ALASKA STATE LEGISLATURE  HOUSE HEALTH, EDUCATION AND SOCIAL SERVICES STANDING COMMITTEE  Anchorage, Alaska November 8, 2006 4:18 p.m. MEMBERS PRESENT Representative Peggy Wilson, Chair Representative Sharon Cissna MEMBERS ABSENT  Representative Paul Seaton, Vice Chair Representative Tom Anderson Representative Carl Gatto Representative Vic Kohring Representative Berta Gardner COMMITTEE CALENDAR  OVERVIEW: USING ALASKA'S HEALTHCARE DOLLARS WISELY: REVIEW OF FINAL RECOMMENDATIONS - HEARD PREVIOUS COMMITTEE ACTION  No previous action to record WITNESS REGISTER STEPHANIE BIRCH, Chief Women & Children, and Family Health Division of Public Health Department of Health and Social Services (DHSS) Anchorage, Alaska POSITION STATEMENT: Presented information during the overview and responded to questions. JERRY FULLER, Project Director Office of Program Review Office of the Commissioner Department of Health and Social Services (DHSS) Juneau, Alaska POSITION STATEMENT: Provided comments during the overview. KARLEEN JACKSON, Commissioner Department of Health and Social Services (DHSS) Juneau, Alaska POSITION STATEMENT: Provided comments during the overview. ACTION NARRATIVE CHAIR PEGGY WILSON called the House Health, Education and Social Services Standing Committee meeting to order at 4:18:34 PM. Representatives Wilson and Cissna were present at the call to order. ^Overview: Using Alaska's Healthcare Dollars Wisely: Review of Final Recommendations 4:20:34 PM CHAIR WILSON [announced that the only order of business would be a review of the final recommendations regarding using Alaska's healthcare dollars wisely]. The committee took an at-ease from 4:21 p.m. to 4:24 p.m. CHAIR WILSON recapped the process that the committee has engaged in thus far with regard to discussing the topic of using Alaska's healthcare dollars wisely, and highlighted the issues of changing demographics, budget concerns, sustainable programs, and working together on common goals. She indicated that the House Health, Education and Social Services Standing Committee would be forwarding its eight recommendations on to the new legislature and the new administration. REPRESENTATIVE CISSNA spoke of her concern regarding preparing Alaska for an uncertain future, particularly with regard to funding efforts, and acknowledged the difficulty of getting the public involved in becoming partners [with the state] in making the tough decisions. She noted that many agencies and entities now use teleconference and videoconference technology, posited that the use of such technology by the legislature could really be helpful in bringing people from all over Alaska into the discussion, and suggested inserting another recommendation after recommendation (4) that would read [original punctuation provided]: The process for health care system improvement must include public comment and collaboration as an important element at all layers of health policy development and implementation. Expand the legislature's use of communication technology to economically bring people throughout the state face- to-face with legislative health committees and policy makers. CHAIR WILSON observed that the recently approved ballot measure that [statutorily] reduces the legislative session to 90 days will have an impact on the amount of time available for public participation in legislative matters. REPRESENTATIVE CISSNA remarked that the legislature could hold more interim meetings, at which videoconferencing technology could be used. CHAIR WILSON surmised that Representative Cissna's additional recommendation would be inserted after recommendation (4) and then the remaining recommendations would be renumbered. 4:34:56 PM STEPHANIE BIRCH, Chief, Women & Children, and Family Health, Division of Public Health, Department of Health and Social Services (DHSS), relayed that she has updated the list of Alaska State health plans and special reports; spoke of the Early Childhood Comprehensive Care Systems (ECCS) Grant, information about which can be found on the Office of Children's Services (OCS) web site; noted the impact pre-conception and prenatal care for the mother can have on efforts to have healthy babies and stimulate early child brain development; and suggested that language regarding such care be added to recommendation (4). CHAIR WILSON expressed a willingness to add concepts that would improve the recommendations. She noted that Representative Seaton had suggested the use of a pilot project that would distribute vitamins, especially those containing folic acid, to young women; characterized that as an excellent recommendation; and offered her observation that the number of personal care attendants (PCAs) has "mushroomed over night from 8 million to 80 million." 4:42:23 PM JERRY FULLER, Project Director, Office of Program Review, Office of the Commissioner, Department of Health and Social Services (DHSS), after relaying that he is the Medicaid director, suggested that an epidemiologist should called upon to assist in any vitamin distribution pilot project so as to ensure that the sample size of the project is sufficient to arrive at valid and applicable results. REPRESENTATIVE CISSNA pointed out that recommendations (6) and (7) speak to the issue of having the studies be scientific in nature so as to facilitate the instituting of proper courses of action by policymakers. MR. FULLER, on the issues of health savings accounts and consumer directed healthcare, said his information indicates that there is a certain segment of the population for which such things make quite good sense and provide a good way for relatively healthy, relatively wealthy folks to save money. Furthermore, health savings accounts have been incorporated into the Florida Medicaid demonstration waiver, though any conclusions about how applicable health savings accounts and high-deductible insurance plans are to other populations - those less healthy and definitely poor - aren't available yet, and so it may be premature to jump completely into such programs. Referring to PCAs, he asked the committee to keep in mind that it takes a significant amount of oversight to keep things on track, and so additional resources may be necessary in order to ensure that the "truly needy" get the services they need. 4:48:57 PM KARLEEN JACKSON, Commissioner, Department of Health and Social Services (DHSS), extended her thanks to everyone who'd been involved in the process of compiling the committee's recommendations. CHAIR WILSON said she would like to have the aforementioned suggestions incorporated into the recommendations. The committee took an at-ease from 4:50 p.m. to 4:55 p.m. CHAIR WILSON said she would seek committee members' consensus on adding the aforementioned suggestions to the recommendations; after those suggestions are incorporated, the recommendations will be sent to both the incoming and outgoing administrations, perhaps individual legislators, and the appropriate legislative committees. REPRESENTATIVE CISSNA suggested that the House Health, Education and Social Services Standing Committee also host an informational meeting for all legislators - both returning and new - specifically outlining the information gleaned from these interim meetings, and the resultant recommendations, perhaps even making use of the legislature's existing videoconferencing equipment to do so. COMMISSIONER JACKSON noted that it would be helpful for the committee to specifically ask the commissioner of the DHSS - whether that is her or a new appointee - to conduct such briefings for new [and returning] legislators, adding that those briefings could be tailored to fit specific needs. CHAIR WILSON thanked everyone who'd been involved in the process, and said she would try to have the recommendations concurred upon, finalized, and distributed by December 1, 2006. MS. BIRCH suggested that that information also be forwarded to the organizations that sponsored the first meeting of the House Health, Education and Social Services Standing Committee on the issue of using Alaska's healthcare dollars wisely. ADJOURNMENT  5:04:24 PM There being no further business before the committee, the House Health, Education and Social Services Standing Committee meeting was adjourned at 5:04 p.m.