Legislature(2015 - 2016)BUTROVICH 205
04/13/2015 08:00 AM Senate STATE AFFAIRS
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| Audio | Topic |
|---|---|
| Start | |
| SB74 | |
| Confirmation of Governor's Appointments for the Board of Fisheries | |
| Adjourn |
* first hearing in first committee of referral
+ teleconferenced
= bill was previously heard/scheduled
+ teleconferenced
= bill was previously heard/scheduled
| += | SB 74 | TELECONFERENCED | |
| + | TELECONFERENCED | ||
| + | TELECONFERENCED |
ALASKA STATE LEGISLATURE
SENATE STATE AFFAIRS STANDING COMMITTEE
April 13, 2015
8:02 a.m.
MEMBERS PRESENT
Senator Bill Stoltze, Chair
Senator John Coghill, Vice Chair
Senator Charlie Huggins
Senator Bill Wielechowski
MEMBERS ABSENT
Senator Lesil McGuire
OTHER MEMBERS PRESENT
Senator Kevin Meyer
Senator Pete Kelly
Representative Jim Colver
COMMITTEE CALENDAR
SENATE BILL NO. 74
"An Act relating to permanent fund dividends; relating to a
medical assistance reform program; establishing a personal
health savings account program for medical assistance
recipients; relating to the duties of the Department of Health
and Social Services; establishing medical assistance
demonstration projects; and relating to a study by the
Department of Health and Social Services."
- HEARD & HELD
CONFIRMATION OF GOVERNOR'S APPOINTMENTS HEARING:
Board of Fisheries
Orville Huntington
Robert Ruffner
- HEARD
PREVIOUS COMMITTEE ACTION
BILL: SB 74
SHORT TITLE: MEDICAID REFORM/PFD/HSAS/ER USE/STUDIES
SPONSOR(s): SENATOR(s) KELLY
03/13/15 (S) READ THE FIRST TIME - REFERRALS
03/13/15 (S) HSS, STA, FIN
03/13/15 (S) HSS AT 1:30 PM BUTROVICH 205
03/13/15 (S) -- MEETING CANCELED --
03/23/15 (S) HSS AT 1:30 PM BUTROVICH 205
03/23/15 (S) Heard & Held
03/23/15 (S) MINUTE(HSS)
04/01/15 (S) HSS AT 1:30 PM BUTROVICH 205
04/01/15 (S) Heard & Held
04/01/15 (S) MINUTE(HSS)
04/02/15 (S) STA AT 9:00 AM BUTROVICH 205
04/02/15 (S) <Pending Referral>
04/03/15 (S) HSS AT 1:30 PM BUTROVICH 205
04/03/15 (S) -- MEETING CANCELED --
04/08/15 (S) HSS AT 1:30 PM BUTROVICH 205
04/08/15 (S) Heard & Held
04/08/15 (S) MINUTE(HSS)
04/10/15 (S) HSS AT 1:30 PM BUTROVICH 205
04/10/15 (S) Moved CSSB 74(HSS) Out of Committee
04/10/15 (S) MINUTE(HSS)
04/11/15 (S) HSS RPT CS 3DP 1NR NEW TITLE
04/11/15 (S) DP: GIESSEL, ELLIS, STOLTZE
04/11/15 (S) NR: STEDMAN
04/13/15 (S) STA AT 8:00 AM BUTROVICH 205
WITNESS REGISTER
HEATHER SHADDUCK, Staff
Senator Kelly
Alaska State Legislature
Juneau, Alaska
POSITION STATEMENT: Provided an overview of the CS for SB 74.
COMMISSIONER VALERIE DAVIDSON
Alaska Department of Health and Social Services
Juneau, Alaska
POSITION STATEMENT: Addressed questions on SB 74.
JON SHERWOOD, Deputy Commissioner
Alaska Department of Health and Social Services
Juneau, Alaska
POSITION STATEMENT: Addressed the time required for regulation
changes to be written for SB 74.
ORVILLE HUNTINGTON, appointee
Board of Fisheries
Huslia, Alaska
POSITION STATEMENT: Addressed his background.
ANDREW COUCH, representing himself
Palmer, Alaska
POSITION STATEMENT: Supports Mr. Huntington's reappointment.
PAUL SHADURA, advocate
South K-Beach Independent Fishermen's Association
Kenai, Alaska
POSITION STATEMENT: Supports Mr. Huntington's reappointment.
BRUCE KNOWLES, representing himself
Wasilla, Alaska
POSITION STATEMENT: Supports Mr. Huntington's reappointment.
BYRON CHARLES, representing himself
Ketchikan, Alaska
POSITION STATEMENT: Did not address Mr. Huntington's
appointment.
ROBERT RUFFNER, appointee
Board of Fisheries
Soldotna, Alaska
POSITION STATEMENT: Addressed questions from the committee
regarding his appointment.
MIKE TINKER, representing himself
Ester, Alaska
POSITION STATEMENT: Opposes Mr. Ruffner's appointment.
AL BARRETTE, representing himself
Fairbanks, Alaska
POSITION STATEMENT: Opposes Mr. Ruffner's appointment.
LOREN FLAGG, representing himself
Kenai, Alaska
POSITION STATEMENT: Supports Mr. Ruffner's appointment.
DAVID ATHONS, representing himself
Soldotna, Alaska
POSITION STATEMENT: Supports Mr. Ruffner's appointment.
GARY STEVENS, representing himself
Chugiak, Alaska
POSITION STATEMENT: Opposes Mr. Ruffner's appointment.
ANDREW COUCH, representing himself
Palmer, Alaska
POSITION STATEMENT: Supports Mr. Ruffner's appointment.
BRUCE KNOWLES, representing himself
Wasilla, Alaska
POSITION STATEMENT: Did not provide an endorsement for or
against Mr. Ruffner's appointment.
BILL IVERSON, representing himself
Soldotna, Alaska
POSITION STATEMENT: Opposes Mr. Ruffner's appointment.
MIKE NAVARRE, Mayor
Kenai Peninsula Borough
Soldotna, Alaska
POSITION STATEMENT: Supports Mr. Ruffner's appointment.
ACTION NARRATIVE
8:02:41 AM
CHAIR BILL STOLTZE called the Senate State Affairs Standing
Committee meeting to order at 8:02 a.m. Present at the call to
order were Senators Coghill, Huggins, Wielechowski, and Chair
Stoltze.
SB 74-MEDICAID REFORM/PFD/HSAS/ER USE/STUDIES
8:03:30 AM
CHAIR STOLTZE announced the consideration of SB 74. He welcomed
Senator Kelly's office to review bill.
8:03:43 AM
HEATHER SHADDUCK, Staff, Senator Kelly, Alaska State
Legislature, Juneau, Alaska, provided an overview of the
committee substitute for SB 74 as follows:
Senate Bill 74 starts the process of cost containment
and reform needed to slow the growth of the Alaska
Medicaid Program. Medicaid has grown to $1.8 billion
of the annual operating budget and has accounted for
22 percent of the total Unrestricted General Fund
(UGF) increases over the last 10 years.
The current and former administrations have testified
that the Medicaid program as it stands is not
sustainable. Low oil prices and billions of dollars in
revenue short falls have forced us to change how we do
business. In July 2013, the Medicaid budget group of
Department of Health and Social Services (DHSS)
reported that the total spending on Medicaid services
will reach $6.3 billion in 2032, including $2.8
billion in state matching funds. If we don't act now
to bend the growth curve of Medicaid, many of our most
vulnerable Alaskans, those who are disabled and our
children, will be without the critical healthcare
services they need. We look at reform as pushing the
right care in the right place at the right time and
you can certainly add for the right price.
8:05:27 AM
MS. SHADDUCK addressed specific changes to SB 74 as follows:
Section 1, page 1, line 7, this was a new section
added in by the Senate Health and Social Services
Committee; it replaced a previous Section 1, so this
adds new sections establishing civil penalties for
false claims for Medicaid assistance and it authorizes
the DHSS to assess civil penalties against Medicaid
assistance providers that submit false claims.
Section 2, page 3, line 6, this is our Medicaid
assistance reform program that we put into statute.
