Alaska Health Policy Review  comprehensive, authoritative, nonpartisan
February 22, 2008  Vol 2 Issue 7
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SB 160 Mandatory Universal Health Care Hearing Summary
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From the Editor  

Dear Reader:

In this issue of the Review we present a summary of the Senate HESS Committee third hearing on Senate Bill 160 Mandatory Universal Health Care, which was conducted February 18, 2008. The discussion is far from boring.  Learn why the individual mandate provision may mean that some Alaskan university students will have to pay out-of-state tuition. Senator Dyson admits to "demagoging," and an ammendment was added to the bill that expands the scope of the proposed Alaska Health Care Board.

The Alaska Health Policy Calendar is moving briskly with hearings on drug bills, mental health, air safety, and more. Note that we do our best to make this calendar current as of 5pm thursday evening, but events change rapidly and on a continuing basis, so check the link we provide for additional changes.

Our Bills on the Move section is longer than it has been at any time during this session. There is tremendous activity during this part of the session with lots of bills moving in and out of committees.  Drugs, nursing mothers, brain injuries, behavioral health, abortions, and aging, to name a few, are some of the categories of bills on the move.  

Your comments are always invited.  Please send them directly to me at [email protected], or call my cell, 907.240.4141.  Thanks so much for your support.

Lawrence D. Weiss
Editor
SB 160 Mandatory Universal Health Care Hearing Summary

Introduction

The Senate Health, Education, and Social Services Committee held its third hearing on Senate Bill 160 Mandatory Universal Health Care on February 18, 2008. SB 160, sponsored by Senators French, Ellis, and Wielechowski, would establish a mandate for all Alaskans to purchase a health insurance policy. To facilitate that mandate, the bill would establish the Alaska Health Care Board which would perform two functions: it would oversee a fund designed to provide sliding-scale vouchers to Alaskans who need help purchasing a policy; and it would certify health care plans to ensure they provide adequate coverage to the policy holder.

The hearing was open for public testimony. Presiding over the hearing was Senate HESS chair Senator Davis. Also present were Senators Dyson, Elton, and Thomas, with Senator Cowdery online.

Senator French, bill sponsor

Senator French explained the purpose of SB 160 and gave an overview of the bill. He explained that the voucher system would help individuals purchase one of several plans. Most people who would need the voucher, he said, would have incomes that fall between 100 and 300 percent of the Federal Poverty Line (FPL), and thus a sliding scale voucher system would best address the needs of the people. Senator French added that this wouldn't affect anyone who already has coverage, and that it is only for people who don't get it through their jobs or a government program. He stressed that the bill was not government run health care.

Senator French cleared up several misunderstandings about the bill that had been brought to his attention. He addressed the concerns raised by a small business owner over the employer levee. The employer has five employees and wants to provide coverage, but felt the levee would unfairly harm his business.

"The bill says that if you have zero to ten employees, there's no (employer) levee whatsoever. So this bill would help his employees at absolutely no cost to that business owner. If you have between 10 and 20 employees--which is now getting up into the upper ranges of a small business--the levee is one percent of your gross payroll. If you have 20 or more employees, the levee is two percent. However, there are ways to get around those fairly light levees. One, if you offer to pay 33% of the premium costs of a health insurance plan, there's no levee. If you enroll 25% of your employees in an employer-sponsored plan, there's no levee. Finally, if you set up a so-called 'section 125 plan,' which is a plan that the federal government has made available to small businesses--that plan allows employees to purchase health care coverage with pre-federal tax dollars--then you're exempt from the levee."

He also noted what the bill won't do. It won't address Medicare, and it won't address reimbursement rates, which are set by the federal government. Again, Senator French reiterated that SB 160 is not proposing a government-run program.

"What the bill will do is reduce the unspoken financial penalty on individuals and businesses who currently buy coverage. It will reduce the penalty that they pay to cover the people who opt out or cannot afford health care coverage." Hospitals are required by federal law to give medical attention to everyone who needs emergency care. If a patient cannot pay, those who can pay pick up the costs. Federal law also prevents this cost shifting from being borne by government programs--like Medicaid.

Acknowledging that SB 160 is a "work in progress," Senator French offered an amendment that would ensure that Medicaid continued to have a role in health reform efforts. The amendment would also charge the Health Care Board to offer recommendations on possible expansions to Medicaid, and take into account the fiscal impact of those changes.

Carly Sims

Sims raised three major concerns about the bill: 1) the cost to the individual; 2) penalties that were addressed in the last hearing, including a "no insurance, no state college" prohibition and problems getting coverage with a pre-existing condition; and 3) the lack of clarity about how the Health Care Board would interact with a second board, the state's licensing board that operates out of the Economic Development Department.

Senator French's legislative aide, Andy Modorow, answered Sims's questions. "One issue that was brought up is 'guarantee issue,' and I think that is the term that would be used to describe what she was speaking about. The bill does require that an insurance company issue a policy to an individual who is within the Alaska Health Care Program, which is basically the shorthand term for this whole bill. Alaska Small Group Market--if you have a group between two and fifty--currently has such a law. And it's one of the things that some of the responsibility clauses in the bill provide for, because it reduces the moral hazard that would come about without having coverage required by everyone."

Modorow addressed the concern about the college/insurance relationship, and said, when the issue was brought up previously, it was with regards to in-state tuition, not access to the university. He also said that the current version of the bill addresses concerns brought up by people who only qualify for CHIA (Comprehensive Health Insurance Association, Alaska's high-risk pool). The bill provides vouchers for up to 450 percent FPL for individuals who cannot get individual access, and that while the guarantee issue clause does overlap with this, it provides a safety net while SB 160 is being implemented.

Patricia Senner, Alaska Nurses Association

Senner brought up two sides to the same problem: in the past, she personally has had to advise patients to do what's necessary to stay on Medicaid, rather than risk losing coverage entirely because of pre-existing conditions; and that many nurses work in hospitals where it is evident that fewer and fewer patients have health insurance coverage, while many of the traditional sources of income for hospitals are being siphoned off by private imaging and surgical centers.

"It is difficult for us to analyze whether the model outlined in Senate Bill 160 is financially viable," Senner said. "However, we are convinced that the solution to getting affordable health care for Alaskans is to have the cost for that insurance being split between the individual, the state, and the employer, and Senate Bill 160 employs this model. We do think that it is time that some responsibility [is] placed on the individual for ensuring that health care services are available in Alaska. If Alaskans want a hospital to be available when they need it, then they should be willing to help pay for them to be able to keep their doors open."

Lawrence Weiss, executive director of the Alaska Center for Public Policy

Weiss expressed "some serious concerns" about the structure of SB 160. "I'm concerned that Senate Bill 160 was not selected after careful and objective comparison to several other possible health reform plans," Weiss said.

