SENATE BILL NO. 56 "An Act extending the January 15, 2021, governor's declaration of a public health disaster emergency in response to the novel coronavirus disease (COVID-19) pandemic; providing for a financing plan; making temporary changes to state law in response to the COVID-19 outbreak in the following areas: occupational and professional licensing, practice, and billing; telehealth; fingerprinting requirements for health care providers; charitable gaming and online ticket sales; access to federal stabilization funds; wills; unfair or deceptive trade practices; and meetings of shareholders; and providing for an effective date." 9:50:05 AM ADAM CRUM, COMMISSIONER, DEPARTMENT OF HEALTH AND SOCIAL SERVICES, ANCHORAGE (via teleconference), read from a prepared statement: SB 56 was introduced by the Governor on January 25 after issuing a declaration of a public health disaster emergency in response to the COVID-19 pandemic on January 15. 1. This was done pursuant to AS 26.23.020 and AS 26.23.025 2. Generally these statutes provide that a disaster proclamation may not remain in effect longer than 30 days, unless extended by the Legislature. 3. The Governor brought forth bills for the Legislature to consider extending the declaration. 4. However, absent legislative action and pursuant to AS 26.23.020, the Public Health Disaster Emergency expired on February 14. In the time leading up to the February 14 expiration: 1. The Administration evaluated the current COVID-19 response plan which includes elements which you are all familiar with, such as: a. widespread testing b. supporting non-congregate housing for certain groups of individuals who need to quarantine or isolate c. providing alternative care sites, procurement of PPE and testing supplies d. guidelines for critical infrastructure work force and employers, and e. vaccine allocation, distribution, and administration. 2. The Administration evaluated what we needed to do to keep Alaska in the top tiers, nationwide, for safety, testing, and vaccine distribution. We evaluated what would be necessary for the next month, the next 3 months, and the next 6 months. 3. We evaluated what tools were necessary to continue our response efforts this involved looking at regulations previously waived, authorities that are provided for under the Alaska Disaster Act and the current statutory authority under the Alaska Public Health Emergency. 4. We met extensively with our response partners federal agencies, local governments, health care providers, tribal health entities, health care facilities, associations to discuss operations and response efforts by the state, if the Disaster Declaration was not extended. As part of our evaluative process we looked closely at the authorities that are available to the Governor under the Alaska Disaster Declaration Act. I would like to review the authorities under the Alaska Disaster Act - AS 26.23.020 (b) The governor may issue orders, proclamations, and regulations necessary to carry out the purposes of the Disaster Act. • used to allow state agencies to be nimble and flexible in response to the public health emergency and disaster; • provided protections for the spread of the disease by establishing guidelines for travel into Alaska, around Alaska, and for our critical infrastructure workforce AS 26.23.020 (e) A proclamation of a disaster emergency activates the disaster response and recovery aspects of the state, local, and interjurisdictional disaster emergency plans • used to allow the Unified Command structure to support local jurisdictions, statewide healthcare system and statewide response to the pandemic. • Allowed for the establishment of alternative care sites, including outpatient therapeutic treatment centers. • Allowed for the state to coordinate the use of supplies and materials. AS 26.23.020 (f) The governor may delegate or assign command authority for the National Guard by appropriate orders or regulations. • allowed us to utilize the National Guard for response purposes, such as contact tracing, testing and logistical support AS 26.23.020 (g) there are a lot of authorities under this section of the Alaska Disaster Act the primary ones that were used - 26.23.020 (g)(1) suspend the provisions of regulations or statutes if compliance would prevent, or substantially impede or delay, action necessary to cope with the disaster emergency We use this statute for: • Emergency procurement of commodities/supplies for hospitals, health clinics, providers, communities. • Emergency procurement for contracts for additional cold-chain shippers • Emergency procurement for contracts for testing and supplies • Hiring of temporary personnel to support public health response plans contact tracers, public health nurses, microbiologists, support for data systems, etc. • Allowed for increased flexibility in how we care for and provide services to our most vulnerable populations in congregate settings and facilities. 