Subsection (a) directs the DHSS to design and
implement a program for reforming Medicaid. The reform
program must include 10 items. The first one, which
starts on line 9, is referrals to community and social
support services including career and education
training services available through the Department of
Labor, the University of Alaska, and others. As you
know, our state has a lot of training opportunities
through our current network of job centers, vocational
rehabilitation offices, our Workforce Investment Act
programs, vocational training programs, and supports
through our extensive nonprofits that provide job
services in case management. We certainly believe that
jobs are the path to self-staining and an improved
self-image.
Number 2, line 12, is the distribution of an
Explanation of Benefits (EOB) to recipients. We've
heard other states are providing EOBs, this may or may
not be something that our state should be doing and we
think it is just one of those tools to get folks
thinking about their healthcare.
8:07:15 AM
MS. SHADDUCK continued to provide an overview as follows:
Number 3, line 14, is expanding the use of
telemedicine for Primary Care Behavioral Health and
urgent care.
Number 4, line 16, is enhancing fraud prevention
detection enforcement. As you are probably aware, a
lot has been done under Andrew Peterson's lead at the
Medicaid Fraud Control Unit and we want to encourage
as much fraud prevention and enforcement as possible.
Number 5, line 17, is reducing the cost of Behavioral
Health Senior and Disability Services provided to
Medicaid recipients under the state's Home and
Community-Based Services Waiver; we line up with the
administration in our goals for this and we would
anticipate them using a 1915(k) waiver like the DHSS
has testified in previous committees this session and
this would enhance our federal match rate from 50
percent to 56 percent and I believe it would also use
a 1915(i) option in here as well and that switches
folks who were currently paying for with 100 percent
general funds (GF) to a 50-50 state match. We also
anticipate using telemedicine in these areas and this
is kind of if folks are at home and getting care, you
can increase telemedicine and just have check-in on
them daily, make sure they are taking their meds and
those kind of things.
Number 6 is pharmacy initiatives and this is expanding
on what DHSS has already done, including using generic
meds, claims pricing, and payment reforms prior to
authorization, etc.
Number 7, line 21, page 3, is Enhanced Care Management
(ECM), so this could be set up in a couple of
different ways and these are methods to teach the
proper use of our healthcare system which could be
pretty overwhelming and it's not intuitive to just
access that if you are new at that. Primary Care
Management Plans (PCMP) can be used with the use of a
patient-centered medical home and this is where a
Medicaid user, often a super-utilizer, is assigned to
a primary care provider to oversee their care.
8:09:17 AM
CHAIR STOLTZE asked for super-utilizer to be defined.
MS. SHADDUCK explained that a super-utilizer has been a term
coined by the DHSS under the previous administration and those
are folks who are in the emergency room (ER) more than most. She
added that there are some thresholds for an individual to be
referenced as a super-utilizer where users us an ER 10 times or
more. She specified that super-utilizers are the folks using the
ER as their primary care doctors instead of using more
appropriate care.
CHAIR STOLTZE asked if "excessive" would have been a better
adjective than "super."
MS. SHADDUCK answered probably.
She continued to provide an overview as follows:
With this case management, these folks would have
access to preventative care, primary care, vaccines,
flu shots, and all appropriate care. Another example
is special treatment for identified needs, folks who
are pregnant, have diabetes, asthma and so on, you
want to have the appropriate specialized care for
those folks.
Number 8, line 22, is redesigning the payment process,
including fee agreements for performance measures that
include premium payments for Centers of Excellence and
penalties for hospital acquired infections,
readmissions, and failures of outcomes. We would
anticipate DHSS would also use bundled rates for
physicians and diagnosis related groups for hospitals.
For example, instead of going into the hospital and
having a fee for service and getting charged for an
Advil, an IV and everything they do, it would be one
bundled rate; for instance, if you go in and get a
knee replacement.
Number 9 is stakeholder involvement in setting annual
targets for quality and cost effectiveness.
Number 10, line 28, is reducing travel cost by
requiring a recipient to obtain Medicaid services in
their home community to the extent appropriate when
services are available there. We definitely need to
reduce travel where we can. We would anticipate
expanded use of telemedicine. DHSS has options like
going after a choice-waiver that they can direct folks
where to receive their care. We would hope to see a
better coordination of travel overall if a mom and her
kids have several preventative trips that they would
need to come in from a village to Anchorage instead of
having mom come in to get one checkup and returning to
her village and then traveling again into Anchorage a
couple of weeks later with her children that would
need somebody to travel with them. DHSS and Indian
Health Service (IHS) facilities can coordinate that
travel all together if it is preventative in nature.
SENATOR HUGGINS addressed number 10 regarding "To the extent
consistent with federal law." He asked what the federal law is
and what hurdles are involved.
MS. SHADDUCK answered that Medicaid has many hurdles with
federal law. She detailed that many of the provisions in the
proposed reforms must be approved by the federal government for
state plan amendments. She surmised that "consistent with
federal law" probably means that the reforms are in line with
Alaska's state plan for everything that the Medicaid program
authorizes.
SENATOR HUGGINS commented that he has heard that the state has
applied for waivers and asked if travel is an issue that has a
waiver potential.
CHAIR STOLTZE asked that should the bill be enacted, would there
be an implicit agreement to pursue all of the items noted in the
bill or would the pursuit continue to be on a "trust me" basis
with both DHSS and the federal government.
8:13:59 AM
MS. SHADDUCK explained that there are explicit directions that
DHSS would apply for any waivers required to implement the items
addressed in the bill. She added that the fiscal notes back up
what waivers that would be applied for, so legislative intent is
certainly shown. She detailed that a little bit later there are
some conditional effects so that once DHSS receives the okay
from the federal government to change the state plan and gets
approval for the waivers, the law won't officially go into
effect.
MS. SHADDUCK continued to provide an overview as follows:
Subsection (b), line 31, page 3, this subsection has
DHSS identify the areas of the state where
improvements and access to telemedicine would be most
effective in reducing the cost of Medicaid; it also
allows DHSS to enter into an agreement with IHS
providers if necessary to improve access to
telemedicine facilities and equipment. As you are
probably aware, IHS facilities have a pretty extensive
network of telemedicine, we would certainly want to
partner with them where possible.
Subsection (c), line 7, page 4, this is a section
about reports and the subsection requires the DHSS to
annually report to the Legislature on October 15 of
every year and to have those reports roll in before
the legislative session. Some of these measures would
focus on: realized cost savings related to the reforms
in the program, savings from reforms efforts
undertaken by DHSS, and a statement of whether DHSS
has met annual targets for quality and cost
effectiveness. There would be other recommendations
for the Legislature, including legislative changes,
budget changes, impacts of federal laws, and results
of the demonstration projects. Basically I look at
this section as everything that legislators want to
know to continue to monitor and reform the Medicaid
program. I suspect that this report will be very
useful to our Health and Social Services Committee and
both of the finance committees.
8:16:14 AM
SENATOR HUGGINS asked if he was being naïve to expect tangible
results to be reported by October 15.
MS. SHADDUCK replied that results for the first year on October
15 will be sketchy. She pointed out that the report will be
presented annually. She noted that the date was chosen to leave
enough time to propose legislative or budgetary changes.
SENATOR HUGGINS commented that he supports reform. He remarked
that the questions of expansion should be based upon the results
of reform and not in spite of it.
MS. SHADDUCK continued to provide an overview as follows:
Subsection (d), page 5, line 10, this just provides a
definition for telemedicine.
Section 3, page 5, line 15, this requires DHSS to
design and implement a demonstration project to reduce
the non-urgent use of the emergency departments of
Medicaid recipients; again, this is where I used the
term super-utilizer, this would build on what DHSS has
already done with their super-utilizer program and
it's about directing individuals to the right care, at
the right time, at the right place.
Subsection 5, page 6, line 1, sets out a process for
referring a frequent ER utilizer to a primary care
provider within 96 hours after an ER visit. We are
really trying to teach people how to use proper
healthcare and get them into primary care where ever
possible and this section also includes strict
guidelines for the prescribing of narcotics and a
prescription monitoring program.
Section 4, page 6, line 12, this was also an addition
by the Senate HSS Committee, this requires DHSS and
the Attorney General to annually prepare a report
regarding fraud prevention, abuse, prosecution, and
vulnerabilities in the Medicaid program.
8:19:02 AM
She continued to provide an overview as follows:
Section 5, page 7, line 6, this sets out our Medicaid
managed care or a case management demonstration
program for individuals enrolled in the Medicaid
program.
