ALASKA STATE LEGISLATURE  HOUSE HEALTH AND SOCIAL SERVICES STANDING COMMITTEE  March 7, 2023 3:03 p.m. MEMBERS PRESENT Representative Mike Prax, Chair Representative Justin Ruffridge, Vice Chair Representative CJ McCormick Representative Jesse Sumner Representative Zack Fields Representative Genevieve Mina MEMBERS ABSENT  Representative Dan Saddler COMMITTEE CALENDAR  HOUSE BILL NO. 17 "An Act relating to insurance coverage for contraceptives and related services; relating to medical assistance coverage for contraceptives and related services; and providing for an effective date." - MOVED CSHB 17(HSS) OUT OF COMMITTEE HOUSE BILL NO. 58 "An Act relating to medical assistance for recipients of Medicaid waivers; establishing an adult care home license and procedures; providing for the transition of individuals from foster care to adult home care settings; and providing for an effective date." - MOVED HB 58 OUT OF COMMITTEE HOUSE BILL NO. 59 "An Act relating to Medicaid eligibility; expanding eligibility for postpartum mothers; conditioning the expansion of eligibility on approval by the United States Department of Health and Human Services; and providing for an effective date." - MOVED HB 59 OUT OF COMMITTEE HOUSE BILL NO. 60 "An Act relating to the licensing of runaway shelters; relating to advisors to the board of trustees of the Alaska Mental Health Trust Authority; relating to the sharing of confidential health information between the Department of Health and the Department of Family and Community Services; relating to the duties of the Department of Health and the Department of Family and Community Services; and providing for an effective date." - HEARD & HELD PREVIOUS COMMITTEE ACTION  BILL: HB 17 SHORT TITLE: CONTRACEPTIVES COVERAGE:INSURE;MED ASSIST SPONSOR(s): REPRESENTATIVE(s) CARRICK 01/19/23 (H) PREFILE RELEASED 1/9/23 01/19/23 (H) READ THE FIRST TIME - REFERRALS 01/19/23 (H) HSS, CRA, L&C, FIN 02/07/23 (H) HSS AT 3:00 PM DAVIS 106 02/07/23 (H) Heard & Held 02/07/23 (H) MINUTE(HSS) 02/18/23 (H) HSS AT 3:00 PM DAVIS 106 02/18/23 (H) -- MEETING CANCELED -- 03/02/23 (H) HSS AT 3:00 PM DAVIS 106 03/02/23 (H) Moved CSHB 17(HSS) Out of Committee 03/02/23 (H) MINUTE(HSS) 03/07/23 (H) HSS AT 3:00 PM DAVIS 106 BILL: HB 58 SHORT TITLE: ADULT HOME CARE; MED ASSISTANCE SPONSOR(s): RULES BY REQUEST OF THE GOVERNOR 02/03/23 (H) READ THE FIRST TIME - REFERRALS 02/03/23 (H) HSS, L&C, FIN 02/07/23 (H) HSS AT 3:00 PM DAVIS 106 02/07/23 (H) Heard & Held 02/07/23 (H) MINUTE(HSS) 03/07/23 (H) HSS AT 3:00 PM DAVIS 106 BILL: HB 59 SHORT TITLE: MEDICAID ELIGIBILITY: POSTPARTUM MOTHERS SPONSOR(s): RULES BY REQUEST OF THE GOVERNOR 02/03/23 (H) READ THE FIRST TIME - REFERRALS 02/03/23 (H) HSS, FIN 02/21/23 (H) HSS AT 3:00 PM DAVIS 106 02/21/23 (H) Heard & Held 02/21/23 (H) MINUTE(HSS) 03/07/23 (H) HSS AT 3:00 PM DAVIS 106 BILL: HB 60 SHORT TITLE: RUNAWAYS; DFCS/DOH: DUTIES/LICENSING/INFO SPONSOR(s): RULES BY REQUEST OF THE GOVERNOR 02/03/23 (H) READ THE FIRST TIME - REFERRALS 02/03/23 (H) HSS, FIN 02/28/23 (H) HSS AT 3:00 PM DAVIS 106 02/28/23 (H) Heard & Held 02/28/23 (H) MINUTE(HSS) 03/07/23 (H) HSS AT 3:00 PM DAVIS 106 WITNESS REGISTER STEPHANIE WHEELER, Ombudsman Alaska State Long Term Care Ombudsman program Anchorage, Alaska POSITION STATEMENT: Provided testimony in support of HB 58. PATRICK REINHART, Executive Director Governor's Council on Disability and Special Education Homer, Alaska POSITION STATEMENT: Provided testimony in support of HB 58. MARGE STONEKING, Advocacy Director AARP Alaska Anchorage, Alaska POSITION STATEMENT: Provided testimony in support of HB 58. KIM CHAMPNEY, Executive Director Alaska Association on Developmental Disabilities Juneau, Alaska POSITION STATEMENT: Provided testimony in support of HB 58 BROOKE IVY, Vice President of Policy and Advocacy Alaska Children's Trust Anchorage, Alaska POSITION STATEMENT: Provided testimony in support of HB 59. JAMIE MORGAN, Senior Government Relations Regional Lead American Heart Association Sacramento, California POSITION