9:54:58 AM Commissioner Crum continued to read from his statement: 26.23.020(g)(7) control ingress to and egress from a disaster area, the movement of persons within the area, and the occupancy of premises in it; • this is the authority that was used to implement pre-travel testing requirements for travel into Alaska and to communities off of the road system and on the Alaska Marine Highway System 26.23.020(g)(9) make provisions for the availability and use of temporary emergency housing; • this was used for non-congregate housing for homeless, for travelers that arrived in Alaska and tested positive, for health care workers 26.23.020(g)(10) allocate or redistribute food, water, fuel, clothing, medicine, or supplies; • this is the authority that was used for PPE, testing supplies, vaccine and therapeutic treatments. Other Authorities under AS 26.23.020 (g) that we did not use at all - such as • Use all available resources of the state government and of each political subdivision of the state as reasonably necessary; • Commandeer or utilize any private property • Suspend or limit the sale, dispensing, or transportation of alcoholic beverages, explosives or combustibles • Use money from the oil and hazardous substance release response account to respond to a disaster related to an oil or hazardous substance discharge. In Summary of These Authorities: 1. We asked ourselves how does Alaska proceed to a "recovery phase" moving beyond "Disaster" and "Emergency" can we take a more limited approach that provides us the tools that we need to keep Alaska's public health response plan as one of the best in the nation and that also supports our state improving in economic metrics. 2. Through our evaluative process, we realized we don't need all of the authorities available under the Alaska Disaster Act to keep Alaska's public health response plan as one of the best in the nation. 3. We think that there is room to utilize a more limited, or targeted approach vs. a blanket approach that the disaster declaration provides by using uncodified law to establish the authorities that we need that are important for our response plan and for a limited period of time. Commissioner Crum stated that Alaska ranked in the top tier in the country as it pertained to public health and safety, especially as it pertained to COVID-19 testing. He emphasized the high number of tests conducted in the state, with a very rapid turnaround in the state. He noted that case counts had plateaued since March 2020. He also remarked that the number of COVID-19 hospital patients was currently low. He stressed that it was a much different situation than in the winter of 2020. He also noted that approximately 29.6 percent of Alaskans 16 or older were currently vaccinated against COVID-19. 10:00:26 AM Commissioner Crum stressed that Governor Dunleavy had opened the vaccination availability for those 65 and older, because COVID-19 hospitalizations and deaths were highest for that age group. He noted that there would be many additional vaccination doses arriving in the coming weeks. He announced the combination of these things resulted in the conclusion that a disaster declaration was unnecessary. He continued to read from his prepared statement: We concluded we needed limited authorities to support four elements of the state's response: 1. The ability to allocate and distribute vaccines and therapeutics 2. Limited immunity for officials performing their duties related to the state's response plan 3. The continued use of enhanced telehealth services 4. Necessary authority accessing federal relief funding as they pertain to the state's continued response and nexus to the federal public health emergency and major disaster declaration which includes EA SNAP benefits, blanket waivers in place due to the federal public health emergency, FEMA support for non-congregate housing supported by DMVA. 10:05:41 AM Commissioner Crum continued with his testimony: We understand the sensitivity of using the Disaster Declaration and a Public Health Emergency to provide such broad authority. We understand the need to progress to a "recovery phase" for Alaska but also have the tools that we need to respond if things change such as the entry of variants. Which we are watching closely. It is possible to allow the appropriate authorities to the Department of Health and Social Services and the Department of Military and Veterans Affairs to continue the state's response plan without providing the overbroad authority of a public health emergency disaster declaration under the Alaska Disaster Declaration Act. Senator Wielechowski wondered how many other states had current disaster declarations. Commissioner Crum replied that all the states except for Michigan and Alaska had current disaster declarations. Senator Wielechowski surmised that 48 states did not have disaster declarations. Commissioner Crum agreed. 