Subsection (a), Alaska is about one of only 12 states
to not employ some sort of managed health plan in
their Medicaid population. Individuals would be
managed by a traditional insurance carriers like Moda,
Aetna, or Premera. I would anticipate these Medicaid
folks would get regular insurance cards instead of
Medicaid cards and that is certainly helping their
self-outlook; some folks that have run health plans
like these cite better outcomes and more one-on-one
engaged care.
Comprehensive care management and care coordination
would be a part of this program. For instance, someone
like an expectant mother who is enrolled in the Denali
Kid Care Program would be engaged by a PCCM case
manager once she became pregnant, this would be her
go-to person. There would be check-ins along the way
to make sure that the woman is having a healthy
pregnancy, that she was taking her prenatal vitamins,
and that she was getting her questions answered by the
same provider; the goal of this is to have the
healthiest outcomes we can have and this type of plan
sets up relationships and trusts between providers. If
you are going in regularly and seeing the same person
and talking to them, those vulnerabilities will come
down and those walls will come down. I would fully
anticipate that providers would pick up on things that
folks will not share originally; this is all about the
best care at the best time. This program also requires
individual and family support and referrals to
community and social support services including job
training. Again, we are looking at the whole person,
not just the immediate healthcare needs.
8:21:01 AM
SENATOR HUGGINS asked how an expectant mother using alcohol
would fit into the program that Ms. Shadduck described.
MS. SHADDUCK replied that comprehensive care management would be
a way to see the factors where a case manager would check in on
women. She stated that hope is that the woman Senator Huggins
described would feel comfortable enough about sharing
information with the case manager without feeling any judgement
and be able to get the help that she needs. She said the hope is
that comprehensive care management will help reduce the number
of Fetal Alcohol Syndrome (FAS) cases.
She continued to provide an overview as follows:
Section 5, subsection (b), page 7, line 29, this
requires DHSS to enter into contracts with one or more
third party administrators for this project.
Subsection (c), page 8, this outlines requirements for
DHSS and the third party administrator for services
and fees.
Subsection (d), page 8, line 12, this shows that the
project must include cost saving measures that include
innovations and that would be reducing travel through
the expanded use of telemedicine for primary and
urgent care services. Alaska Native Tribal Health
Consortium (ANTHC) has led the way on telemedicine;
they have done studies that show about 40 percent of
telemedicine visits have avoided travel. ANTHC has
capacity across the state, so we can certainly expand
on that and learn from what they have done. Subsection
(d) also simplifies administrative procedures for
providers including streamlining the audit payment
process for stakeholders.
8:23:31 AM
SENATOR COGHILL called attention to subsection (b) regarding
"third party" and asked Ms. Shadduck if she had a chance to
research those that are available. He inquired if the
Legislature will have a chance to hear from the potential field
of third party administrators.
MS. SHADDUCK answered that there is a letter from Aetna
supporting managed care in the Medicaid program. She detailed
that conversations with the third party administrators have not
occurred, but she surmised that Aetna, Moda, and Premera would
be interested; however, the legal process regarding the request
for proposal (RFP) must be taken into account.
SENATOR COGHILL replied that his intent is to make sure the
Legislature is directing the third parties to something out
there.
MS. SHADDUCK specified that "third party administrator" was
added to the latest version of the bill's CS. She noted that the
bill's sponsor wanted to make sure the insurance network was
used rather than adding more state employees in DHSS.
She continued to provide an overview as follows:
Section 6, page 8, line 20, this sets up the
feasibility studies that DHSS would undergo. Before
the state can considers privatizing any state
function, the contracts require that a feasibility
study be done. The studies would not look the same for
each listed facility to study; those facilities are:
Alaska Psychiatric Institute (API), the Alaska network
of Pioneer Homes, and select facilities of the
Division of Juvenile Justice; for example, there are
private companies that all they do is run psychiatric
hospitals and they have great outcomes. API has some
of the highest rates of workers' compensation rates,
so we are studying if privatization is going to lower
the cost and provide better care. One more example,
certain facilities of Juvenile Justice, there are
places like Nome where you could turn over the
facility that is not full to the local native health
corporation and turn it into a residential psychiatric
treatment center. Not only would folks be getting a
culturally relevant care by the tribes, they would be
staying in their home communities. As a bonus, instead
of DHSS paying 100 percent general funds (GF), it
would be Medicaid reimbursable at 50 percent.
SENATOR HUGGINS addressed lines 27 and 28 regarding dates as
follows:
10 days after the convening of the second regular
session of the 29th Legislature.
He asked if a meeting would be held around February 1, 2016.
MS. SHADDUCK answered yes.
SENATOR HUGGINS requested that a cause-and-effect report on the
changes be submitted prior to the meeting.
8:27:26 AM
MS. SHADDUCK continued to provide an overview as follows:
Section 7, page 8, line 30, this section requires DHSS
to amend the state Medicaid plan and apply for any
waivers necessary to implement the projects and
programs described in the bill.
Section 8, page 9, line 10, this section allows DHSS
to adopt regulations necessary to implement the
changes by the act and the regulations may not take
effect before the dates of the relevant provisions of
the act takes effect. Section 8 allows DHSS to start
on the regulations now, they are transition
regulations that do not have to wait for the bill to
actually get the federal government to pass and agree
to everything, DHSS can start the lengthy regulation
process beforehand.
Section 9, page 9, line 16, this section protects DHSS
from having to follow a law on the books if the
federal government won't approve state plan amendments
or waivers needed to implement the law.
Sections 10-14, starting on page 10, line 7, these
provide for effective dates for provisions that
require waiver and state plan amendment approvals from
the U.S. Department of Health and Human Services.
Section 15, line 22, provides an immediate effective
date for Sections 6, 7, and 8.
8:29:33 AM
COMMISSIONER VALERIE DAVIDSON, Alaska Department of Health and
Social Services (DHSS), Juneau, Alaska, commented as follows:
With regard to committee substitute for SB 74, DHSS
wants the committee to know that we have really
appreciated the collaboration that Senator Kelly's
office has sought with us to refine and improve SB 74.
The committee substitute as outlined by Ms. Shadduck
includes costs for fraud control efforts, contracts to
establish performance metrics, and also conducting the
feasibility study on privatizing some of DHSS's
facilities.
The bill does contain a section on managed care and
calls for a demonstration project in managed care to
start by January 2016. We appreciate the flexibility
in the language that will enable DHSS to be able to
really find the greatest possible savings and coverage
because as we have discussed before, not in this
committee, what works in one region of the state may
not work in another. DHSS really appreciates the
sponsor's willingness to add some flexibility so that
we have the ability to provide what is necessary and
what will actually work in a particular region.
SENATOR HUGGINS asked to confirm that Commissioner Davidson was
referring to Medicaid.
COMMISSIONER DAVIDSON answered that the bill is about Medicaid
and specified as follows:
Medicare is a federal program, federally authorized,
and federally funded that provides care to people who
are 65 and older. Medicaid is a federally authorized,
state authorized, and state administered program that
provides aid to people typically dependent based upon
income and there are some folks who can be eligible
for both, but because Medicaid is federally authorized
and state administered, there's a federal-match as
well as a state-match.
8:32:09 AM
SENATOR HUGGINS remarked that approximately $720 billion was
supposed to come out of Medicare to fund "ObamaCare;" that is a
big number that you cannot take that kind of money out of a
program. He said he was told that Medicaid will in fact infringe
upon Medicare patients' ability to get medical service, i.e.
done at the expense of some of his peers.
COMMISSIONER DAVIDSON replied as follows:
When the Affordable Care Act was being drafted, there
were a number of considerations that were made with
regard to providers across the country. At the time,
Medicaid expansion was actually mandatory under the
Affordable Care Act before the U.S. Supreme Court
struck down the mandatory provision and made it
optional for states so that states could reject
Medicaid expansion; a part of that included the way to
be able to pay for that Medicaid expansion, providers
across the country agreed to making cuts in the
Medicare program in terms of the payment and also
making cuts to Disproportionate Share Hospital (DSH)
payments because they would not be able to make up
those losses in Medicaid expansion. After the U.S.
Supreme Court decided that states could reject
Medicaid expansion, many providers felt that they got
a part of the deal that they bargained for, which was
they gave up the potential revenue in Medicare, and
they gave up their potential revenue in disproportion
share payments, but they lost the opportunity to be
able to regain the revenue in Medicaid expansion.
