB 178.
4:02:49 PM
SENATOR TOBIN expressed frustration that fiscal notes do not
capture the long-term cost savings of early intervention.
Although SB 178 requires upfront investment, providing services
at a lower delay threshold would reduce the need for more
intensive and costly interventions later, ultimately saving
state and school resources over time.
4:04:01 PM
CHAIR DUNBAR held SB 178 in committee.
4:04:07 PM
At ease.
SB 45-MEDICAID MENTAL HEALTH PARITY
4:05:06 PM
CHAIR DUNBAR reconvened the meeting and announced the
consideration of SENATE BILL NO. 45 "An Act relating to medical
assistance services; relating to parity in mental health and
substance use disorder coverage in the state medical assistance
program; and providing for an effective date."
4:06:14 PM
SENATOR GIESSEL asked why the fiscal note amount had increased.
4:06:52 PM
CHAIR DUNBAR asked Ms. Dompeling to explain why the fiscal note
for the second version of SB 45, developed with assistance from
the department, was nearly twice as large as the original
version developed by the Behavioral Health Association.
4:07:25 PM
MS. DOMPELING replied that upon reviewing the latest version,
the team found clearer expectations for reporting and parity
analysis, leading them to conclude that the original fiscal note
no longer reflected current understanding. She emphasized that
implementing the provisions, particularly within Medicaid, is a
significant undertaking that will require both additional
staffing and contractual support.
4:08:18 PM
CHAIR DUNBAR asked whether returning to the original version of
SB 45 would reduce the fiscal note to it's original cost.
4:08:33 PM
MS. DOMPELING replied that the cost would be lower if the
committee used the original fiscal note. She said as
expectations became clearer, the team recognized that earlier
assumptions underestimated the scope of the work.
4:09:14 PM
SENATOR TOBIN asked why the fiscal note shows higher costs in FY
2026 and FY 2031 compared to the lower amounts projected in the
other years.
MS. DOMPELING replied that the difference reflects workload, not
an error: higher costs occur in years requiring full parity
analyses, while lower-cost years involve only annual reports and
action plans with reduced contractor needs. She said staffing
levels remain consistent throughout.
4:10:35 PM
CHAIR DUNBAR expressed dissatisfaction that the Behavioral
Health Association worked with the Department of Health on a
compromise, after which the fiscal note doubled.
4:11:26 PM
CHAIR DUNBAR held SB 45 in committee.
4:11:27 PM
At ease.
SB 147-PHARMACIST PRESCRIPTION AUTHORITY
4:14:54 PM
CHAIR DUNBAR reconvened the meeting and announced the
consideration of SENATE BILL NO. 147 "An Act relating to the
prescription and administration of drugs and devices by
pharmacists; relating to reciprocity for pharmacists; and
providing for an effective date."
4:15:26 PM
SENATOR GIESSEL speaking as sponsor gave a brief recap of SB
147. She said the bill narrowly authorizes certain pharmacists
to independently prescribe medications and devices for minor
illnesses, chronic disease management, and preventive care
within their training. She stated that SB 147 does not expand
pharmacists' scope beyond their education or allow prescribing
abortion-inducing medications, which remains prohibited under
current Alaska law.
4:16:30 PM
CHAIR DUNBAR solicited the will of the committee.
4:16:31 PM
SENATOR GIESSEL moved to report SB 147, work order 34-LS0274\I,
from committee with individual recommendations and attached
fiscal note(s).
4:16:47 PM
CHAIR DUNBAR found no further objection and SB 147 was reported
from the Senate Health and Social Services Standing Committee.
4:17:33 PM
There being no further business to come before the committee,
Chair Dunbar adjourned the Senate Health and Social Services
Standing Committee meeting at 4:17 p.m.
| Document Name | Date/Time | Subjects |
|---|---|---|
| SB 178 Version A 4.22.25.pdf |
SHSS 4/29/2025 3:30:00 PM |
SB 178 |
| SB 178 ILP Eligibility Expansion Presentation SHSS 4.29.25.pdf |
SHSS 4/29/2025 3:30:00 PM |
SB 178 |
| SB 178 Fiscal Note DOH MS 4.24.25.pdf |
SHSS 4/29/2025 3:30:00 PM |
SB 178 |
| SB 178 Fiscal Note DOH SDSA 4.24.25.pdf |
SHSS 4/29/2025 3:30:00 PM |
SB 178 |
| SB 178 Letter of Support GCDSE 4.28.25.pdf |
SHSS 4/29/2025 3:30:00 PM |
SB 178 |
| SB 147 LOS Recieved as of 4.29.25.pdf |
SHSS 4/29/2025 3:30:00 PM |
SB 147 |
| SB 45 Fiscal Note DOH-BHA 4.29.25.pdf |
SHSS 4/29/2025 3:30:00 PM |
SB 45 |
| SB 178 Sponsor Statement Version A 4.22.25.pdf |
SHSS 4/29/2025 3:30:00 PM |
SB 178 |
| SB 178 Sectional Analysis Version A 4.22.25.pdf |
SHSS 4/29/2025 3:30:00 PM |
SB 178 |