He said that California had considered health care reform several years ago, and offered a brief history of how that debate was structured. There, state policy analysts invited nine different organizations to submit comprehensive proposals. At one end of the spectrum were proposals that recommended minor changes, and at the other end was a proposal that would create the California Health Service Health Plan, which would make all health care facilities publicly-owned. All nine plans were submitted to the east coast consulting firm, The Lewin Group, who provided detailed reports on the cost and coverage implications of each proposal. These proposals were sent to a second consulting firm, AZA Consulting, who did a qualitative analysis of the reform options, looking at things such as access, continuity of care, and quality of care. "I bring it up because now anyone who is in the state of California when some particular proposal is brought up has the ability to say, 'Well, some other proposal was better,' or 'some other proposal is worse,' or whatever, because it was done in a systematic fashion."

Weiss was also concerned about the over-reliance of the entire plan on private health insurance. "That means, because it is private health insurance, it's going to be a very expensive overhead for the state that is unnecessary and doesn't occur in other approaches. There are going to be very expensive deductibles and co-payments for patients, and the research shows that these will prevent people from using the insurance they have."

He was also concerned that the private health insurance market in Alaska is a highly concentrated one, "Where only one insurer controls something like 60 percent of all private health insurance in the state. I really don't think there's a competitive market here, and I really don't think that whatever advantages that's supposed to bring to the plan is actually going to happen."

The lack of built-in provisions for quality of care was another concern, as was the requirement of individual mandates. "I'm very concerned about this whole notion of individual mandates. It's a punitive approach that appears to be stumbling quite a bit in Massachusetts, and really is simply unnecessary with other plans."

Weiss suggested another approach that he hoped would be part of a more systematic comparative analysis. "This approach would take a look at the expansion of programs that we already have and that we know work, that we know are cost-effective, and that have quality-of-care elements built in already. I did hear that there was an amendment about Medicaid. I was very happy to hear that. I would say we should look towards expanding Medicaid to the maximum extent possible to serve Alaskans. A Medicaid insurance policy is much less expensive for the state than a comparable private health insurance policy. It costs the recipients nothing, co-pays and deductibles are minimal or non-existent, and the federal government pays at least half of all the state's Medicaid costs."

He also recommended looking at expanding Denali KidCare to the maximum extent possible to serve as many uninsured Alaska children as possible. "This has all the benefits of expanding Medicaid as noted above, but in addition, recruitment for Denali KidCare was seriously hampered under the Murkowski administration by the firing of all five state recruiters for the program. We know right now there are about 10,000 children--that's 10% of the uninsured population in this state who qualify for Denali KidCare but remain uninsured because they are not in the program. A very simple solution [is] to hire back the recruiters. And that's a very inexpensive solution, by the way.

"And finally," Weiss finished, "develop a comprehensive package of funding for the 125 or 130 community health clinics scattered across Alaska, to enable these nonprofits ... to recruit and retain staff, and to directly serve those who need health care." This not only eliminates the administrative costs that accompany private health insurance, but also directly provides medical care to those in need of it. "This approach--expanding the community health centers--would address the Medicare problem in this state because Medicare patients are accepted at every one of those 125 or 130 clinics across the state. So expanding them would help to address that problem, too."

Senator Davis noted that Medicaid and Denali KidCare are issues that can be addressed before SB 160 is even passed, and that once people get insurance, they need quality of care and access. She said that while examining Medicaid, Medicare, and Denali KidCare are important, it does not need to be done within the context of the bill.

Mark Vinsel, executive director of United Fishermen of Alaska (UFA)

Vinsel said that UFA didn't have a position on the bill, but wanted to enter into the record a paper the UFA wrote last summer on the challenges and opportunities facing commercial fishermen in Alaska on access to health care and access to insurance.

"We think commercial fishermen up here, especially in Alaska, pretty much fall through the cracks to an extent that we don't see in any other demographic or occupation that we might compare ourselves to. I think the problems are well understood, and for commercial fishermen, there's definitely a higher percentage of us that live in rural areas that are less likely to be served by a hospital or a road system that provides an ability to get to health care facilities. And then being largely self-employed with variable and seasonal income, opportunities for affordable health insurance are also very difficult to come by for commercial fishermen."

He finished, "In general, while we don't have a position on the bill, it is clear that this is a problem that needs to be addressed, both for access to health care, which is not a subject for the bill, but access to health insurance could go a long way in helping the problems of all rural Alaskans."

William Streur, deputy commissioner for Medicaid and Health Care Policy, Department of Health and Social Services

Streur spoke on behalf of DHSS, which supports the bill and the intent to make affordable health care for all Alaskans possible. "This is good legislation taking on the significant challenge of providing care to medically needy Alaskans. It will open doors to health care that have been closed, and we applaud the effort."

He continued, "This legislation is a great first step, but we must not lose sight that opening doors is but part of the equation. We must work concurrently to ensure that there are providers that are willing to accept those seeking services. As Senator French has brought up, health insurance alone does not guarantee that those seeking services will receive it if there are no providers. From the department's perspective, we believe that this bill is primarily an access and insurance issue, and as such, is not best placed under the sole management and implementation of HSS. "We're dealing with issues of eligibility, we're dealing with issues of provider systems, rates, premiums: stuff that Medicaid is not familiar with.

"This is a new paradigm for the state of Alaska," he finished, "and no one department may be currently equipped to address this legislation. It's not to say it shouldn't be addressed; it merely says we will need to figure out a way to address the issues of this undertaking."

Senator Dyson asked for clarification on whether it was the administration's position that they agree with the provision that everyone must have health insurance. Streur answered that the department hadn't yet taken a position on that.

"This bill, as I read it," Senator Dyson responded, "says it requires that everyone have health insurance so that there would be no self-payers left in the state, and a multimillionaire who chose to take good care of his health and pay his own bills would not be allowed to do that. It's your position that that's what we should do?"

Streur repeated that the department had not taken a position on that issue, to which Senator Dyson replied, "But you personally are very much in favor of this bill?" At Streur's affirmative response, Senator Dyson continued his line of questioning.

"And you would be in favor, then, of forcing an insurance company to take any citizen, including one who is being very reckless with their health--swapping body fluids or weighing 800 pounds or all kinds of toxic things--that the insurance company would have to take that person, even though their behavior was destructive and they were unrepentant." Senator Dyson pressed to work out whether Streur was personally in favor of the individual mandate.

"If you're talking about destructive behavior," Streur replied, "a lot of that is not covered, Sir."

"It's not covered under this bill?" Senator Dyson asked.

"I'm afraid I would have to defer to the sponsor on that, Sir," Streur answered.

Senator Elton noted that it might be helpful to know who was paying for the health consequences of the behavior cited by Senator Dyson. "My impression is that much of those health care costs are being borne by you and I and many other people. In my community, we have a taxpayer-supported hospital. I think to put it in perspective, the questions that were asked by the previous member of the committee, it would be helpful, maybe, just to talk briefly about who's paying for the health care consequences of that kind of behavior now."

"We are all paying for that right now," Streur said. "Ultimately--I believe it was mentioned that Providence Hospital in write-offs--a lot of that is directly attributable [to] that. We're paying it."