We have heard from some folks that they are concerned
that there would be a crowd-out of Medicare
beneficiaries who are receiving services. In Alaska,
Medicaid actually pays more than Medicare, which is
different than in other states, but we also believe
that we shouldn't limit the access and limit the
opportunity for Alaskans to have coverage because
another federally administered program isn't paying
sufficiently to be able to do that.
8:35:51 AM
SENATOR HUGGINS noted that Commissioner Davidson used the term
"limit." He asked what Commissioner Davidson is going to limit.
COMMISSIONER DAVIDSON replied that she would take a moment to
respond.
SENATOR HUGGINS stated that he is not trying to ask hard
questions, but conceded that the questions have implications
regarding a lot of people, a lot of money, and emotions by some.
He stated that the Commissioner can take more time to provide a
comprehensive answer, whatever is accurate is best.
CHAIR STOLTZE remarked that the committee is not dealing with
the Medicaid expansion bill, but separating the two bills is
hard. He assumed that a lot of work and thought has gone into
the bill, but asserted that providing a list of the private care
providers that accept Medicaid or Medicare should be easy. He
declared that the provider listing is an integral part to what
Senator Huggins addressed regarding crowding-out. He said
physicians have told him how many Medicaid or Medicare patients
that they can afford to take because they are small businesses
as well has having to deal with the government. He remarked that
having a discussion about Medicaid or Medicare without primary
care physicians is hard. He added that senior citizens have
voiced their frustration in trying to find a doctor that will
even take them. He said the whole issue of crowding-out and
having a discussion about Medicaid expansion is hard without
having the information. He asserted that Commissioner Davidson
has had an opportunity over the past few months to interact with
the medical community and now has a pretty good handle where
getting a list of how many folks are accepting patients should
not be very hard.
8:37:59 AM
SENATOR HUGGINS remarked that Chair Stoltze's comments are a
diplomatic way of saying let's get back to reform. He stated
that he is a wholesale supporter of reform.
COMMISSIONER DAVIDSON said in terms of the payers, private
insurance is the best and that includes employer-covered
insurance and state-covered insurance. She detailed that
Medicaid is the next best payer, followed by Medicare, and then
the challenge with people who self-pay or people who have no
coverage. She encouraged the committee to think about the
arguments for whether crowd-out continues; for example, if
private insurance is a better payer than Medicaid, then there
should be an equal concern that the number of private insurers
should be reduced due to its possible crowd-out of Medicaid and
Medicare beneficiaries. She remarked that her previous example
is not done because payment is recognized as being a patchwork.
CHAIR STOLTZE asked if Commissioner Davidson was really talking
about getting to a single-payer.
COMMISSIONER DAVIDSON answered no.
8:39:49 AM
She said there are general reforms that are called for in SB 74
where DHSS will use the same options as in SB 78: 1915(i) option
and the reduction in the non-urgent use of the emergency
department's super-utilizer. She pointed out that the term
super-utilizer is actually defined by the Centers for Medicare
and Medicaid Services (CMS) because a number of states have been
focusing on the super-utilizer population for some time. She
detailed that CMS has defined super-utilizer as, "Patients who
accumulate large number of emergency department visits and
hospital admissions which might have been prevented by
relatively inexpensive early intervention and primary care." She
revealed that DHSS has undertaken the provision in the bill as a
voluntary effort, but the bill makes the provision mandatory.
She summarized that DHSS thinks the reforms are a great idea.
SENATOR COGHILL asked to verify that Commissioner Davidson is
talking about demonstration projects for a directive care or
managed care. He queried how and where the demonstration
projects will occur.
8:41:23 AM
COMMISSIONER DAVIDSON answered that the super-utilizer program
is a voluntary program that started in December. She detailed
that 2,000 people were identified and enrolled in the program.
She said DHSS's contractor contacted super-utilizers to schedule
appointments with a primary care provider to hopefully teach a
better way to access service. She added that the contractor
reminds the super-utilizers the day prior to appointments as
well. She revealed that DHSS was initially apprehensive that
people would be resistant, but she noted that people loved and
embraced the primary care provider alternative because the
program showed that somebody cared about their health outcome.
She detailed that the bill allows flexibility where the state
either uses a contractor or partners with a hospital where the
hospital can share in their savings.
SENATOR COGHILL asked where the voluntary demonstration project
is being implemented.
COMMISSIONER DAVIDSON answered that the program started in
Anchorage and will be implemented next in Fairbanks and the Mat-
Su Borough.
She revealed that SB 74's fiscal notes do not include the
savings revenue and costs through Medicaid expansion because the
bill does not have Medicaid expansion. She added that the fiscal
notes do not include the savings from the Tribal 1115 Waiver
which are included in SB 78.
8:44:57 AM
SENATOR HUGGINS asked for an explanation of the 1115 Waiver.
COMMISSIONER DAVIDSON answered that Medicaid has a lot of
federal requirements, including choice of provider. She detailed
that states can implement a number of waivers, including the
1115 Waiver, which allows states to waive or negotiate a deal
with CMS to waive some of the requirements.
SENATOR HUGGINS asked if the super-utilizer or any provision is
waivable. He remarked that he finds it interesting that a law
has turned the state's system into a totally dysfunctional one
where the state continues to feel bound by that law.
COMMISSIONER DAVIDSON answered that there are times when limits
in the law are recognized and DHSS is allowed to do things on a
voluntary basis. She detailed that the super-utilizer program is
voluntary and not mandatory because a voluntary program may not
necessarily require a demonstration waiver. She specified that a
mandatory program may have to seek a waiver where requirements
are waived; for example, freedom of choice is waived where a
person is required to be matched with a primary care provider
rather than having the freedom to choose an emergency room.
SENATOR COGHILL asked to verify that the 1115 Waiver is the
broadest waiver that can be applied to the Medicaid program's
sections.
8:47:35 AM
COMMISSIONER DAVIDSON answered correct.
SENATOR COGHILL asked to verify that the 1915 Waiver is much
more specific.
COMMISSIONER DAVIDSON answered that the 1915(i) and 1915(k)
options were created under the Affordable Car Act. She specified
that 1915(i) and 1915(k) are options and not waivers. She
explained that the options allow DHSS to negotiate an agreement
with CMS to refinance the way services are provided; for
example, instead of having to use 100 percent from state general
funds, the 1915(i) allows 50 percent general funds and the
1915(k) moves the state-match from 50 percent to 44 percent.
SENATOR HUGGINS pointed out that some regulations have required
several years to write. He asked how long writing regulations
for Medicaid reform will take.
8:49:55 AM
JON SHERWOOD, Deputy Commissioner, Alaska Department of Health
and Social Services, Juneau, Alaska, replied that based upon the
regulations project's complexity and priority, 3 to 9 months. He
noted that time for two levels of review by the Department of
Law and a public comment period has to be taken into account as
well.
SENATOR COGHILL noted that the directive under Section 7
instructs DHSS on waivers and notices for demonstration
projects, telemedicine, and case management. He asked
Commissioner Davidson if she has a list of things required in SB
74 for a State Plan Amendment (SPA) or waivers. He inquired if
either "waiver" or "amendment" is the right word to say under
Section 7.
COMMISSIONER DAVIDSON answered that DHSS has a good handle on
which would require a waiver or SPA. She explained that waivers
are generally required when certain Medicaid requirements of the
Medicaid program are going to be waived; for example, waiving
statewideness or choice provider. She detailed that a SPA is
submitted to the CMS in order to change the state plan. She
noted that negotiating agreements and collaborating with CMS
prior to an SPA submission helps move things along and avoids
surprises.
SENATOR COGHILL asked what the timelines were for waivers and
the SPA process.
8:53:56 AM
COMMISSIONER DAVIDSON answered that SPAs are generally faster
and can be done in a few months when there is pretty good
alignment and agreement. She said 1115 Waivers that are
complicated can take up to a year or longer to negotiate;
however, the time is well worth the effort based on the
opportunity for savings.
SENATOR HUGGINS pointed out that the U.S. Supreme Court is
making a ruling in June on "ObamaCare" and asked if modifiers
are being anticipated for what is currently being discussed in
the committee.
COMMISSIONER DAVIDSON specified that the case before the U.S.