10:10:00 AM Senator Wielechowski looked at the definition of "disaster declaration" in statute and noted that it was defined as the "occurrence or imminent threat of widespread damage, injury, or loss of life or shortage of food, water, or fuel." He noted that Section E mentioned, "an outbreak of disease or credible threat of an imminent outbreak of a disease." He wondered whether the current pandemic met those criteria. Commissioner Crum replied that he did not believe that, in Alaska, the threat had not risen to a level of a disaster declaration currently, because of the tools and infrastructure implementation and availability. Senator Wielechowski noted that the definition of disaster declaration included "the occurrence or imminent threat of widespread or severe damage, injury, loss of life from an outbreak of disease." He wondered whether Commissioner Crum believed that the current pandemic did not meet that statutory definition of "disaster." Commissioner Crum replied in the affirmative. Senator Hoffman looked at the letter from DHSS, which stated that there was a discussion of the extension of the health disaster emergency from January 15, 2021, to March 15, 2022. He remarked that there was also a letter from the governor dated January 1, which stated that the bill would extend the health disaster period to September 30, 2021, and left it open ended or until the outbreak no longer exists. He wondered where in the bill it delineated how long the disaster emergency period exists. Commissioner Crum replied that the Health and Social Services subcommittee changed the date from September to March. Senator Hoffman wondered where the appropriation would be targeting. He asked whether it was the full funding or whether bill authorized expenditure from President Biden's federal appropriation. Commissioner Crum replied that the bill would only deal with the past aspects of the financial plan, but deferred to OMB for the current plans of the Alaska Recovery Plan that was passed on the federal level. 10:15:44 AM Senator Hoffman wondered when there was an expectation of the request to expend the Biden administration's Covid funds before the committee. Commissioner Crum replied that he did not know the official timeline, but stated that DHSS was working to ensure that there was a thorough understanding of what dollars and rules were coming in through programs administers by DHSS. He deferred to OMB about the timing of the presentation to the committee. Senator Hoffman commented that the discussion was about the health of the Alaskan people. He felt that an expeditious request meant that there could be time to give it due consideration for appropriation. He felt that expedience was required to assure that the people were protected as early as possible, and hoped there could be more information from the administration. Co-Chair Bishop commented that the conversation would continue on the upcoming Friday. Senator Hoffman wondered whether there was satisfaction with the change made in the Senate Labor and Commerce subcommittee for the March 15 extension, and whether there were comments on the original request of the September 30 deadline. Commissioner Crum replied that a further timeframe beyond March would be beneficial for his department. 10:19:46 AM HEIDI HEDBERG, DIRECTOR OF THE DIVISION OF PUBLIC HEALTH, ANCHORAGE (via teleconference), furthered that there was a current focus of vaccine confidence. She remarked that vaccine was still a scarce resource. She shared that the federal government was allocating to the states based on state population. She remarked that Alaska was mimicking that distribution within the state, and distributed the vaccines based on the census area. She noted that the department was working on vaccine confidence and education of Alaskans related to the science of vaccines. She stressed that there was limited authority needed to allocate by population. 10:20:37 AM Senator Wielechowski looked at page 3, line 28 of the bill said that "if the commissioner of Health and Social Services certifies to the governor that there was no longer a current outbreak of novel coronavirus, Covid-19 or credible threat of imminent outbreak, the governor shall issue a proclamation of public health disaster emergency no longer exists." He wondered whether there Commissioner Crum had certified to the governor that there was no longer a credible threat of outbreak of novel coronavirus. Commissioner Crum replied that he understood that phrasing to be about whether there was current disaster declaration in place, then he would need to provide certification. Senator Wielechowski wondered whether Commissioner Crum believed that there was no longer and outbreak of the novel coronavirus. Commissioner Crum replied that there were current ongoing outbreaks, but they were not to the level needed for a disaster declaration. Senator Wielechowski queried the level at which there would be a determination of a disaster declaration. Commissioner Crum replied that there were many factors and a metric that would require that determination of a disaster declaration. Co-Chair Bishop surmised that, to date, there was a 29.6 percent of 16 and older vaccinated in the state. Commissioner Crum agreed. Co-Chair Bishop stated that there was approximately 70 percent of those 65-years-old and older vaccinated in the