The Senators

Senator Dyson followed up on the conversation with the final speaker. "So what we're doing here is, instead of all of us paying through cost-shifting and various other sorts of things, we're going to force an individual insurance company to take anyone who applies, even with pre-existing conditions and destructive behavior? And even though we are all arguably paying now, it's still a paradigm shift to go out there and force somebody in private enterprise to assume this burden. I think that's worth noting."

Senator Davis added that the public is already paying for a lot of the people Senator Dyson was talking about who would be forced to get insurance. "But in the mean time, we have other responsibilities to those people," she said. "It's to provide the services that they need. And those people that already have insurance, that can pay their own way, that bill won't touch them at all. But the poor, we're going to have to take care of them anyway. It's going to come from Medicaid or Medicare, or whatever subsidies we put into it." She noted that the bill did say that insurance companies would have to take people even with pre-existing conditions.

Senator French told the committee that the issue of individual mandates was one that was currently playing out on the national level, as the two Democratic candidates for president differed on that very issue in their health care proposals.

"My belief is that the mandatory requirement has the better of the argument," Senator French said, "that you can't get universal health care by letting healthy adults out of the insurance net. Insurance works best when everybody participates. That's the basic idea behind insurance. Every human being has a human body, and they're going to need a doctor sooner or later. If they don't have insurance, they're essentially saying, 'You pay for it when I get sick. You pay for it when I have a snow machine accident, when I have a car accident, when I get Hodgkin's Lymphoma. You pay for it because, hey, there's a hospital out there and someone will pick up the tab.'" He added that there is a way to set a policy for young adults who don't want to pay into the system, and make it in tune with their needs.

Senator Dyson returned to his earlier argument about the wealthy person who can pay for their own health care and wants to, but isn't allowed to under SB 160. Senator French said he would be "happy to write an amendment that excuses the half-a-dozen multimillionaires in the state of Alaska who currently don't have insurance, if they're willing to post a bond sufficient to cover their health insurance when they arise, or upon the posting of some financial net worth to satisfy the Health Care Board."

"I suspect both of us are guilty of demagoguing the issue," Senator Dyson replied. "But to me, this is an absolute personal liberties issue, that we would force everybody in the state, because we're worried that this multimillionaire might run out of his wealth and not be able to pay his own bills." He also asked again about insurance companies not being able to opt out of covering people with bad behaviors.

Senator French agreed that a healthy lifestyle should be rewarded somehow, but said, "at some level you've got to let every single person into the boat."

Senator Elton drew a comparison to mandatory auto insurance. "It's not been an issue in which anybody has ever come up to me and said 'I think we made a mistake.' Have you thought of the provisions in your bill in the terms of what we now do with auto insurance?"

Senator French agreed that the "parallels are fairly profound," and said that he thought a few states might allow a person to post a bond and say they have enough ready cash to cover accident expenses. "You can do the same thing for your health insurance bills." He said that it was "conceivable to write an exception in there, and I would leave that to any senator interested to draft such an amendment."

Senator Dyson disagreed with the auto insurance comparison, stating that auto insurance is liability against harming others. "You don't have to have auto insurance unless you're driving on the public roads." He added, "I think there's a magnitude of difference when you're covering liability and harm you do to others, as opposed to the damage you're doing to yourself. And ultimately, we've got to have a system that rewards individual responsibility and there's a downside to irresponsible behavior."

Senator Thomas asked about Senator French's seeming reluctance to offer an amendment to excuse people with "substantial incomes, something less than millionaires that might allow them access to the plan." He wanted to clarify whether there was anything in the bill that allowed such people to pay their own premiums.

"Let's say a millionaire who doesn't have insurance. What does that person do the day after this bill becomes law?" Senator French answered. "That person should get a 15% reduction in the cost of the insurance policy that the bill would require him or her to go out and purchase. They wouldn't get a voucher because they're over 300% of the federal poverty line," but if they decide to go through the Alaska Health Care Clearinghouse, they should get a cheaper policy after the bill becomes law, because "everyone now has a policy and suddenly more people are paying into the system."

Senator Elton questioned if the Alaska Health Care Board would have the power to approve some plans but not others based on deductibles or services covered. Senator French said that the board would act as gatekeepers and make sure that all Alaskans get meaningful coverage.

Senator Elton also asked, "What happens if no private insurer wants to participate." Senator French said that he assumed that someone else would move into that market because there is a health care fund that's helping to buy the insurance policies. He envisioned a medical insurance plan similar to what state employees get.

The hearing was nearing its close, and Senator Davis asked to take up the proposed amendment to SB 160.

Senator French explained the amendment. "Let's have the Health Care Board, as part of its job, look into the potential expansion of the Alaska Medicaid program, including a comparison of the costs of the Medicaid program as it exists, and the cost of providing benefits through this bill. So if they see a huge imbalance, then they'll push towards Medicaid. If Medicaid starts to blow apart and doesn't get funded, then they'll push folks back towards this model. But [the amendment seeks] to maintain that safety valve and that gateway to Medicaid."

Senator Elton moved for unanimous consent to consider the amendment, which passed.

During discussion on the amendment, Senator Dyson spoke to the problem of Medicaid reimbursement rates. He noted that many providers say that Medicaid reimbursement rates are lower than the cost to provide the services. Senator Dyson offered this as a reason indigent people might have difficulty finding a provider. "Would it be possible for us to reimburse that provider the delta between what the Medicaid rate is and what their actual costs are?"

Senator French deferred to his legislative aide, Modorow, who in turn said that Medicaid was probably something better suited to someone else for an in-depth answer.

Senator Davis interrupted and explained to the committee that they were over time, but said that the representatives from DHSS might be able to answer. Senator Dyson said he was willing to let his question go.

Senator Elton made a motion to move the bill as amended to the Senate Finance Committee. The role call yielded Senators Elton, Thomas, and Davis voting 'yes' on the motion, and Senator Dyson voting 'no.'

The motion carried, and Senator Davis said the bill and amendment would be moved to Finance [after Labor and Commerce]. The meeting was then adjourned. 
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Alaska Health Policy Calendar
This calendar of health policy-related legislative meetings is current as of February 21, 2008 at 5 PM. Please visit the Alaska State Legislature's list of committee hearings for the most current listings, as they are subject to change.

