SPONSOR SUBSTITUTE FOR SENATE BILL NO. 49 am "An Act relating to women's health services and defining 'medically necessary abortion' for purposes of making payments under the state Medicaid program." Representative Wilson MOVED to ADOPT the proposed committee substitute for SSSB 49(FIN), Work Draft 28-LS0410\Y (Mischel, 4/13/13). Representative Costello OBJECTED. A roll call began and was voided by Co-Chair Stoltze prior to its completion. 11:02:10 AM AT EASE 11:02:29 AM RECONVENED Co-Chair Stoltze referred to the previous motion to adopt the CS. He asked the bill sponsor to explain his preference and the substantive differences between the CS and the prior bill version. SENATOR JOHN COGHILL, SPONSOR, spoke in favor of the bill version that removed a family planning mandate; he believed the cost would be approximately $1 million per year. He relayed that much of the provision would do something that was already done in the state. He believed the current operating budget had addressed some of the issues. He relayed that there were 18 core services under the component for women, children, and family services. He listed some of the services including school nursing, school health consultation, technical assistance for optimal health and safety, and educational achievement growth and development for school-aged children (AS 10 related to child health; AS 5 related to reproductive health services). Additional services included a prenatal health program aimed at safeguarding and promoting the health of Alaskan mothers and babies through leadership and partnering and promoting professional standards. Senator Coghill listed additional core services under the women, children, and family component including a women's health program that promoted resources and was essentially about healthy living. He stated the program was at the core of what the amendment had requested. The fifth core service related to an adolescence health team, out of wedlock prevention program to promote healthy relationships and strategies to prevent "mistimed" pregnancies. Another core service related to emergency and disaster preparedness for pregnant and postpartum women, children, and adolescents (particularly for individuals with special health care needs). He discussed a data analysis resulting from surveys on pregnancy risk assessment and monitoring. Additionally, a maternal, infant, and child death review was conducted. He stated that the amendment directed the state to do a "health care plan rewrite." Senator Coghill mentioned a request from the current year and budgetary struggles. The request would add federal and state funds into the program on top of current funding. He read from component challenges related to the Department of Health and Social Services (DHSS) budget: "continued lack of access to family planning providers in many areas of the state contribute to the persistently high mistimed out of wedlock teen births." He relayed that help had been requested. He encouraged that "if we really want to do this, we can do it much more measured rather than doing it under this, what I would consider a rather large mandate." The mandate would require a rewrite of the entire health plan to be submitted to the U.S. Department of Health and Human Services for approval. He relayed that approval already existed and the issue was talked about in the existing DHSS budget. 11:06:23 AM Representative Edgmon stressed that the bill focused on a "hugely controversial" issue. He requested to come back to the bill after the House floor session. Senator Coghill offered to make the information available to committee members. Co-Chair Stoltze deferred to Representative Edgmon's request. He expressed his desire to vote on the adoption of the CS prior to recessing. He expected that a vigorous debate would occur at a later time. He wanted to have the discussion with the "member's" bill before the committee. Representative Edgmon requested to defer action on the adoption of the CS. Co-Chair Stoltze agreed to defer action. Representative Edgmon requested an opportunity to contemplate the adoption of the CS. 11:07:45 AM RECESSED 7:21:09 PM RECONVENED