Supreme Court, King v. Burwell, is really a case about the
subsidized insurance plans on the federally facilitated
marketplace. She explained that when the Affordable Care Act
started, the federal government offered grants to participating
states to build up state marketplaces for residents to shop and
purchase insurance plans. She said states that chose not to
participate or did not meet timelines were subject to the
federally facilitated marketplace; Alaska and other states are
subject to the federally facilitated marketplace. She specified
that the case before the U.S. Supreme Court addresses whether
the marketplace plans on the federally facilitated marketplace
can continue to stand. She said in anticipation of the ruling,
either states will continue status quo or build up their own
state marketplace. She added that states building up their own
marketplace is typically very expensive. She revealed that the
opportunities for the significant federal dollars that came with
the original grants has gone away and are no longer available to
states. She detailed that options that states are considering
are building up a state "store front" in front of the federally
facilitated marketplace that looks like a state specific
marketplace, or consideration in a state's ability to utilize
another state's marketplace.
8:57:29 AM
SENATOR HUGGINS asked to verify that Commissioner Davidson's
previous description on the insurance plans is essentially the
ability to take taxpayers' money and subsidize if a state
exchange is not used.
COMMISSIONER DAVIDSON answered yes.
CHAIR STOLTZE asked if anyone in the public wished to testify on
the bill. He announced that public testimony was closed.
He asked that DHSS bring back a chart with the department's and
Governor Walker's letterhead regarding the anticipated growth of
Medicaid, absent expansion. He reiterated that Medicaid is one
of the state's three cost-drivers for budget growth.
CHAIR STOLTZE announced that SB 74 is set aside.
9:00:21 AM
At ease.
^Confirmation of Governor's appointments for the Board of
Fisheries
Confirmation of Governor's appointments for the Board of
Fisheries
9:06:05 AM
CHAIR STOLTZE called the committee back to order. He announced
that the committee's next order of business is the confirmation
of the Governor's appointments for the Board of Fisheries.
9:06:33 AM
ORVILLE HUNTINGTON, appointee, Board of Fisheries, Huslia,
Alaska, revealed that his primary employer is the Tana Chiefs
Conference and he serves as the Wildlife and Parks Director. He
detailed that he has lived in Alaska his entire life, served on
many educational science boards, and has tried to promote
education in the state for many years. He revealed that he has
served one term on the Board of Fisheries and expressed his
interest in serving for another term.
CHAIR STOLTZE pointed out that three committee members had heard
Mr. Huntington testify in the Senate Resources Committee.
SENATOR COGHILL said he appreciated Mr. Huntington's willingness
to serve on the Board of Fisheries and noted that he had a good
record while serving his first term.
CHAIR STOLTZE opened public testimony.
9:08:31 AM
ANDREW COUCH, representing himself, Palmer, Alaska, said he
supports Mr. Huntington's reappointment. He noted that he is a
member of the Mat-Su Fish and Wildlife Commission and the
Matanuska Valley Fish and Game Advisory Committee. He revealed
that the two groups that he mentioned have not taken a formal
position and he will strictly be representing his own business
interest. He specified that his experience working through the
Upper Cook Inlet Board of Fisheries meetings with Mr. Huntington
were positive and he supports Mr. Huntington's nomination.
9:10:05 AM
PAUL SHADURA, advocate, South K-Beach Independent Fishermen's
Association, Kenai, Alaska, said he supports Mr. Huntington's
reappointment. He declared that South K-Beach Independent
Fishermen's Association has reviewed Mr. Huntington's
qualifications and agrees with the Governor's appointment to
serve another term.
9:12:24 AM
BRUCE KNOWLES, representing himself, Wasilla, Alaska, said he
supports Mr. Huntington's reappointment. He said he had worked
with Mr. Huntington during his first term on the Board of
Fisheries and recommends his reappointment. He noted that Mr.
Huntington supports addressing issues regarding low salmon
returns to the Mat-Su Valley region.
9:13:24 AM
BYRON CHARLES, representing himself, Ketchikan, Alaska, did not
address Mr. Huntington's reappointment.
9:15:44 AM
CHAIR STOLTZE closed public testimony for Mr. Huntington's
nomination. He announced that Mr. Huntington's confirmation will
be set aside.
9:16:08 AM
At ease.
9:16:40 AM
CHAIR STOLTZE called the committee back to order. He announced
that the committee will take up the appointment of Robert
Ruffner for the Board of Fisheries.
9:18:28 AM
ROBERT RUFFNER, appointee, Board of Fisheries, Soldotna, Alaska,
stated that he will explain his qualifications and why he wants
to serve on the Board of Fisheries, but first asked to address
some of his opposition as follows:
My name is Robert Ruffner, I am very honored to be in
this position and it's a big deal to deal with
fisheries across the State of Alaska. I don't have the
track record that the other nominee who has already
served on the Board. I understand that there are a lot
more questions and a lot more vetting to be done.
I lived in Alaska since 1996, 46 years old, married
for 22 years, and have 2 children. I am a graduate of
the University of Minnesota where I studied geology
and really had an emphasis in rivers. I've done some
graduate work after my undergraduate degree in
covering a lot of modeling and statistics. I've been
the director of a conservation organization down on
the Kenai Peninsula called the Kenai Watershed Forum
since 1997. I have served on the Planning Commission
on the Kenai Peninsula Borough Road Service Area
Board.
My fishing experiences, mostly these days I harvest
all of the fish that I have in my freezer and on my
shelves out of the Kenai and Kasilof personal-use
fishery, it's an important fishery to me. Rod and real
fishing, I've caught all five species of salmon,
Rainbow Trout, Dolly Varden, Grayling, Pike, Rock
Fish, and Halibut, from Sitka when I spent a summer
down there all the way up to the Jim River on the
south side of the Brooks Range. My commercial fishing
experience has been limited to two days where I was,
back in the late 90s, a crew member on a commercial
gill net; I explained in the other committees, at
least I have that experience and I know how that
fishery operates.
Why would I want to do this? Family values are one of
those things that have led me to working in
conservation my whole professional career. I very much
think that fishing is an important thing, my earliest
childhood memories are fishing with my grandfather and
my dad. I came up to Alaska largely to do adventure
sports, hunting, and fishing. Now I am passing that
tradition to my two daughters. I am interested in
public service where I think I can make a difference.
I have followed the Board of Fisheries since I've
moved here and I do think that I can make a positive
contribution to the whole state. A lot of the issues
that we deal with relate to the Cook Inlet, but we all
should remember that this is a statewide
responsibility and I am looking forward to learning a
lot about the various parts of the state and
challenging myself as I move into this position if I
am confirmed.
9:21:37 AM
MR. RUFFNER addressed what he brings to the board and summarized
as follows:
What do I have to offer? I have a strong personal use
and sport fishing experience, scientific background,
knowledge about habitat and sustainable salmon
policies, and a strong commitment to public process.
So that's a briefer version of what I said to the
committees personally. In this committee there's some
new information that has come forward since the last
one, there's a couple of new opposition letters that
have come forward.
He addressed opposition to his appointment as follows:
As I see it, there are three general points of
opposition. There are probably some more that I'd be
happy to answer some question on in the vetting
process, but there are three general ones that I would
like to address.
The first one is that I will not represent all
Alaskans, specifically those in Anchorage and Mat-Su,
and this is a criterion by which I should be rejected.
Second issue that I see is that I am aligned with
commercial fishing organizations to promote their
allocative agenda.
Third, I have testified in the previous three hearings
to change several specific elements of the Cook Inlet
management plans.
The first claim is that I won't represent all
Alaskans, including Anchorage and Mat-Su. As far as I
can tell, this appears to be based solely on the fact
that I do not reside in Anchorage, which is a fact
that I can't deny. I do not live in Anchorage, I live
on the Kenai Peninsula between the Kenai and Kasilof
rivers. However, the allocation criteria that is laid
out before board members clearly speaks to the number
of users and benefits to recreational and personal
use. At each of the previous three hearings, I have
stated that I will follow this criteria that is set
forth in regulation for us and will weigh heavily when
it comes to our most popular sport fisheries. If the
Legislature thinks that Anchorage residency is a valid
criterion to consider, I would respectively ask that
we amend AS 16.05.221, which states that "Members
shall be appointed on the basis of interest in public
affairs, good judgement, knowledge, and ability in the
field of action of the board and a view to providing
diversity of interest and points of view to the
membership." All members of the Legislature are
ultimately the judge of whether I meet that criteria
or not, I would submit to you, based on my previous
testimony in what is in my resume, that I meet that
criteria.