STATEMENT: Provided testimony in support of HB 59. ACTION NARRATIVE 3:03:51 PM CHAIR MIKE PRAX called the House Health and Social Services Standing Committee meeting to order at 3:03 p.m. Representatives Ruffridge, McCormick, Sumner, Mina, and Prax were present at the call to order. Representative Fields arrived as the meeting was in progress. HB 17-CONTRACEPTIVES COVERAGE:INSURE;MED ASSIST  3:05:09 PM CHAIR PRAX announced that the first order of business would be HOUSE BILL NO. 17, "An Act relating to insurance coverage for contraceptives and related services; relating to medical assistance coverage for contraceptives and related services; and providing for an effective date." 3:06:20 PM REPRESENTATIVE RUFFRIDGE moved to report CSHB 17(HSS) out of committee with individual recommendations and the accompanying three zero fiscal notes that were not attached when the committee moved the bill out on 3/2/23. There being no objection, CSHB 17(HSS) was reported from the House Health and Social Services Standing Committee. HB 58-ADULT HOME CARE; MED ASSISTANCE  3:06:45 PM CHAIR PRAX announced that the next order of business would be HOUSE BILL NO. 58, "An Act relating to medical assistance for recipients of Medicaid waivers; establishing an adult care home license and procedures; providing for the transition of individuals from foster care to adult home care settings; and providing for an effective date." 3:07:12 PM CHAIR PRAX opened public testimony on HB 58. 3:07:57 PM STEPHANIE WHEELER, Ombudsman, Alaska State Long Term Care Ombudsman program, said the Alaska State Long Term Care Ombudsman program was in support of HB 58 as the bill aligned with its mission to protect the rights, health, safety, and welfare of Alaskans living in long-term care facilities. She highlighted many elders wished to live in facilities close to family or the place where they were born. She stated Alaska had the fewest options for assisted living homes despite its size, and that HB 58 would help provide more options for elders. 3:10:19 PM PATRICK REINHART, Executive Director, Governor's Council on Disability and Special Education, stated the Governor's Council could provide its position paper in support of HB 58 to the committee. He said HB 58 could provide more tools for young people who were in therapeutic foster care that grew out of foster care homes. 3:11:53 PM MARGE STONEKING, Advocacy Director, AARP Alaska, stated that AARP supported HB 58, expansions, and improvements to home and community based waiver programs. She said most elders desired to remain in their own homes and communities as they age, and that community based services were significantly less expensive than nursing home care. She added that Alaska had a shortage of home care workers which threatened access to home care-based services, and that nursing homes and institutional care housing increased the cost of Medicaid. She said that HB 58 would reduce administrative burden and offer elders more home-like settings. 3:14:35 PM KIM CHAMPNEY, Executive Director, Alaska Association on Developmental Disabilities, stated that the Alaska Association on Developmental Disabilities (AADD) had 81 members that provided services from Utqiagvik to Metlakatla, and was a member of the Key Coalition of Alaska. She highlighted the struggle Alaska had faced with workforce shortages disproportionately affecting those with disabilities, and that HB 58 would provide another opportunity for care to be provided from neighbors or family members that may not typically work at a provider organization. MS. CHAMPNEY provided a story about a mother with a disability who had two children with disabilities and could not provide care for them. She described that an uncle had taken care of the children and raised them under a Medicaid waiver, but as the children had aged out he struggled to make his home into an assisted living home. She stated that if the uncle had not been able to jump through hoops, the two children would have taken up spots in a group facility that could have been used by others. She emphasized that adding flexibility to home-based care would help address the shortages Alaska had faced. 