SENATE BILL NO. 172 "An Act establishing the Alaska Health Care Commission in the Department of Health and Social Services; and providing for an effective date." 9:35:46 AM DENISE LICCIOLI, STAFF, SENATOR OLSON, delivered the sponsor statement. Alaska is currently facing serious healthcare cost, access and quality issues. Between 1991 and 2005, health care expenditures in our state more than tripled from $1.6 billion to $5.3 billion. All levels of government--state, local, and federal- are affected, and Alaska's economy cannot sustain this inflationary growth. The purpose of SB 172 is to establish in statute the Alaska Health Care Commission to address the need for health care reform in our state. The issue is complex and broad in scope, and cannot be dealt with adequately unless we have a permanent body to plan and follow through for long range comprehensive health care reform. The two most recent groups to work on the issue of health care reform in Alaska, the Alaska Health Care Roundtable (2005) and the Alaska Health Care Strategies Planning Council (2007), both recommend that a permanent body be established to address the problem of health care reform. The Roundtable (which met for 2 years) and the Planning Council (which met for 6 months) recognized that the problem is too great to be effectively addressed though a short-term, ad- hoc body. The Alaska Health Care Commission would be established in the Department of Health and Social Services, and would consist of a ten member body including public officials and private citizens. Representatives from both the executive and legislative branches of state government are included, as well as citizens representing the private business sector, the health care community, and consumers. Three members are to be ex officio appointees from the legislature and the governor's office. The composition and small size would enable efficient and effective teamwork and decision-making, while bringing a balance of viewpoints and perspectives. The commission would provide its recommendations and support the development of a statewide plan to address the quality, accessibility, and availability of health care for all citizens of the State. A plan for reform will be based on education, sustainability, management efficiency, health care effectiveness, private-public partnerships, research, personal responsibility and individual choice. Alaska's need for healthcare reform is pressing and must be dealt with thoroughly and efficiently, with a long range view toward meaningful and lasting change. The Alaska Health Care Commission would play an important role in this process, and it is essential that we make it permanent as well as future issues with Alaska's healthcare systems can be better anticipated, understood, and addressed. 9:40:45 AM Co-Chair Hoffman asked why a permanent board is proposed when the administration performs similar work by administrative order. Ms. Liccioli responded that the administrative order establishing the healthcare commission was temporary. Senator Thomas asked if the university was considered for board representation as they employ many on the involved work force. Ms. Liccioli responded that the university was considered along with many other groups who would bring valuable expertise to the commission. She understood that the desire was to keep the commission small while including a wide range of views and perspective. 9:42:31 AM WARD HURLBURT, CHAIR HEALTH CARE COMMISSION, DEPARTMENT OF HEALTH AND SOCIAL SERVICES, stated that the administration supports the legislation. He commented that the state lacks affordable health care services. Nationally, analysts state that we spend 18 percent of gross domestic product on health care services. Alaska spends approximately $6 billion a year on health care services. Every state is overwhelmed by the increasing cost of Medicare. The individuals on the current health care commission have united as a small working group with every member invested and engaged. He commented on challenges presented by the national health care reform commission. He cited the need for specific Alaskan analysis as health care reform is addressed. 9:48:13 AM Senator Egan asked if the commission will perform the contracting for the projected funding. Mr. Hurlburt responded that the funding is available through the fiscal note. 9:49:08 AM LAURIE HERMAN, DIRECTOR GOVERNMENT AFFAIRS, PROVIDENCE HEALTH AND SERVICES testified in support of SB 172. She echoed the comments of Senator Olson's staff. 9:50:18 AM SONIA HANDFORTH KOME, PRESIDENT, ALASKA PRIMARY CARE ASSOCIATION (via teleconference) stated that the Alaska Primary Care Association strongly supports the SB 172 for the establishment of the health commission. She appreciated the inclusion of a primary care physician seat; however, the association feels that a primary care safety net seat and more specifically a community health center seat on the commission is important. She advocated for community health centers, which belong to a statewide and nationwide system and provide primary and preventative medical care and case management along with dental and behavioral health care prevention and case management. Community health centers have been shown to reduce Medicaid costs. She opined that a designated community health center seat, in statute is therefore necessary. 9:52:52 AM PAT LUBY, ADVOCACY DIRECTOR, AMERICAN ASSOCIATION OF RETIRED PERSONS (via teleconference) testified in support of the legislation. He stated that SB 172 would extend the life of the Alaska Health Care Commission. With the recent national action on health care, every state must have a group of experts who can determine how to make the federal legislation work. He advocated for extending the sunset date. Co-Chair Stedman mentioned one fiscal note from the Department of Health and Social Services for $500 thousand in general funds to cover the cost of operations in the commission. SB 172 was HEARD and HELD in Committee for further consideration.