Claim number two is that I am aligned with commercial
sport fishing organizations to promote their
allocative agenda since they are the majority of my
supporters. I have not done a tally of who my
supporters are and who my objectors are, but I don't
believe that the majority of the people that have gone
on the record in support of me are in fact commercial
fisherman. Nearly every governmental entity on the
Kenai Peninsula has offered support, either in the
form of a letter or in the form of a formal resolution
and that includes: the Kenaitze Indian Tribe, the
Kenai Peninsula Borough, the City of Kenai, the City
of Homer, the City of Soldotna, and the City of
Seward, all of these are elected officials that
represent their respective communities; in addition to
those, there are major sport fishing organizations
including the past president of the Alaska Fly
Fishers, the Alaska Charter Association which
represents 115 membership organizations, Trout
Unlimited, and several other regional organizations
that are clearly defining themselves as sport fishing
interests.
There are a number of guides and individuals that have
offered their written support, but there is bit of a
spilt between the sport fishing community in support
and opposition. The one that really caught my
attention was the opposition raised by the Kenai River
Sportfishing Association letter and I'd be happy to
address the points that they have in their letter one-
by-one, but that's going to take some time because
those are complicated issues, but I am very willing to
go through them on by one and address those points
should the committee desire. At no point in this
process have I committed or implied to any user group
that I am going to advance an allocative interest.
Only one organization has specifically asked me to do
so and when I told them that it was not appropriate to
make a commitment before I am on the board, they
reversed course and chose to reverse their support for
me.
9:26:17 AM
MR. RUFFNER addressed the third claim against his appointment as
follows:
Claim number three, I have testified and have stated
on the record the following four items:
First, that the recent Board of Fisheries actions in
the Upper Cook Inlet including allocation decisions
are questionable and need to be readdressed;
fortunately for me there is a very clear record with
video tape included of what I have specifically said,
I did not say this in any form. I did not say that I
thought that we should readdress these allocation
decisions and I will go on to say that the management
plans for Upper Cook Inlet are among the most
complicated in the state, if not the entire U.S.; they
evolved over a long period of time and that precedent
in developing these plans is important to these
complex fisheries and that precedent is important for
me to take into consideration when we move forward and
talk about Upper Cook Inlet, I never said they needed
to be readdressed.
Second part of that claim was that the Cook Inlet
commercial fishery managers need additional management
flexibility to meet escapement goals; for example,
avoid large Sockeye escapements regardless of their
resulting impacts on other fisheries and other stocks.
In fact what I said was, I said that fishery managers
need to retain their flexibility that is presently in
regulation, so that regulation deals with the
emergency authority openings and closings which cut
both ways, so that is not an additional flexibility
that I am suggesting they needed, I'm just saying the
current flexibility that they have is important and
that is a very important distinction that needs to be
made in that claim.
Next claim was that the commercial fishery closure
windows in the Cook Inlet do not provide substantial
benefit to inner-river fisheries, again, what I said
on the record in Senate Resources was that windows do
not always provide fish to the river on weekends
because of natural variability including things like
the wind and the tide patterns, and people have been
disappointed in the past just like they were last year
when windows didn't guarantee weekend-fish. I went on
to say that I generally support the concept of windows
because they increase the probably that fish will be
available when the majority of Anchorage and Mat-Su
residents can participate in the personal-use
fisheries, so I am saying that I support that concept.
Last claim was the Kenai rivers sport fishing
activities contribute to cumulative habitat impacts on
humans, that is they may warrant substantial fisheries
restrictions even when there are no measurable
biological impact. I didn't say that anywhere, I don't
know where that claim came from.
I thought it was really important for me to go through
those claims and again there are a number of others in
there that we can tackle should the committee desire
one-by-one, but I want to make this very clear where I
stand on how my thought process is moving into some
that is very important to so many people in the State
of Alaska.
9:29:27 AM
SENATOR WIELECHOWSKI noted that he appreciates Mr. Ruffner's
attendance at the meeting. He said he has great admiration for
anyone that would want to serve on the Board of Fisheries. He
stated that serving on the Board of Fisheries is a tremendous
responsibility with a lot of competing interests. He remarked
that the concern people have with Mr. Ruffner's appointment
appears to be due to the perception that the board's fundamental
composition for the past 30 years is being changed where an
equal number of sport fishing and commercial fishing interests
are represented. He noted that the Board of Fisheries'
composition for the past 30 years is not constitutionally or
legally required. He pointed out that the Board of Fisheries
would no longer have someone from Anchorage. He said the
Legislature has heard from some that the Board of Fisheries
process is broken and particularly in regards to the Cook Inlet
and he asked if Mr. Ruffner agrees or disagrees.
MR. RUFFNER answered that he disagrees that the Board of
Fisheries process is broken.
SENATOR WIELECHOWSKI asked if Mr. Ruffner agreed with some of
the management decisions that have been made in recent years,
e.g., to shutdown set-nets back in 2012.
MR. RUFFNER answered that he agreed with the decision.
SENATOR WIELECHOWSKI asked if he agreed with the conservation
corridor that was established for Mat-Su this past year.
MR. RUFFNER answered yes.
9:31:35 AM
SENATOR WIELECHOWSKI asked if Mr. Ruffner believes that there
are any salmon fishery management plans that are currently not
working.
MR. RUFFNER replied that there are a lot of salmon management
plans across the entire state that he has not viewed. He
specified that he does not think there are any management plans
in the Cook Inlet that are broken or fundamentally flawed.
SENATOR WIELECHOWSKI noted that he had a conversation with Mr.
Ruffner regarding Senator Stoltze's personal-use priority bill
and noted that he thought he heard that Mr. Ruffner supported
the bill; however, Mr. Ruffner stated in last week's Resource
hearing that he did not support the bill. He asked if he
misheard Mr. Ruffner's stance on the bill or did he change his
position.
MR. RUFFNER answered that his position did not change.
SENATOR WIELECHOWSKI asked to clarify that Mr. Ruffner did not
say he supported the bill and to also verify that he does not
currently support the bill.
MR. RUFFNER replied that answering Senator Wielechowski's
question with a "yes" or "no" is difficult due to its
complexity. He summarized that he could support the bill if the
personal-use still fell within the confines of the existing
allocation criteria that is outlined in the existing salmon
policy where the conservation burden is shared equally.
9:33:54 AM
CHAIR STOLTZE asked if Mr. Ruffner thinks that the two
dipnetting organizations that first supported and then rescinded
his appointment may have misheard him as well. He asked Mr.
Ruffner to verify that three folks misheard him with clarity.
MR. RUFFNER answered that he has not heard from the dipnetting
organizations if they thought that that was what he had said.
CHAIR STOLTZE remarked that withdrawing an endorsement is
unusual. He asked if the dipnetting organization mishearing Mr.
Ruffner was a possibility.
MR. RUFFNER answered that mishearing was a possibility. He
specified that the South-Central Dipnetters Association asked
him if he would fight for a very specific allocation and he told
them that he could not. He added that he would not fight for a
specific allocation for any other organization as well.
CHAIR STOLTZE asked to verify that the reason for the
endorsement withdrawal was due to the allocation request.
MR. RUFFNER answered yes.
CHAIR STOLTZE asked to confirm that the dipnetting organizations
as well as Senator Wielechowski could have misheard Mr. Ruffner.
MR. RUFFNER replied that being misheard was possible.
9:35:16 AM
SENATOR WIELECHOWSKI asked that Mr. Ruffner address the burden
of conservation sharing as it pertains to the Chinook salmon
season on the Copper River. He inquired if the personal-use
fishery bears a little more conservation burden when the Chinook
season is shutdown.
MR. RUFFNER answered that the Chinook harvest was exactly the
issue asked of him whether he would push to change the
allocation. He explained that the Copper River Area Management
Report showed that portion to which everybody was reduced was
pretty close to being equal across the board. He remarked that
each fishery is different where timing for every user group is
complicated. He detailed that Copper River issues include
harvesting during low abundance and subsistence fishing.