3:17:45 PM CHAIR PRAX, after ascertaining there was no one else who wished to testify, closed public testimony on HB 58. 3:19:12 PM REPRESENTATIVE RUFFRIDGE moved to report HB 58 out of committee with individual recommendations and the accompanying zero fiscal notes. There being no objection, HB 58 was reported from the House Health and Social Services Standing Committee. 3:19:36 PM The committee took an at-ease from 3:19 p.m. to 3:22 p.m. HB 59-MEDICAID ELIGIBILITY: POSTPARTUM MOTHERS  3:22:00 PM CHAIR PRAX announced that the next order of business would be HOUSE BILL NO. 59, "An Act relating to Medicaid eligibility; expanding eligibility for postpartum mothers; conditioning the expansion of eligibility on approval by the United States Department of Health and Human Services; and providing for an effective date." 3:22:43 PM CHAIR PRAX opened public testimony on HB 59. 3:23:31 PM BROOKE IVY, Vice President of Policy and Advocacy, Alaska Children's Trust, said the Alaska Children's Trust was the lead agency on preventing child abuse and neglect. She emphasized that extending postpartum Medicaid care was primary prevention and would give mothers more time to address postpartum medical issues. She stated that 41 percent of all substantiated child abuse and neglect cases in Alaska took place when children were age birth to four. She added that postpartum depression decreased child safety practice, decreased health check-ups for the child, and made bonding more difficult, and that extending postpartum coverage would also reduce maternal death and decrease medical debt. 3:25:53 PM JAMIE MORGAN, Senior Government Relations Regional Lead, American Heart Association, stated the global maternal mortality rate was decreasing, while the U.S. maternal mortality rate was increasing. She added that heart disease and stroke constituted more than one in three pregnancy related deaths primarily due to cardiomyopathy, cerebrovascular disease, or other cardiovascular conditions. She emphasized the death of a mother impacts the child, the family, and the community, and that maternal morbidity had lasting health consequences and medical expenses. MS. MORGAN said the American Heart Association had released a policy statement, Call to Action: Maternal Health and Saving Mothers, in the journal, Circulation, which had the key recommendation to extend Medicaid postpartum coverage. She stated that the American Heart Association was in support of HB 59 to give children the best start in life and address disparities. 3:28:07 PM CHAIR PRAX, after ascertaining that no one wished to testify, closed public testimony on HB 59. 3:29:18 PM REPRESENTATIVE RUFFRIDGE moved to report HB 58 out of committee with individual recommendations and the accompanying fiscal notes. There being no objection, HB 58 was reported from the House Health and Social Services Standing Committee. 3:29:45 PM The committee took an at-ease from 3:29 p.m. to 3:31 p.m. HB 60-RUNAWAYS; DFCS/DOH: DUTIES/LICENSING/INFO  3:31:45 PM CHAIR PRAX announced that the final order of business would be HOUSE BILL NO. 60, "An Act relating to the licensing of runaway shelters; relating to advisors to the board of trustees of the Alaska Mental Health Trust Authority; relating to the sharing of confidential health information between the Department of Health and the Department of Family and Community Services; relating to the duties of the Department of Health and the Department of Family and Community Services; and providing for an effective date." 3:32:03 PM CHAIR PRAX opened public testimony on HB 60. After ascertaining that there was no one who wished to testify, he closed public testimony. 3:32:57 PM CHAIR PRAX announced that HB 60 was held over. 3:33:12 PM ADJOURNMENT  There being no further business before the committee, the House Health and Social Services Standing Committee meeting was adjourned at 3:33 p.m.