February 22, 2008, 9 AM
What: Senate Finance Committee
Where: Senate Finance 532, Juneau
Other information: SB 249 Capstone Avionics Fund/Loans; teleconferenced

February 22, 2008, 1 PM
What: House Judiciary Committee
Where: Capitol 120, Juneau
Other information: HB 316 Prescription Database; SB 196 Prescription Database; teleconferenced

February 22, 2008, 1:30 PM
What: Senate Health Education and Social Services Committee
Where: Butrovitch 205, Juneau
Other information: bills previously heard/scheduled; teleconferenced

February 22, 2008, 4 PM
What: House Finance Committee
Where: House Finance 519, Juneau
Other information: HB 312 Approp: Mental Health Budget; public testimony, limit 2 minutes each; will continue February 23 at 10 AM; teleconferenced

February 23, 2008, 9 AM
What: House Health Education and Social Services Committee
Where: Capitol 106, Juneau
Other information: HB 337 Health Care: Plan/Commission/Facilities; HB 345 Medical Facility Certificate of Need; bills previously heard/scheduled; teleconferenced

February 23, 2008, 10 PM
What: House Finance Committee
Where: House Finance 519, Juneau
Other information: HB 312 Approp: Mental Health Budget; public testimony, limit 2 minutes each: 10:00-11:30am - Kenai, Valdez, Ketchikan, Kodiak, Seward, Matsu, Glennallen, Tok; 11:45-1:00pm - Bethel, Kotzebue, Barrow, Nome, Delta Junction, Offnets; 2:00-3:15pm - Sitka, Wrangell, Petersburg Homer, Dillingham, Cordova; 3:30-5:00pm - Fairbanks; teleconferenced

February 25, 2008, 1 PM
What: House Judiciary Committee
Where: Capitol 120, Juneau
Other information: HB 400 Mitigating Factor: Care for Drug Overdose; teleconferenced

February 25, 2008, 1:30 PM
What: House Finance Committee
Where: House Finance 519, Juneau
Other information: HB 312 Approp: Mental Health Budget; public testimony, limit 2 minutes each: 1:30-3pm - Juneau; teleconferenced

February 26, 2008, 1 PM
What: House Military & Veterans' Affairs special committee
Where: Barnes 124, Juneau
Other information: SJR 11 Supporting US Veterans' Health Care; telelconferenced

February 28, 2008, 8 AM
What: Senate Health Education and Social Services Committee finance subcommittee
Where: Fahrenkamp 203, Juneau
Other information: Department budget - questions and answers; invitation-only testimony; teleconferenced

February 28, 2008, 1:30 PM
What: Senate Labor & Commerce Committee
Where: Beltz 211, Juneau
Other information: SB 113 Nursing Mothers in Workplace; SB 258 Paid Sick Leave; SB 160 Mandatory Universal Health Care; teleconferenced

February 29, 2008, 1 PM
What: House Judiciary Committee
Where: Capitol 120, Juneau
Other information: HB 364 "Notice & Consent for Minor's Abortion"; teleconferenced

March 5, 2008, 12 noon
What: House Joint Legislative Health Caucus
Where: Butrovich 205, Juneau
Other information: Maximizing Access; Measuring Success: Improving Health Indicators; teleconferenced

March 5, 2008, 12 noon
What: Senate Joint Legislative Health Caucus
Where: Butrovich 205, Juneau
Other information: Maximizing Access; Measuring Success: Improving Health Indicators; teleconferenced

March 6, 2008, 12:30 PM
What: Senate Health Education and Social Services Committee finance subcommittee
Where: Senate Finance 532, Capitol, Juneau
Other information: Department budget close-out; invitation-only testimony; teleconferenced

April 2, 2008, 12 noon
What: House Joint Legislative Health Caucus
Where: Butrovich 205, Juneau
Other information: High Quality, Low Cost; teleconference

April 2, 2008, 12 noon
What: Senate Joint Legislative Health Caucus
Where: Butrovich 205, Juneau
Other information: High Quality, Low Cost; teleconference
Bill Tracking: Bills on the Move

Bills on the Move


There was quite a bit of action on the health policy front this week, with several bills having been introduced this week. Multiple bills were heard in committee during the last few days, with even more bills scheduled for hearings in the upcoming days. Three bills were moved from one committee to the next, and one bill passed the Senate and was transmitted to the House.

HB 400 Mitigating Factors: Care for Drug Overdose was introduced on February 19, and is scheduled for a hearing in House Judiciary on February 25. HB 398 Medical Assistance for Infusion Services was introduced on February 19, and referred to House HES. HB 407 Health Reform Policy Commission was introduced and referred to House HES, where it is scheduled for a hearing on February 26.

HB 345 Medical Facility Certificate of Need is scheduled for hearings in House HES on February 23 and February 26. HB 304 Cancer Drug Repository is scheduled for a hearing in House HES on February 28. SB 181 Anatomical Gifts is scheduled to be heard in Senate State Affairs on February 26. SJR 11 Supporting US Veterans' Health Care is scheduled to be heard in House Military & Veterans' Affairs on February 26. HB 312 Approp: Mental Health Budget is scheduled to be heard in House Finance on February 22, 23, 25, 26, 27, and 28. HB 364 Notice & Consent for Minor's Abortion is scheduled to be heard in House Judiciary on February 28 and 29. SB 113 Nursing Mothers in Workplace is scheduled to be heard in Senate Labor & Commerce on February 28.

SB 170 Insurance Coverage for Well-Baby Exams was heard in Senate Finance on February 20. HB 337 Health Care: Plan/Commission/Facilities was heard in House HES on February 19, and is scheduled for more hearings on February 23 and 26. SCR 17 Brain Injury Awareness Month: March 2008 was heard in House HES on February 21.

SB 160 Mandatory Universal Health Care was moved out of Senate HES and into Labor & Commerce, where it is scheduled to be heard on February 26 and 28. SB 209 Extend Alaska Commission on Aging was moved out of Labor & Commerce and is awaiting its next committee assignment. SB 117 Workers' Comp: Disease Presumption was moved out of Senate Labor & Commerce on February 18 and referred to Senate Finance.

SB 196 Prescription Drug Database passed the Senate, 14-4, with 2 legislators exempted. It was transmitted to the House and will be heard in the Judiciary Committee on February 22.


Bill Tracking Methodology


The following is a list of all health-related bills currently sitting in various legislative committees. This list represents a combination of old bills from 2007 that were left in committees when the first session ended and new bills that have been introduced during the second session. Bill information is current as of February 21 at 5 PM.

Bills listed here were selected based on a series of subjective criteria to determine whether they were "health policy-related" or not. All bills currently sitting in the Senate and House Health, Education, and Social Services committees were examined, and any that obviously dealt with non-health-related education or social services issues were eliminated. Every other House and Senate committee was then examined for health-related bills, which were included in the final list.

After determining the full set of health-related bills still in committee or pre-filed for the new session, they were divided into several general categories. This was done to facilitate finding bills that dealt with certain key health policy issues and to make overall navigation of the list easier. The remaining bills were categorized as "general" health policy-related because of the wide range of subjects they covered.

The information listed for each bill includes the bill number, the short title, the primary sponsor or sponsors, the committee in which the last action on the bill took place, and the date on which the last action on the bill took place. A short summary of each bill is also included.

