HOUSE HEALTH, EDUCATION AND SOCIAL SERVICES STANDING COMMITTEE April 28, 1997 3:45 p.m. MEMBERS PRESENT Representative Con Bunde, Chairman Representative Al Vezey Representative Fred Dyson Representative J. Allen Kemplen Representative Tom Brice MEMBERS ABSENT Representative Joe Green, Vice Chairman Representative Brian Porter COMMITTEE CALENDAR SENATE JOINT RESOLUTION NO. 23 Urging the United States Congress to amend the Social Security Act so that the higher cost of living in Alaska is reflected when the per capita income of the state is used as a factor in determining the federal share of Medicaid costs. - MOVED SJR 23 OUT OF COMMITTEE SENATE BILL NO. 100 "An Act relating to grant authority for services for developmentally delayed or disabled children and their families." - MOVED SB 100 OUT OF COMMITTEE SENATE CONCURRENT RESOLUTION NO. 6 am Relating to the Alaska Telemedicine Project. - MOVED HCSSCR 6(HES) OUT OF COMMITTEE SPONSOR SUBSTITUTE FOR HOUSE BILL NO. 148 "An Act relating to the public school funding program; relating to the definition of a school district, to the transportation of students, to school district layoff plans, to the special education service agency, to the child care grant program, and to compulsory attendance in public schools; and providing for an effective date." - SCHEDULED BUT NOT HEARD (* First public hearing) PREVIOUS ACTION BILL: SJR 23 SHORT TITLE: REFLECT AK. COLA IN FED MEDICAID SHARE SPONSOR(S): HEALTH, EDUCATION & SOCIAL SERVICES JRN-DATE JRN-DATE ACTION 03/12/97 690 (S) READ THE FIRST TIME - REFERRAL(S) 03/12/97 690 (S) HES 03/17/97 (S) HES AT 9:00 AM BUTROVICH ROOM 205 03/17/97 (S) MINUTE(HES) 03/18/97 765 (S) HES RPT 5DP 03/18/97 765 (S) DP: WILKEN, LEMAN, ELLIS, GREEN, WARD 03/18/97 765 (S) ZERO FISCAL NOTE (DHSS) 03/19/97 (S) RLS AT 10:45 AM FAHRENKAMP RM 203 03/19/97 (S) MINUTE(RLS) 03/24/97 832 (S) RULES TO CALENDAR 3/24/97 03/24/97 835 (S) READ THE SECOND TIME 03/24/97 835 (S) ADVANCED TO THIRD READING UNAN CONSENT 03/24/97 835 (S) READ THE THIRD TIME SJR 23 03/24/97 836 (S) PASSED Y16 N- E2 A2 03/24/97 839 (S) TRANSMITTED TO (H) 03/25/97 824 (H) READ THE FIRST TIME - REFERRAL(S) 03/25/97 825 (H) HES 04/24/97 (H) HES AT 3:00 PM CAPITOL 106 04/24/97 (H) MINUTE(HES) 04/28/97 (H) HES AT 3:30 PM CAPITOL 106 BILL: SB 100 SHORT TITLE: DEVELOPMENTALLY DISABLED CHILDREN/GRANTS SPONSOR(S): HEALTH, EDUCATION & SOCIAL SERVICES BY REQUEST JRN-DATE JRN-DATE ACTION 02/21/97 450 (S) READ THE FIRST TIME - REFERRAL(S) 02/21/97 450 (S) HES, FIN 03/05/97 (S) HES AT 9:00 AM BUTROVICH ROOM 205 03/05/97 (S) MINUTE(HES) 03/05/97 566 (S) HES RPT 3DP 03/05/97 566 (S) DP: WILKEN, WARD, GREEN 03/05/97 566 (S) ZERO FISCAL NOTE (HES) 03/21/97 809 (S) FIN REFERRAL WAIVED 03/25/97 (S) RLS AT 0:00 AM FAHRENKAMP RM 203 03/25/97 (S) MINUTE(RLS) 03/26/97 875 (S) RULES TO CALENDAR 3/26/97 03/26/97 876 (S) READ THE SECOND TIME 03/26/97 876 (S) ADVANCED TO THIRD READING UNAN CONSENT 03/26/97 876 (S) READ THE THIRD TIME SB 100 03/26/97 876 (S) PASSED Y18 N- A2 03/26/97 881 (S) TRANSMITTED TO (H) 03/27/97 870 (H) READ THE FIRST TIME - REFERRAL(S) 03/27/97 870 (H) HES, FINANCE 04/24/97 (H) HES AT 3:00 PM CAPITOL 106 04/24/97 (H) MINUTE(HES) 04/28/97 (H) HES AT 3:30 PM CAPITOL 106 BILL: SCR 6 SHORT TITLE: ALASKA TELEMEDICINE PROJECT SPONSOR(S): SENATOR(S) PEARCE,Ellis; REPRESENTATIVE(S) JRN-DATE JRN-DATE ACTION 03/07/97 627 (S) READ THE FIRST TIME - REFERRAL(S) 03/07/97 627 (S) HES 03/19/97 (S) HES AT 9:00 AM BUTROVICH ROOM 205 03/19/97 (S) MINUTE(HES) 03/24/97 830 (S) HES RPT W/AMENDMENT 1DP 1NR 2AM 03/24/97 831 (S) DP: WILKEN; NR: WARD; AM: LEMAN, ELLIS 03/24/97 831 (S) ZERO FISCAL NOTE (S.HES) 03/25/97 (S) RLS AT 0:00 AM FAHRENKAMP RM 203 03/25/97 (S) MINUTE(RLS) 03/26/97 875 (S) RULES TO CALENDAR 3/26/97 03/26/97 876 (S) READ THE SECOND TIME 03/26/97 877 (S) AM NO 1 OFFERED BY HES CMTE 03/26/97 877 (S) AM NO 1 ADOPTED UNAN CONSENT 03/26/97 877 (S) AM NO 2 OFFERED BY PEARCE 03/26/97 877 (S) AM NO 2 ADOPTED UNAN CONSENT 