9:38:19 AM
SENATOR HUGGINS opined that Mr. Ruffner is a victim of
circumstances, but noted that opposition was also due to his
judgement and statements on why he wants to be on the Board of
Fisheries. He remarked that he would rather have Mr. Johnstone,
the person that previously held the board seat, serving on the
Board of Fisheries. He asserted that the Governor missed a grand
opportunity in not re-appointing Mr. Johnstone to the Board of
Fisheries. He addressed escapement goals and asserted that
lowered escapement goals has limited the number of fish in the
Mat-Su.
9:41:22 AM
MR. RUFFNER agreed that Mr. Johnstone is a good man and the
situation on reappointment was unfortunate. He remarked that
lowering an escapement goal does not sound like a very good
plan. He noted that his opposition has stated that he is aligned
with commercial fishermen with a desire to reduce an escapement
goal and that is absolutely not the case. He asserted that he is
going to ask some very hard questions should the department
present information on why the Board of Fisheries should lower
the escapement goal. He stated that he is not inclined to lower
escapement goals without some really good evidence.
SENATOR HUGGINS asked if Mr. Ruffner supports the way the Cook
Inlet is currently managed.
MR. RUFFNER answered yes. He detailed that the 20 year precedent
in developing the Cook Inlet's management plans has worked out
by and large pretty well.
SENATOR HUGGINS divulged that he is a supporter of closing the
Cook Inlet north of its mouth. He asserted that the current
management plan is not working due to his observations. He said
he is angry when people write articles that the problem in the
Mat-Su is due to culverts and Northern Pike. He asked if Mr.
Ruffner had written articles about the fishing problems in the
Mat-Su.
9:43:52 AM
MR. RUFFNER replied that he has not written any articles. He
noted that he has surveyed culverts in the Mat-Su and is
generally aware of the problems in the urban areas. He said he
has written some articles that compared invasive species in
Kenai to the Mat-Su. He added that he had testified before
Senate Resources the previous year regarding Northern Pike.
SENATOR HUGGINS noted that areas in South Central without
Northern Pike and culverts are closed to fishing. He asked that
Mr. Ruffner explain why he believes the Cook Inlet's management
plans are working.
9:47:03 AM
MR. RUFFNER answered that the whole state has a Chinook salmon
problem.
SENATOR HUGGINS replied that he accepts the problem with Chinook
salmon.
MR. RUFFNER asked what specific species Senator Huggins was
referring to.
SENATOR HUGGINS replied Coho salmon.
MR. RUFFNER answered that he has not looked into the details on
how Coho salmon is being managed in the area Senator Huggins was
referring to.
SENATOR HUGGINS replied that he is disappointed that Mr. Ruffner
thinks the management plan is working because his experience is
it is hard to catch species other than Chinook salmon.
9:49:42 AM
CHAIR STOLTZE noted that Mr. Ruffner lauded his support from all
of the local governments on the Kenai Peninsula. He pointed out
that commercial fishing is the Kenai Peninsula's dominant
industry and noted their goal to maintain status quo. He asked
what Mr. Ruffner is trying to convey by noting his support from
communities that have taken positions in favor of the commercial
industry.
MR. RUFFNER replied that the Kenai Peninsula is a pretty good
reflection of the entire state with both commercial and sport
fisheries. He noted that he serves on Soldotna's Chamber of
Commerce and has received letters of support from fishing guides
as well as bed and breakfast businesses. He remarked that
Soldotna is a pretty small community that is primarily dependent
on its sport fishery.
9:52:07 AM
SENATOR WIELECHOWSKI asked what criteria would Mr. Ruffner use
to decide what level of Coho salmon harvest is appropriate in
the Upper Cook Inlet.
MR. RUFFNER asserted that his 20 year record on the Kenai
Peninsula has shown that nobody has a track record of working
more for the overall conservation and for producing more fish.
He specified that his number one criteria for how many fish
should be commercially harvested is contingent on the department
and the public telling the Board of Fisheries whether or not
there are fish that are on the spawning grounds to produce
sufficient fish for sustaining runs that are consistent with
Alaska's constitution. He said the hard part is having to weigh
and balance the excess for the different user groups. He
summarized that there is not a blanket answer and decisions come
down to which area is being addressed.
SENATOR WIELECHOWSKI asked if Mr. Ruffner believes there is such
a thing as over-escapement.
9:54:27 AM
MR. RUFFNER answered yes. He detailed that over-escapement is a
yield concept that is rooted in biology. He noted that friends
in commercial fishing have told him that over-escapement ruins
runs and he said that statement is categorically false.
CHAIR STOLTZE remarked that the Mat-Su is not familiar with the
term "over escapement" and noted that the Legislature has been
told to make sure that the United Cook Inlet Drift Association
(UCIDA) gets most of the fish. He remarked that Fish and Game
has testified that the driftnet fleet is their most important
management tool.
MR. RUFFNER explained that Sockeye salmon coming out of the
Kenai and Kasilof rivers drives a lot of what happens in the
Cook Inlet. He remarked that fisheries managers have a very
tough job and there are times when the Mat-Su suffers from the
decisions that are made. He said if confirmed, he will address
the concerns from the Mat-Su for being leery of his appointment.
SENATOR WIELECHOWSKI commented that Senator Stoltze raises a
really important point in the way over-escapement or perceived
over-escapement is dealt with in the Kenai and Kasilof rivers.
He said the rivers' management tool is to open up the drift
fleet and allow more set-netting. He remarked that committee
members' constituents head down to the Kenai to dipnet and there
are no fish due to a blockade from an emergency-opener. He asked
if Mr. Ruffner would be open to changing the management tool
where the hours are extended for earlier dipnetting and
expanding the number of sport fish that can be taken. He noted
that the Copper River's personal-use fishery allows an extra 10
salmon. He inquired if Mr. Ruffner would support changing the
management tool for the Kenai and Kasilof rivers.
9:58:10 AM
MR. RUFFNER He replied that he would certainly entertain changes
and would be interested in hearing proposed changes. He detailed
that the sport harvest as is currently set up is taking out of
the escapement goal because most of that sport fishing occurs
above the "counters;" they are taking 350,000 Sockeyes with rod-
and-reel. He said part of the issue is the "fishing power," with
a rod-and-reel you can only catch so many fish and the
dipnetters are getting better at catching fish and approximated
that 400,000 and 500,000 Sockeyes were caught in the previous
year. He admitted that the previous year was not a great year
for weekends. He said he does have a shorter drive to the Kenai
and Kasilof rivers, but he does not want to limit the number of
Alaskans that want to come down to his neighborhood to catch
fish. He opined that problems will occur where people will get
hurt and conflict between communities increases if the Kenai
fisheries do not become more orderly. He asserted that he wants
the job on the Board of Fisheries to address the Kenai
fisheries.
SENATOR WIELECHOWSKI asked what Mr. Ruffner meant by "more
orderly."
MR. RUFFNER replied that he would be surprised if anyone that
comes down on the third weekend of July and looked at the boat
fishery and say "orderly."
SENATOR WIELECHOWSKI asked if the number of boats should be
limited.
MR. RUFFNER answered that the number of boats should not be
limited. He said a plan must be devised that keeps people from
bumping into each other, arguing, and creating an unsafe
condition. He asserted that everyone that is a policymaker has a
responsibility to figure out how to make the fishery more
orderly. He said he does not have the answers, but wants to be a
part of the solution on the Board of Fisheries.
10:01:08 AM
SENATOR WIELECHOWSKI asked if Mr. Ruffner could provide some of
his ideas.
MR. RUFFNER answered that some of the conflicts come strictly
from the infrastructure that is in place. He said not enough
infrastructure is in place to readily accommodate the number of
people that want to come down to the Kenai. He noted that people
put their boats in miles upstream due to a lack of parking and
the result is the river is used as a highway to move in and out
of the fishery. He added that more enforcement is needed to
address concerns that the fishery is abused. He noted that he
has fished in the Kenai fishery since 1997 and has only been
checked once. He asserted that lack of enforcement is probably
pervasive across all fisheries.
CHAIR STOLTZE asked if Mr. Ruffner subscribes to a conspiracy
where fish that is being shipped out of state needs to be
investigated.
MR. RUFFNER answered no.
SENATOR WIELECHOWSKI asked if Mr. Ruffner would recommend drift-
boat-only areas in the Kenai River.