Abbreviations have been used for committee names. The committee names and their abbreviations are:
�    (H) HES: House Health, Education, and Social Services Committee
�    (S) HES: Senate Health, Education, and Social Services Committee
�    (H) L&C: House Labor & Commerce Committee
�    (S) L&C: Senate Labor & Commerce Committee
�    (S) SED: Senate Special Committee on Education
�    (H) FIN: House Finance Committee
�    (S) FIN: Senate Finance Committee
�    (H) RLS: House Rules Committee
�    (S) JUD: Senate Judiciary Committee

�    (H) MLV: House Military & Veterans' Affairs Committee
�    (S) STA: Senate State Affairs Committee

Certificate of Need
HB 4 HB MEDICAL FACILITY CERTIFICATE OF NEED
Sponsor: Representative Lynn
Committee(s) and date of last action: (H) HES, 01/16/07

"HB 4 removes the current Certificate of Need requirement for health care facilities in Alaska boroughs having a population of over 25,000 people." -Rep. Lynn

SB 65 MEDICAL FACILITY CERTIFICATE OF NEED
Sponsor: Senator Huggins
Committee(s) and date of last action: (S) HES, 02/19/07

"SB 65 removes the current requirement for a Certificate of Need (CON) for health care facilities, except for nursing homes and residential psychiatric treatment centers, 'in a borough with a population of more than 25,000.' Smaller communities would still require, as a practical matter, the Certificate of Need." --Sen. Huggins

HB 345 MEDICAL FACILITY CERTIFICATE OF NEED
Sponsor: Representatives Kelly and Kawasaki
Committee(s) and date of last action: (H) HES and (H) FIN, 02/09/08

HB 345 would amend the current certificate of need statute to exclude expenditures for diagnostic imaging equipment in certain circumstances. The bill defines "critical access hospital" for the purposes of certificate of need applications, and adds a section to the uncodified law of the state regarding the applicability of the new statute to facilities.
Drugs
HB 81 ALASKA PRESCRIPTION DRUG TASK FORCE
Sponsors: Representatives Guttenberg and Cissna
Committee(s) and date of last action: (H) HES, 01/16/07

"HB 81 will create a Prescription Drug Task Force within the Alaska Department of Health and Social Services. This Task Force will find ways to reduce the cost of prescription drugs and increase affordable access to prescription drugs for Alaskans.

"Ten members representing various entities and business sectors will sit on the task force and will gather information from industry, government, citizens, and other sources. Subsequent present reports to the Governor and to the Legislature will suggest actions to increase access to and reduce the cost of prescription drugs." -Rep. Guttenberg

HB 82 PRESCRIPTION DRUG DISCOUNTS
Sponsors: Representatives Guttenberg, Cissna, and Greunberg
Committee(s) and date of last action: (H) HES, 01/16/07

This bill would affect prescription drug discount pricing, and would place requirements on pharmacies that obtained prescription drugs through discount pricing. It would also require DHSS to conduct a study pertaining to prescription drug discounts, and report the findings to the legislature.

Pharmacies would segregate prescription drugs purchased through discount pricing from other drug stock by physical or electronic means, and maintain records of the acquisition and disposition of the discounted drugs in a way that is separate from other pharmacy records. The purchase of discounted prescription drugs is regulated according to guidelines in the federal Social Security Act. The mandated DHSS report would be a study of the feasibility of providing discounted prescription drug pricing to every person in the state who is not otherwise covered by a prescription drug plan. A report summarizing the findings would be presented to the legislature on or before January 1, 2008.

HB 208 DRUG PRODUCT SUBSTITUTION
Sponsor: House Health, Education, and Social Services committee
Committee(s) and date of last action: (H) HES, 03/19/07

This bill affects the substitution by a pharmacist of an equivalent drug product. With a few specific exceptions, unless a prescription indicates that it is to be dispensed as written, a pharmacist may, with the consent of the patient or the minor patient's parent or guardian, substitute an equivalent drug product.

The two exceptions mentioned explicitly in the bill relate to drugs for epilepsy or seizures, and to the substitution of a drug for a registered brand or trade name product. The substitution of drugs for epilepsy or seizure disorders must follow strict guidelines, including a timeframe for how long a pharmacist may dispense an equivalent drug product when supply of the prescribed drug is at issue. The substitution of a drug for a registered brand or trade name product can only be done with permission from the author of the prescription, with a procedure laid out should the pharmacist be unable to get in contact with the author of the prescription.

HB 300 DOCUMENT PRENATAL ALCOHOL EXPOSURE
Sponsor: Representative Doll
Committee(s) and date of last action: (H) HES and (H) L&C, 01/15/08

HB 300 would require health care professionals to document an infant's prenatal exposure to alcohol. The bill intends for such information to be used for the purposes of screening for fetal alcohol syndrome. A person licensed under the statute attending or making a postnatal examination of a mother and infant would, if the mother consents to such information being put in the medical file, document the infant's prenatal exposure to alcohol. Such information would only be used for the purposes of providing medical diagnosis, treatment, or care.

HB 304 CANCER DRUG REPOSITORY
Sponsor: Representative Nelson
Committee(s) and date of last action: (H) HES and (H) FIN, 02/28/08

HB 304 amends the statute covering the Board of Pharmacy to include regulations for the implementation of the cancer drug repository and redistribution program established for recipients of medical assistance. Medical Assistance for Needy Persons statute (AS 47.07) would be amended to define and describe the cancer drug repository and redistribution program, and establishes guidelines that must be followed by dispensing pharmacies.

HB 400 MITIGATING FACTOR: CARE FOR DRUG OVERDOSE
Sponsor: Representative Kerttula
Committee(s) and date of last action: (H) JUD, then (H) FIN, 02/19/08

HB 400 amends the factors to be considered by a sentencing court against a person who seeks medical attention for another person experiencing a drug overdose.

SB 114 DRUG PRODUCT SUBSTITUTION
Sponsor: Senate Health, Education, and Social Services committee
Committee(s) and date of last action: (S) L&C, 03/12/07

This bill affects the substitution by a pharmacist of an equivalent drug product. With a few specific exceptions, unless a prescription indicates that it is to be dispensed as written, a pharmacist may, with the consent of the patient or the minor patient's parent or guardian, substitute an equivalent drug product.

The two exceptions mentioned explicitly in the bill relate to drugs for epilepsy or seizures, and to the substitution of a drug for a registered brand or trade name product. The substitution of drugs for epilepsy or seizure disorders must follow strict guidelines, including a timeframe for how long a pharmacist may dispense an equivalent drug product when supply of the prescribed drug is at issue. The substitution of a drug for a registered brand or trade name product can only be done with permission from the author of the prescription, with a procedure laid out should the pharmacist be unable to get in contact with the author of the prescription.

SB 196 PRESCRIPTION DATABASE
Sponsors: Senators Green, Ellis, Davis, Dyson, and Stevens
Committee(s) and date of last action: (S) JUD, then (S) FIN, 02/22/08

This bill would amend statutes related to the control and regulation of pharmacy. It would add a provision of the Board of Pharmacy that allows for the establishment and maintenance of a controlled substance prescription database.

