CS FOR SENATE BILL NO. 93(HSS) "An Act relating to a workforce enhancement program for health care professionals employed in the state; and providing for an effective date." 9:00:51 AM Vice-Chair Johnston MOVED to ADOPT proposed House Committee Substitute for CSSB 93 (FIN), Work Draft 31-LS0589\S (Marx, 04/24/19)(copy on file). There being NO OBJECTION, it was so ordered. 9:01:26 AM BARBARA BARNES, STAFF, REPRESENTATIVE TAMMIE WILSON, reviewed the changes of the committee substitute. She pointed to page 1, line 9. Rural was added to the list of areas to be covered by the bill. On page 5, lines 12-16 a new subsection was added to allow for inflation and utilization of the Consumer Price Index 5-year average for calculations and allowing for the option of changing the annual amounts without having to come back to the legislature. Ms. Barnes continued to page 7, lines 19-21 rural was defined as a community with a population of 5,500 people or less that was not connected by road or rail to Anchorage or Fairbanks or with a population of 1,500 or less connected by road or rail to Anchorage or Fairbanks. On page 7, line 25 doctor of nursing practice, clinical psychologist, and counseling psychologist were added to the Tier 1 health care professionals category. She concluded with the changes to the committee substitute. Co-Chair Wilson asked for a review of the fiscal notes. 9:02:54 AM AT EASE 9:03:17 AM RECONVENED SARA CHAMBERS, DIRECTOR, DIVISION OF CORPORATIONS, BUSINESS, AND PROFESSIONAL LICENSING, DEPARTMENT OF COMMERCE, JUNEAU (via teleconference), reviewed Fiscal Note 1. She explained that the original version of SB 93 included some responsibilities for the Board of Nursing within the division. Therefore, she had submitted a zero fiscal note. However, the responsibilities were taken out in the committee substitute. The division had withdrawn its fiscal note and currently did not have any affiliation with the bill. Co-Chair Wilson reviewed Fiscal Note 2 from the Department of Health and Social Services (DHSS). She explained that the only change to the fiscal note was the amount of money to start the program. She reminded members that it had to be a state program in order to receive the benefits from the federal government. She reported there would be a change in revenue in a forthcoming fiscal note. She highlighted that as the fiscal note was currently written, it was a general funds source but would be changed to statutory receipt authority and would match page 2. The wrong fund source was originally inserted but the amounts would not change. Representative Tilton referred to page 3, lines 27-29 which talked about how an employer's payment could come from any available source including a philanthropic institution, health foundation, government agency, community organization, or private individuals. She wondered if it was possible for an employer to be receiving grants from the State of Alaska and using them for the program. Co-Chair Wilson invited the sponsors of the bill to the table. 9:05:50 AM REPRESENTATIVE IVY SPOHNHOLZ, COMPANION BILL SPONSOR, responded that it would have to be consistent with the grant award received by an employer and would depend on whether the grant award allowed for the funds to be used for the compensation of employees. She did not believe there would be a conflict, but it depended on the grant in question rather than the eligibility for SHARP. Representative Tilton asked whether, as long as a grant was consistent with a grant award, the monies could be used for repayment. She was asking because it sounded like that much of the program came through non-profits. Many non-profit organizations received grant funding through the federal government. Representative Spohnholz responded that most of the organizations eligible for the SHARP 3 Program were primarily non-profits for Medicaid billing. It could also include some grant funding. The state did some substance abuse treatment that was grant funding. She surmised that as long as it was consistent with the terms of the grant application, she thought it would be okay. Representative Carpenter noted the comment regarding not having to come back to the legislature for additional authority. He asked Representative Spohnholz to comment. Representative Spohnholz explained that the rational was to allow for the program to keep up with the cost of doing business over time without having to come back for permission from the legislature. She felt if the private sector was going to essentially fund the program support increases, and was willing to pay for it, it would not be necessary to come back to the legislature, especially with appropriate sideboards in place. She noted that health care inflation was more aggressive that the Consumer Price Index (CPI). Health are in the State of Alaska in the prior year was about 7 percent, whereas CPI was under 2 percent. The increases were not aggressive. Co-Chair Wilson commented on the use of the word "may" instead of "shall." Representative Carpenter added that the increases were not decided by the federal government. They would be decided by the employer. Co-Chair Wilson responded that he was correct that they would have that opportunity. Representative Spohnholz followed up that the decisions would be made by the SHARP Council in consultation with members of the employer community. It was not being done to employers but by them. Vice-Chair Johnston MOVED to report HCSCSSB 93(fin) out of Committee with individual recommendations and the accompanying fiscal note. There being NO OBJECTION, it was so ordered. HCS CSSB 93(FIN) was REPORTED out of committee with a "do pass" recommendation and with one new fiscal impact note by the Department of Health and Social Services. 9:09:51 AM AT EASE 9:10:57 AM RECONVENED