03/26/97 877 (S) PASSED Y19 N- A1 03/26/97 881 (S) TRANSMITTED TO (H) 03/27/97 869 (H) READ THE FIRST TIME - REFERRAL(S) 03/27/97 869 (H) HES 04/24/97 (H) HES AT 3:00 PM CAPITOL 106 04/28/97 (H) HES AT 3:30 PM CAPITOL 106 WITNESS REGISTER ELMER LINDSTROM, Special Assistant Office of the Commissioner Department of Health and Social Services P.O. Box 110601 Juneau, Alaska 99811-0601 Telephone: (907) 465-3030 POSITION STATEMENT: Testified on SJR 23 and SB 100 JORDAN KOKO, Student Intern for Senator Pearce Alaska State Legislature Capitol Building, Room 518 Juneau, Alaska 99801 Telephone: (907) 465-4993 POSITION STATEMENT: Provided sponsor statement for SCR 6 am CATHE BOUCHA-ROBERTS, Director Alaska Telemedicine Project Anchorage Providence Hospital Anchorage, Alaska 99501 Telephone: (907) 261-4955 ACTION NARRATIVE TAPE 97-36, SIDE A Number 0000 CHAIRMAN CON BUNDE called the House Health, Education and Social Services Standing Committee meeting to order at 3:45 p.m. Members present at the call to order were Representatives Bunde, Vezey, Dyson and Kemplen. Representative Brice arrived at 3:52 p.m. Representatives Green and Porter were absent. SJR 23 - REFLECT AK. COLA IN FED MEDICAID SHARE Number 0095 CHAIRMAN BUNDE announced the first item on the agenda as SJR 23, Urging the United States Congress to amend the Social Security Act so that the higher cost of living in Alaska is reflected when the per capita income of the state is used as a factor in determining the federal share of Medicaid costs. Number 0107 ELMER LINDSTROM, Special Assistant, Office of the Commissioner, Department of Health and Social Services (DHSS), said the resolution petitions the federal government to consider a change in the matched rate for the Medicaid program. Currently the state puts in 50 cents of every dollar which the federal government matches. This is one of the lowest federal participation rates for any state in the union. Based on Alaska's additional costs of health care, the DHSS believes this rate should be increased. The Congressional delegation is aware of this need and this resolution will be welcomed by them. Should the match rate change, it would mean an adjustment of approximately $39 million in federal participation in a given year for the Medicaid program. Number 0187 CHAIRMAN BUNDE asked if this would reduce Alaska's contribution or would it simply mean more things would be covered by the federal government. Number 0199 MR. LINDSTROM answered that it would open up options. One of these options would be a direct offset to current general fund expenditures. It would become a budget matter, allowing the legislature to do what they want should the additional federal funds become available. Number 0251 REPRESENTATIVE FRED DYSON made a motion to move SJR 23 with individual recommendations. Hearing no objections, SJR 23 moved out of the House Health, Education and Social Services Standing Committee. SB 100 - DEVELOPMENTALLY DISABLED CHILDREN/GRANTS Number 0287 CHAIRMAN BUNDE announced the next item on the agenda was SB 100, "An Act relating to grant authority for services for developmentally delayed or disabled children and their families." Number 0294 ELMER LINDSTROM, Special Assistant, Office of the Commissioner, Department of Health and Social Services, said SB 100 represents a technical item which this committee has seen in prior years. This item was included in past omnibus government efficiency bills which did not pass. This year it comprises a separate bill. Several years ago, the DHSS attempted to promulgate regulations, through the Department of Law, relating to the infant learning program. The DHSS was unable to get those regulations through because the message came back that the DHSS did not have specific authority to make grants under this program. The program currently operates this way today. This bill would give DHSS the power, in statute, of grant making authority. This bill is supported by the Governor's Council on Disabilities and