The proposed database would contain data regarding every prescription for a IA, IIA, IIIA, IVA, or VA controlled substance under state law, or a schedule I, II III, IV, or V controlled substance under federal law dispensed in the state to any person other than an in-patient at a licensed health care facility. The bill also establishes guidelines for the pharmacist-in-charge of each covered pharmacy to submit certain information regarding such prescriptions to the board for inclusion in the database. Such information would include the names of prescribing prescriptions and individuals who receive prescriptions for controlled substances from licensed practitioners and who subsequently obtain dispensed controlled substances from a drug outlet in quantities or with a frequency inconsistent with generally recognized standards of dosage for that controlled substance.
Education
HB 55 WWAMI MEDICAL SCHOOL
Sponsor: Representative Kelly
Committee(s) and date of last action: (H) HES, 01/16/07

"The purpose of HB 55 is to address the severe doctor shortage in Alaska. According to the Alaska Physician Supply Task Force, Alaska would need an increase of 28% (375 doctors) to catch up with the lower 48. Increasing the in-state production of physicians by increasing the number of medical school and residency positions in Alaska is the No. 1 goal according the Task Force." -Rep. Kelly

HB 66 REQUIRE CPR FOR HIGH SCHOOL GRADUATION
Sponsor: Representative Gruenberg
Committee(s) and date of last action: (H) HES, 01/16/07

HB 66 would require certification in cardiopulmonary resuscitation and first aid for the issuance of a secondary school diploma. The requirement may be waived when the governing body of the school district provides proof that a student is incapable of performing the necessary functions for certification. Each district in the state public school system would be responsible for initiating and conducting a program leading to CPR/first aid certification for its students.

SB 32 WWAMI/NURSE EDUC LOAN REPAYMENT PROGRAM
Sponsor: Senator Wilken
Committee(s) and date of last action: (S) HES, 01/16/07

This bill recognizes that there is a shortage of qualified medical doctors and registered nurses in the state, and seeks to establish the Alaska medical doctors and registered nurse recruitment loan repayment programs. The purpose of the programs would be to provide financial incentives through the repayment, in whole or in part, by the state, of education loans for medical doctors and registered nurses completing a term of employment as a medical doctor or a registered nurse in the state. In consultation with the Alaska Commission on Postsecondary Education, standards and criteria would be established for the Alaska medical doctor and registered nurses recruitment loan repayment programs. Rules governing the commission's actions related to these programs are specified.

SB 73 WWAMI MEDICAL SCHOOL
Sponsor: Senator Ellis
Committee(s) and date of last action: (S) SED, (S) HES, and (S) FIN, 02/02/07

"Under the WWAMI agreement, students pay in-state tuition at the University of Washington and the State of Alaska pays the difference. Students who enter the program must return to Alaska to practice or pay back the state's subsidy. Current statute places a cap on the number of students allowed into the WWAMI program at 10. Senate Bill 73 removes that cap, and establishes a new minimum of 20 students per year be placed into the WWAMI program." -Sen. Ellis
General Health Policy
HB 36 NURSE SUPERVISION OF EMT TRAINING
Sponsor: Representative Kawasaki
Committee(s) and date of last action: (H) L&C and (H) HES, 03/28/07

"House Bill 36 would allow nurses within an EMT training program to teach skills to paramedics in the clinical setting. Qualified nurses would provide training to paramedics in a scope of activities under direct supervision. By allowing nurses to assist in paramedic's training the state [of] Alaska will be able to provide skilled workers with complete understanding of the necessary lifesaving skills." -Rep. Kawasaki

HB 124 INTENSIVE SERVICES FUNDING
Sponsor: Representative Nelson
Committee(s) and date of last action: (H) HES and (H) FIN, 02/07/07

This bill seeks to amend AS 14.17.420 to affect intensive services funding. It proposes that when a student who is counted for intensive services funding transfers to another school district within the state, the transferring district would have to pay the district receiving the transfer the unused portion of funds allocated for the transferring student within 30 days of the transfer. The transferring district's payment would be based on a pro rata share of the amount received for the period in which the student attended school in the district.

HB 136 DENTAL HYGIENISTS
Sponsor: Senator Stoltze
Committee(s) and date of last action: (S) FIN, 05/04/07

"The provisions of House Bill 136 follow the expanded functions of dental hygienists in other states to improve access to preventative oral health care. Specifically, HB 136:
�    Allows a licensed dental hygienist to place "fillings" into a cavity prepared by a licensed dentist.
�    Authorizes a licensed dental hygienist to administer local anesthetic agents under the general supervision of a licensed dentist.
�    Permits a licensed dental hygienist to enter into a collaborative agreement with a licensed dentist in which the dentist authorizes the dental hygienist to perform certain duties stipulated under HB 136 without the supervision of the dentist." -Rep. Stoltze

HB 319 DENTAL HYGIENISTS/DENTAL PRACTICE
Sponsors: Representatives Ramras, Salmon and Thomas

Committee(s) and date of last action: awaiting next committee, then (H) L&C, 02/14/08


HB 319 would amend the statute regulating the use of dental radiological equipment. The bill would specify the prohibitions under the statute to include the dentist's "direct or indirect" supervision of the use of such equipment. HB 319 would also extend the "direct or indirect" supervision clause to the grounds for discipline, suspension, or revocation of license. New sections are added to the statute regarding dental assistants, including certain certifications and delegation to dental assistants; and definitions of certain terms used in the legislative language.


HB 329 ABORTION NOTIFICATION

Sponsor: Representative Doogan
Committee(s) and date of last action: (H) HES and (H) JUD, 01/17/08

HB 329 would amend several aspects to the current statute governing parental notification of an abortion on a minor, as well as repeal the judicial bypass provisions relating to abortions. Specifically, the bill would lower the age of notification from 17 to 16, and would more clearly define who is capable of giving consent. The bill would also redefine "medical necessity" for abortions and amends the duties of the Office of Public Advocacy in cases involving minors' abortions.


HB 340 CAPSTONE AVIONICS FUNDS/LOAN
Sponsor: Rules by request of the governor
Committee(s) and date of last action: (H) FIN, 02/13/08

HB 340 would establish the Alaska Capstone Avionics Revolving Loan Fund within the Department of Commerce, Community, and Economic Development. The bill declares it to be the policy of the state to increase the safety of air carrier, air taxi, and general aviation intrastate air transportation in the state by providing low interest loans to qualified applicants for the purpose of purchasing and installing capstone avionics equipment. The Fund would exist to provide loans towards that effect.

HB 360 CERTIFIED DIALYSIS TECHNICIANS
Sponsor: Representative LeDoux
Committee(s) and date of last action: (H) HES, (H) L&C, (H) FIN, 02/08/08

"HB 360 develops uniform standards for the training and certification of Dialysis Technicians in the state. . . HB 360 would create a consistent procedure for the application, examination, certification, suspension and severance of patient care dialysis technicians. Under the bill it becomes illegal for anyone to perform in such a capacity without having first completed the certification process under the auspices of the Board of Nursing or the Department of Commerce, Community, and Economic Development.