MR. RUFFNER answered that he responds to the drift-boat-only
question from guides that use single powerboats by saying that
he is not approaching the Board of Fisheries by taking a drift-
boat agenda. He asserted that he will weigh all of the facts as
they come in. He noted that 236 proposals for the fisheries in
the Upper Cook Inlet came before the Board of Fisheries in 2014
and 5 votes were taken where 1 vote would have made a
difference, but the 5 votes did not include a drift-boat vote.
He reiterated that he is not carrying an agenda for drift-boat
fisheries and will listen to the facts if new information comes
forward.
SENATOR WIELECHOWSKI asked if Mr. Ruffner is open to having a
drift-boat-only area for the Kenai River.
MR. RUFFNER replied that the Kenai River has a drift-boat-only
area in the upper river. He stated that based on current facts,
there is no biological reason to push for a drift-boat-only
fishery.
10:04:49 AM
SENATOR WIELECHOWSKI asked if Mr. Ruffner would support some
ideas floating around where the Upper Cook Inlet would be placed
on a three year cycle in addition to adding some conservation
corridors.
MR. RUFFNER answered that responding to Senator Wielechowski's
question that is not a formal request to the Board of Fisheries
is really not fair for him to answer.
SENATOR WIELECHOWSKI asked how large of impact does Mr. Ruffner
believe that the commercial setnet fishery in the Cook Inlet has
on the late Kenai Chinook salmon runs.
MR. RUFFNER answered that he was glad Senator Wielechowski
specified "late run." He explained that the greatest concern is
on the Chinook's early run in the Kenai Peninsula. He noted that
data over the past 20 years has shown that commercial and sport
fishing catches have been fairly equal during abundant Chinook
runs.
10:06:53 AM
SENATOR WIELECHOWSKI asked if the Cook Inlet sharing the
conservation burden with paired prescriptions in the sport
fishery is appropriate.
MR. RUFFNER answered yes. He reiterated that a sustainable
salmon policy requires that the conservation burden is shared
equally. He asserted that the department's authority for
emergency openers must be retained in order to manage the set
goals. He said the Board of Fisheries does not have the purview
to take away the department's emergency authority.
SENATOR WIELECHOWSKI asked if there are too many guides on the
Kenai River.
10:08:24 AM
MR. RUFFNER answered that there are times when portions of the
river are receiving a little bit too much use. He noted that he
has answered the question posed by Senator Wielechowski in the
past and will continue to say that he's concerned about the
river's overall use rather than on a particular segment. He
asserted that guides provide a very important component to
Soldotna's economy and he is reluctant to speak out negatively
about their over-use without talking about the total use on the
river.
SENATOR WIELECHOWSKI asked if Mr. Ruffner is aware of the "one
percent rule."
MR. RUFFNER answered no.
10:10:04 AM
SENATOR WIELECHOWSKI specified that the "one percent rule"
applies at the end of the season when two consecutive periods'
take is less than one percent of the season total where nets are
then required to be taken out of the water. He pointed out that
there has been some argument over how to define "period" where
some define "period" as 12 hours and some define "period" as 96
hours. He asserted that there has been a lot of concern that
defining "period" as 96 hours results in a lot of Coho salmon
being caught that were heading up to the Mat-Su. He asked Mr.
Ruffner if he had any thoughts on how a "period" should be
defined or whether he supported the "one percent rule."
MR. RUFFNER commented that the level of detail requested by
Senator Wielechowski at his current appointment stage may be
above his current pay-grade. He remarked that he agrees with the
concept's intent to provide both the Mat-Su and the sport
fishery with abundant levels of Coho salmon is the best and
highest use.
SENATOR WIELECHOWSKI asked if Mr. Ruffner supported limiting the
"period" to 12 hours.
MR. RUFFNER replied that he is not prepared to answer Senator
Wielechowski's question due to its level of detail. He specified
that he does not know enough about the implications related to
the question.
CHAIR STOLTZE noted that Senator Stedman asked Mr. Ruffner in
the previous committee what the horsepower was on the outboard
that he owns.
MR. RUFFNER answered that he has access to power boats through
his work and the boat that he owns has a 15 horsepower engine.
10:12:30 AM
SENATOR HUGGINS noted that an individual from Kodiak suggested
15 years ago about bringing back fish traps. He asked if Mr.
Ruffner agreed that fish traps were pretty efficient and fish
could not withstand the technique.
MR. RUFFNER answered that he thinks so.
SENATOR HUGGINS replied if Mr. Ruffner agreed, then he should
look at the efficiency in commercial fishing. He stated that he
is not against commercial fishing, but consideration must be
given to resetting management in order to error on the side of
the fish.
CHAIR STOLTZE commented that he has been accused by some
testifiers as promoting the commercial fisheries due to his ex
officio board membership for the Alaska Seafood Marketing
Institute (ASMI). He said he does not think everybody should
have to get their fish from a restaurant or grocery store and
asked if Mr. Ruffner agreed.
MR. RUFFNER answered yes.
10:14:08 AM
MIKE TINKER, representing himself, Ester, Alaska, said he
opposes Mr. Ruffner's appointment. He stated that Mr. Ruffner is
an academic with great research credentials, but he would like
to see a person with broader knowledge. He asserted that the
Board of Fisheries will be unbalanced with a person that has a
commercial fishing preference.
AL BARRETTE, representing himself, Fairbanks, Alaska, said he
opposes Mr. Ruffner's appointment. He commented that he would
rather see people nominated with a history of participating with
the Board of Fisheries.
10:20:01 AM
LOREN FLAGG, representing himself, Kenai, Alaska, said he
supports Mr. Ruffner's appointment. He noted that he worked with
Mr. Ruffner while working at the Alaska Department of Fish and
Game. He said Mr. Ruffner was dedicated to habitat restoration
and resource protection. He added that Mr. Ruffner's leadership
of the Kenai Watershed Forum has been recognized statewide and
nationally. He remarked that the Anchorage area representation
argument used by some in an effort to stop Mr. Ruffner's
confirmation is bogus and totally out of line with Title 16 of
the Alaska statutes.
CHAIR STOLTZE commented that he had better reiterate to his
friends in Kodiak that there is no constitutional right or
designated seats on the Board of Fisheries.
10:21:02 AM
DAVID ATHONS, representing himself, Soldotna, Alaska, said he
supports Mr. Ruffner's appointment. He stated that he was
retired from the Alaska Department of Fish and Game, Division of
Sport Fish as Fisheries Manager in Soldotna. He asserted that
Mr. Ruffner will focus on biology over politics and sound
management practices while considering the best interests of all
Alaskans.
10:23:11 AM
GARY STEVENS, representing himself, Chugiak, Alaska, said he
opposes Mr. Ruffner's appointment. He noted that he currently is
on the Board of Directors for the Alaska Outdoor Council. He
specified that the Board of Fisheries needs to retain balance
and appoint someone who is aggressive about getting more fish
into the rivers. He noted that the commercial fisheries
harvested 98 percent of all of the wild food harvested in the
State of Alaska in 2012.
10:25:08 AM
ANDREW COUCH, representing himself, Palmer, Alaska, said he
supports Mr. Ruffner's appointment.
10:27:13 AM
BRUCE KNOWLES, representing himself, Wasilla, Alaska, did not
provide an endorsement in support or opposition of Mr. Ruffner's
appointment.
10:29:02 AM
BILL IVERSON, representing himself, Soldotna, Alaska, said he
opposes Mr. Ruffner's appointment. He divulged that he is the
President of the Alaska Outdoor Council (AOC). He declared that
AOC opposes Mr. Ruffner being confirmed because his confirmation
would un-balance the Board of Fisheries. He noted that Mr.
Ruffner indicated that the current fish management plans are
working, but clearly they are not working.
10:30:29 AM
MIKE NAVARRE, Mayor, Kenai Peninsula Borough, Soldotna, Alaska,
said he supports Mr. Ruffner's appointment. He stated that the
Kenai Peninsula Borough Assembly passed a resolution endorsing
Mr. Ruffner's appointment to the Board of Fisheries. He asserted
that all fisheries are important to the Kenai Peninsula. He set
forth that Mr. Ruffner will listen to all interested groups and
individuals and will make well informed, balanced, and impartial
decisions in the best interest of the resource.
10:34:40 AM
There being no further business to come before the committee,
Chair Stoltze adjourned the Senate State Affairs Standing
Committee hearing at 10:34 a.m.