HJR 14-FCC: INCREASE RURAL HEALTH CARE BUDGET  5:20:50 PM CHAIR WILSON announced the consideration of HJR 14. He noted that the legislation is time sensitive and his intention is to hear the bill, take public testimony, and hopefully move the resolution out of committee. 5:21:15 PM TIMOTHY CLARK, Staff, Representative Bryce Edgmon, Alaska State Legislature, Juneau, Alaska, sponsor of the resolution, provided the following overview of HJR 14: HJR 14 has to do with a Federal Communications Commission (FCC) funded broadband support program for rural centers in Alaska and across the country. Rural Alaska has made great strides in recent years in the long distance delivery of health care via tele- medicine; these broadband services expand locally available treatment options for an increasing number of maladies including treatment for substance abuse, they accelerate diagnosis and treatment, and help Alaskans avoid expensive travel for care, but despite these advances, we are about to hit a roadblock. The existence of such services depends on the FCC Rural Health Care Universal Service Support Program. The budget for the program has been capped at the same level since it was established in 1997, 20-years ago. The program is funded through Universal Service charges, there is no state-funding obligation. For most of the program's existence, the $400 million budget has been enough to meet demand, but as you can imagine after decades of advances in technology, increases in demand, and the effect of inflation, the FCC expects the demand exceed the budget cap for the first time in 2017. HJR 14 urges the FCC to increase the Rural Health Care Universal Support budget sufficiently to adjust for inflation, to keep up with advances in technology and services available to increase broadband, and to meet the increased demand for these broadband-based services; additionally, the resolution encourages the FCC to index the program budget for inflation and to allow any unused funds to be carried forward to future funding years, this will allow health-care providers to continue improving access to health care in rural locations. 5:24:24 PM SENATOR MICCICHE said he respects the noted names and organizations that support HJR 14. He asked Mr. Clark if he was aware of any opposition to HJR 14. MR. CLARK answered none that he was aware of. He noted that when the resolution crossed the floor of the House concern was expressed regarding the way programs from the Universal Service charges are funded. He opined that the objection may have been related to the potential for increased costs to consumers. He pointed out that a $200 million increase to the budget would equate to pennies on consumers' bills because the fund is a nationwide program. CHAIR WILSON asked Mr. Zasada if he had any comments to add. 5:26:50 PM JON ZASADA, Policy Integration Director, Alaska Primary Care Association, Anchorage, Alaska, addressed the need to increase the rural health-care budget as follows: This issue is moving quickly, federally. For the current fiscal year that we are in, some community health centers are already seeing a drop in the subsidy that they are receiving through this fund, meaning that some providers' monthly internet bills are going up from $500 a month to almost $4,000 a month. The cap-increase effort is very timely, we are working so that it doesn't occur for the fiscal year that starts July 1. Additional ramifications that I wanted to just share with the committee, certain SB 74 redesign components could also be endangered if the cap is not raised and these include: the ability of rural providers to fully use tele-health, to undertake care coordination, to continue to support mental-health parity in rural communities and in their efforts to address the opioid epidemic. Basically, rural health providers have built their care systems around dedicated internet that is subsidized through this program and it is very important. We believe the state of Alaska showed its full support to the federal government as we go through the process of having the cap increased. 5:28:44 PM SENATOR MICCICHE asked if Mr. Zasada believes that Alaska enjoys more support from the program than what the state likely pays into the program. MR. ZASADA replied that Senator Micciche's query is probably the case. He detailed that Alaska uses about $100 million out of the $400 million fund: $38 million for community health, $27 million for rural hospitals, and other care entities take up the rest. SENATOR MICCICHE explained that his question related to the concern about increased costs and pointed out that Alaskans enjoy much more benefit on a dollar value than what is paid in. MR. CLARK stated that his assumption is that Alaskans enjoy a considerable benefit from the program, far short of what is being contributed to the program. 5:30:44 PM SENATOR BEGICH commended Senator Micciche for his question that underscored the state receiving 25 percent of the fund. He asked Mr. Zasada to verify that the state receives 25 percent of the fund. MR. ZASADA answered correct. SENATOR BEGICH agreed that the state really is benefitting from the fund to a great degree. CHAIR WILSON disclosed that during his time at Eastern Aleutian Tribes he was able to see some of the tele-health technologies and its capabilities. He said he could only imagine what some of the health-care centers are doing now in some of the rural entities to try to hopefully lower health-care costs. 5:32:09 PM CHAIR WILSON opened public testimony on HJR 14. 5:32:24 PM CHAIR WILSON closed public testimony on HJR 14. 5:32:39 PM SENATOR MICCICHE moved to report HJR 14, version J, [30- LS0422\J], from committee with individual recommendations and attached zero-fiscal note. 5:32:49 PM CHAIR WILSON announced that being no objection, HJR 14 moved from the Senate Health and Social Services Standing Committee.