The bill provides for the regulation of the education, training and practice of patient care dialysis technicians. It also creates a registry of certified technicians by the Board of Nursing or the Department of Commerce, Community, and Economic Development. The board will also have the authority to conduct hearings against alleged violators and the ability to impose disciplinary measures." -Rep. LeDoux


HJR 26 CONST AM: CONTROL OF MINOR'S MEDICAL CARE
Sponsor: Representatives Coghill and Lynn
Committee(s) and date of last action: (H) HES and (H) JUD, 01/15/08

HJR 26 proposes an amendment to the Alaska Constitution. It would grant a parent or guardian the right to direct and control the medical care and treatment of the parent or guardian's minor child. This right would be subject only to emergency exceptions and judicial bypass. The judicial bypass procedure would be narrowly tailored to protect the rights and health of the minor child and be consistent with standards established by the United States Supreme Court. The proposed amendment would be placed before the voters in the next general election as determined by the state's constitution and election laws.

SB 28 LIMIT OVERTIME FOR REGISTERED NURSES
Sponsor: Senator Davis
Committee(s) and date of last action: (S) FIN, 01/23/08

"SB 28, hereafter also to be known as "The Alaska Safe Nursing and Patient Care Act," prevents Alaska registered and licensed practical nurses from being forced to work mandatory overtime, i.e., compulsory as opposed to voluntary work in excess of an agreed to, predetermined, regularly scheduled shift, and it protects patients from the dangers caused by overworked nurses ... This legislation also protects nurses from discrimination and retaliation by employers who continue to force them into working hours beyond what they believe safe for quality care. SB 28 requires that health care facilities monitor, document, and report overtime semiannually and face penalties for knowing violations." -Sen. Davis

SB 29 MEDICAL PATIENT BILLING DISCLOSURES
Sponsor: Senator Dyson
Committee(s) and date of last action: (S) HES, 01/16/07


SB 29 would affect certain aspects of patient billing disclosures. The bill adds a new section to the existing statute (AS 18.20) that specifies what licensing a hospital must have to be regulated under the proposed law. The bill also adds a new section to the existing statute that specifies what information hospitals that received government money for the purchase, construction, repair, equipping, or operation of the hospital would have to disclose on each patient billing. Several terms that would be related to this information are also defined, including "government money," "hospital," and "patient billing."

SB 98 DENTAL HYGIENISTS
Sponsor: Senator Davis
Committee(s) and date of last action: (S) HES, 03/26/07

"SB 98 allows Alaskans better access to professional training, skills, and technology available to meet their oral health care needs with expanded services provided by dental hygienists licensed under AS 08.32. Many Alaskans either cannot afford regular oral health care, do not understand the need for it, or live in areas or facilities not served by oral health care professionals. SB 98 also will help stem what the Surgeon General reported as a 'silent epidemic of oral diseases ... affecting our most vulnerable citizens ... No one should suffer from oral diseases or conditions that can be effectively prevented and treated.'" -Sen. Davis

SB 107 NATUROPATHS
Sponsor: Senator Davis by request
Committee(s) and date of last action: (S) HES and (S) FIN, 02/13/08

"For purposes of expanding allowed procedures and regulating the growing practice of naturopathic medicine in Alaska, SB 107 establishes required licensing fees, a Naturopathic Advisory Committee, and an Alaska Naturopathic Formulary Council ... New naturopathic procedures under SB 107 allow minor surgery, including operative, electrical, and other methods of repair to superficial lacerations and abrasion or lesions, and removal of foreign bodies in superficial tissues. The bill also allows naturopaths to use antiseptics and local anesthetics in connection with allowed procedures. The law prohibits naturopaths from performing major surgery, and spinal and general anesthetics." -Sen. Davis

SB 181 ANATOMICAL GIFTS
Sponsor: Senator McGuire
Committee(s) and date of last action: (S) STA, then (S) JUD, 02/26/08


This bill would affect anatomical gifts; donations to the anatomical gift awareness fund; a registry of anatomical gifts; and the organizations that handle the procurement, distribution, or storage of all or a part of an individual's body. The majority of changes proposed in SB 181 are to change the particular Alaska statutes that govern anatomical gifts issues to the most current statutory number. The bill would also add a number of sections to the existing statute in order to address several issues, including who may make an anatomical gift before the donor's death; the manner of making an anatomical gift before the donor's death; and the rights and duties of procurement organizations and others. The bill would also address the need for uniformity of the law with regard to the subject matter, and also defines the terms used in the text. 


SB 244 CONSUMER HEALTH INFORMATION WEBSITE

Sponsor: Senator Dyson
Committee(s) and date of last action: (S) HES and (S) FIN, 01/19/08

SB 224 would establish a consumer health information website to be operated by the Alaska Department of Health and Social Services. Included in the information to be made available would be a list of preferred drugs approved by DHSS for reimbursement; a list of the 100 most commonly prescribed medications in the state and the source and price, updated monthly; available hospital ratings, including the rates of hospital acquired infection and mortality occurring at each hospital in the state; and a list of primary care clinics that cater to uninsured and self-pay patients.


SB 248 CAPSTONE AVIONICS FUND/LOANS
Sponsor: Rules by request of the governor
Committee(s) and date of last action: 02/22/08

SB 248 would establish the Alaska Capstone Avionics Revolving Loan Fund within the Department of Commerce, Community, and Economic Development. The bill declares it to be the policy of the state to increase the safety of air carrier, air taxi, and general aviation intrastate air transportation in the state by providing low interest loans to qualified applicants for the purpose of purchasing and installing capstone avionics equipment. The Fund would exist to provide loans towards that effect.

HB 252 LEAVE FOR ORGAN/BONE MARROW DONATIONS
Sponsor: Senator LeDoux, Foster, Lynn, Doogan, Kohring, Thomas, Kawasaki, Gruenberg, Cissna, Roses, Kerttula, Gardner
Committee(s) and date of last action: (S) HES, (H) STA, and (H) FIN, and awaiting next committee, 02/08/08

"The Richard Foster and Alec Cesar Donor Act would require the State of Alaska to grant a paid leave of absence to an employee for the purpose of making a personal organ or bone marrow donation. The employer is not required to provide more than 80 hours of leave, however the leave may not be less than 40 hours unless the employee requests fewer hours. Verification may be required and the State may not retaliate or sanction an employee for requesting this leave." -Rep. LeDoux


HB 100 AIR AMBULANCE SERVICES
Sponsor: Representative Coghill
Committee(s) and date of last action: (H) HES and (H) L&C, 04/03/07

"This legislation exempts for-profit air ambulance services from insurance regulations under AS 21.03 in order that they may solicit membership subscriptions, accept membership applications, and charge membership fees.