Special Education. Number 0409 REPRESENTATIVE AL VEZEY made a motion to move SB 100 with individual recommendations and zero fiscal note. Hearing no objections, SB 100 was moved from the House Health, Education and Social Services Standing Committee. SCR 6 AM - ALASKA TELEMEDICINE PROJECT Number 0431 CHAIRMAN BUNDE announced the next item on the agenda was SCR 6 am, Relating to the Alaska Telemedicine Project. He referred to a proposed committee substitute. Number 0463 REPRESENTATIVE VEZEY made a motion to adopt the proposed committee substitute for SCR 6 am. Hearing no objections HCSSCR 6 am (HES) was before the committee. JORDAN KOKO, Student Intern for Senator Pearce, stated that HCSSCR 6(HES) recognizes the Alaska Telemedicine Project for its accomplishments in the state of Alaska. This program is pioneering in its field and is focused on improving the availability and delivery of health care in the state using telecommunications, telehealth and information technologies. The project involves a consortium of Native health care corporations, regional health care facilities, the University of Alaska and most major telecommunications providers in the state. Number 0531 MR. KOKO explained that the Alaska Telemedicine Project has worked very hard towards its goal of providing and demonstrating telehealth applications. This project has been operating for four years and has been recognized by both national and international organizations including the National Library of Medicine, the United States Department of Commerce and the Government of Romania. The Alaska Telemedicine Project has accomplished all of its functions without state funding. It is been funded through independent grants and sources of revenue. The project was recently awarded a $2 million contract through the National Library of Medicine to assist the Alaska Native Health Board in providing rural health services. Number 0584 MR. KOKO said the adopted committee substitute changes line 22, page 2, from "officially sanction" to "commending the leadership of the Alaska Telemedicine Project". This language alleviates any concerns by outside corporations and individuals that this would preclude other entities from getting grants. Number 0644 REPRESENTATIVE VEZEY asked the position of the American Medical Association (AMA). MR. KOKO did not know if the AMA recognized the project. Representative Brice joined the committee meeting. Number 0650 CATHE BOUCHA-ROBERTS, Director, Alaska Telemedicine Project, Anchorage Providence Hospital, testified next via teleconference from an offnet site. The AMA put forward some "point favors" in relationship to the quality and the conduct related to telemedicine and has not done anything about recognizing any particular project. She said the focus of the project has the equal participation of Native health organizations and private sector health care. The National Library of Medicine contract focuses on the Native health arena, but health care providing entities are equal partners. Number 0757 CHAIRMAN BUNDE commented that the only opposition he had ever heard regarded the fact that when people became sick, they were not automatically sent to Anchorage. Number 0781 MS. BOUCHA-ROBERTS added that testimony was given that patients didn't want to stay home, they wanted to shop at Nordstrom. Number 0812 REPRESENTATIVE TOM BRICE made a motion to move HCSSCR 6(HES) with accompanying zero fiscal note and individual recommendations. Hearing no objections HCSSCR 6(HES) was moved from the House Health, Education and Social Services Standing Committee. CHAIRMAN BUNDE announced an at ease would be taken at 3:55 p.m. to allow Representatives Porter and Green to join the committee. The committee reconvened at 4:30 p.m. [CHAIRMAN BUNDE indicated that SSHB 148 would be heard at a later date.] ADJOURNMENT There being no further business to conduct, CHAIRMAN BUNDE adjourned the meeting of the House Health, Education and Social Services Standing Committee at 4:30 p.m.