state. Commissioner Crum agreed. Co-Chair Bishop announced that there was a dosage expectation in April of approximately 143,000. Commissioner Crum agreed. Co-Chair Bishop stated that 372,000 people had been vaccinated with at least the first dose to date. Commissioner Crum agreed. Co-Chair Bishop queried the state's estimate at reaching herd immunity. Commissioner Crum replied that the primary goal was making sure that the vaccine was available for Alaskans that wanted to take the vaccine. He stated that there was an anticipation of enough doses in the state for Alaskans that wanted to receive the vaccine by April 10:25:42 AM Senator Wilson remarked that there was a concern about the legality of a "vaccine passport program" within businesses and conditions of employment. He asked for information about that issue. Commissioner Crum replied that the Department of Law would be better suited to answer that concern. Co-Chair Bishop stated that there was not. Commissioner Crum agreed to provide that information. Co-Chair Bishop wondered whether there was a deadline for the legislature to have a bill passed to be eligible for the April enhanced SNAP benefits. Commissioner Crum replied that if there was a bill passed in the legislature that allowed for DHSS to apply for SNAP benefits any time in the month of April, then there would be distribution of the April benefits. Co-Chair Bishop wondered whether there was any guidance from the federal government about the date of repealing the SNAP program. Commissioner Crum replied that it was subject to available funding, and tied to the Federal Public Health Emergency. Co-Chair Bishop wondered whether there had been official approval from the Food and Nutrition Services that the approach was sufficient to receive the $8 million benefits. Commissioner Crum replied in the affirmative, and there was an acceptance of language applied to an authorities bill in Covid response. 10:28:31 AM ALBERT WALL, DEPUTY COMMISSIONER, DEPARTMENT OF HEALTH AND SOCIAL SERVICES, JUNEAU (via teleconference), asked for a restatement of the question. Co-Chair Bishop wondered whether there was any official approval from the Food and Nutrition Services that the approach that was requested was sufficient to receive the enhanced $8 million SNAP benefits. Mr. Wall replied that there was work with the regional director for the purpose. The communication from him had been by email and verbally that should the state define the emergency and apply with the emergency in mind, then the money could move forward. 10:29:32 AM Senator Wielechowski asked whether individuals could be denied SNAP benefits and when that would occur. Commissioner Crum replied that because the allotment was outside the typical program, those funds would be coming into the state mid-month so there was a manual process to update those funds. Senator Wielechowski asked about timing of passing legislation to save the delaying of benefits. Commissioner Crum replied that he believed passing legislation by the second week of April would not delay the benefits. Mr. Wall said that regular benefits would continue as usual. Emergency allotments would be disrupted, but could be retroactive. Co-Chair Bishop asked for an average SNAP benefit monthly stipend vs the emergency level. Co-Chair Bishop queried the average monthly SNAP benefit amount. Mr. Wall replied that there was a widespread dollar amount that depended on the need of individual or family. He agreed to provide that information. Senator Wielechowski wondered how many Alaskans were eligible for the enhanced SNAP benefits for the month of April. Mr. Wall agreed to provide that information. Senator Wielechowski wondered when a bill would need to be passed in order to not delay funds reaching Alaskans. Mr. Wall replied that it should be passed any day in April. Senator Wielechowski wondered when the enhanced SNAP benefits would be paid in the month of April. Mr. Wall replied that the benefits were a rolling day, and agreed to provide that information. He stated that the supplemental payment did not all go out on the same day. 10:35:20 AM Senator Wilson stressed that retroactive payments would not feed a person daily. He wondered whether any of the enhanced benefits recipients been notified that their benefits were at risk so they could properly prepare their families. Mr. Wall replied that they had not been specifically notified, but remarked that they had been informed that it was a month-to-month program that was subject to availability. Senator von Imhof noted that there were discussions on this issue in subcommittee. She remarked that a person's situation could change over time. She felt that the economy was opening back up, so the qualifications for the SNAP funds may not reflect the actual need. Senator Wielechowski stressed that receiving the benefit was a critical component of receiving food for people. He felt that the bill needed to be passed as soon as possible. Co-Chair Bishop discussed the following day's agenda. SB 56 was HEARD and HELD in committee for further consideration.