"In order to protect consumers this bill establishes that air ambulance services must:
�    have certification under AS 18.08.082
�    be in operation in Alaska for at least two years
�    not deny emergency medical service to any person." --Rep. Coghill
Mental Health
HB 173 INVOLUNTARY PSYCHOTROPIC DRUG TREATMENT
Sponsor: Alaska Department of Health and Social Services
Committee(s) and date of last action: (H) HES and (H) JUD, 03/05/07

This bill would allow courts to approve the involuntary use of psychotropic drugs on patients after strict guidelines for such administration had been met. The bill would also make it so that the court's approval applies to the patient's initial period of commitment if the decision was reached during the initial period. If the decision is made during a period for which the initial commitment has been extended, then the court's approval would apply to the period for which the commitment was extended.

HB 239 SUBSTANCE ABUSE/MENTAL HEALTH PROGRAMS
Sponsor: Representative Dahlstrom
Committee(s) and date of last action: (H) HES and (H) FIN, 04/17/07

"House Bill 239 proposes several changes to Alaska's statutes concerning drug and alcohol abuse improving the quality of and access to treatment and prevention programs. The legislation:
�    mandates priority treatment for pregnant women seeking help in overcoming addiction. This will hopefully have a positive impact by reducing the incidents of Fetal Alcohol Spectrum disorders and in turn save money;
�    gives priority to state grantees who utilize evidence-based programs, as well as programs that address substance abuse prevention and addiction within prisons;
�    supports the Department of Health and Social Services in their efforts to identify people with co-occurring mental and substance abuse disorders so this population can be better served; and
�    ensures faith-based strategies for treating substance abuse are not discriminated against in statute." -Rep. Dahlstrom

SB 8 MENTAL HEALTH PATIENTS RIGHTS: STAFF GENDER
Sponsor: Senator Davis
Committee(s) and date of last action: (S) FIN, 02/06/08

"SB 8 provides that a mental health patient 18 years of age or older who is receiving mental health treatment and being provided intimate care at a hospital shall have the right to have care provided by a staff member who is the gender that the patient requests ... The supervisor or manager employed by a hospital shall post notice of this right in a conspicuous place, so patients know they may exercise this right when they are concerned about the gender of staff responsible for their personal intimate care ... the bill requires that the facility document the non-compliance in the patient record that the intimate care was provided by a licensed or unlicensed staff member of a gender opposite that requested by the patient ... Lastly, this bill will preserve information for inquiry into grievance procedures at mental health facilities under Title 47." -Sen. Davis

HB 312 APPROP: MENTAL HEALTH BUDGET
Sponsor: Senate Rules by request of the governor
Committee(s) and date of last action: (S) FIN, 02/25/08

This bill would make appropriations for the operating and capital expenses of the state's integrated comprehensive mental health program.

SB 51 APPROP: MENTAL HEALTH BUDGET
Sponsor: Rules by request of the governor
Committee(s) and date of last action: (S) FIN, 01/19/07

This bill, written at the request of Governor Palin, makes appropriations for the operating and capital expenses of the state's integrated comprehensive mental health program.

SB 186 MENTAL HEALTH PATIENT GRIEVANCES
Sponsor: Senator Davis

Committee(s) and date of last action: (S) HES and (S) FIN, 01/16/08


SB 186 would repeal and reenact the patient grievance procedure. It would clarify and expand the current statute, including the definition of who is a mental health patient under the statute, and would clarify the grievance procedure at facilities subject to the statute. The bill lays out what information a grievance form must include.

The bill also sets up three levels of review for grievances: an initial review by a supervisory staff member to attempt to reach a mutually agreed-upon resolution of the grievance; if a resolution is not reached, then the grievant must initiate a review by either the chief executive officer if it is a private facility or the commissioner's designee if it is a public facility within 20 days; the grievant may finally appeal the written decision from level two to the Office of Administrative Hearings within 20 days of the level two decision.

The bill also defines several terms used in the legislative language.

SB 195 MENTAL HEALTH CARE INSURANCE BENEFIT
Sponsor: Senator Davis

Committee(s) and date of last action: (S) HES, (S) L&C, and (S) FIN, 01/16/08


This bill would affect how health care insurance policies treat certain mental health issues, including alcoholism and substance abuse. It would change certain requirements placed on insurers, including prohibiting the insurer from placing a greater financial burden on an insured for diagnosis or treatment of alcoholism or drug abuse than for other medical care. It also defines certain terms related to the changed statute. SB 195 changes language in certain places that clarifies covered medical care, and clarifies definitions of certain terms used in the bill.

SB 222 APPROP: MENTAL HEALTH BUDGET
Sponsor: Rules by request of the governor
Committee(s) and date of last action: (S) FIN, 01/16/08

This bill, written at the request of Governor Palin, makes appropriations for the operating and capital expenses of the state's integrated comprehensive mental health program.
State Boards and Issues
HB 50 CHILD PLACEMENT COMPACT
Sponsor: Representatives Coghill and Neuman
Committee(s) and date of last action: (H) HES and (H) JUD, 02/21/08

This bill affects the Interstate Child Placement Compact by seeking to establish an interstate commission for the placement of children. It also seeks to amend Rules 4 and 24 of the Alaska Rules of Civil Procedure.

HB 114 EXTEND STATE MEDICAL BOARD
Sponsor: House Labor & Commerce committee
Committee(s) and /date of last action: (H) HES and (H) FIN, 01/30/07

This bill would extend the termination date of the State Medical Board through June 30, 2013.

HB 263 CITIZEN HEALTH ADVISORY BOARD
Sponsor: Representative Cissna
Committee(s) and date of last action: (H) HES and (H) FIN, 05/15/07

This bill proposes the formation of the Citizen's Health Advisory Board. It would be created within the Department of Health and Social Services and consist of the following commissioners or commissioners' designees: administration; health and social services; commerce, community, and economic development; corrections; environmental conservation; education and early development; public safety; labor and workforce development; and the attorney general or the attorney general's designee. The board would also consist of 32 persons nominated by all health units or districts who would represent the interested parties in the Alaska health care discussion, including but not limited to insurance companies, Native health care, legislators, and consumers. The stated purpose of the board is to develop strategies and recommendations to improve public health and health care, and to reduce health care costs for state businesses and residents.

HB 276 EXTEND ALASKA COMMISSION ON AGING
Sponsors: Representative Doll
Committee(s) and date of last action: (H) FIN, 02/13/08

HB 276 would extend the termination date of the Alaska Commission on Aging to June 30, 2016.

HB 279 COMMISSION ON AGING
Sponsors: Representatives Doll and Kerttula
Committee(s) and date of last action: awaiting next committee, then (H) FIN, 02/14/08

This bill would make changes to the duties and powers of the Alaska Commission on Aging and DHSS. Added to the duties of DHSS would be the ability to establish state policy relating to and administering federal programs subject to state control as provided under the Older Americans Act of 1965, and to administer the older Alaskans service grants under certain state statutes and the Adult Day Care and Family Respite Care grants. HB 279 would also affect the role of the Executive Director of the Commission, and would also affect various grants and programs administered by DHSS.

HB 337 HEALTH CARE: PLAN/COMMISSION/FACILITIES
Sponsor: Rules by request of the governor
Committee(s) and date of last action: (H) HES and (H) FIN, 02/23/08

HB 337 would establish the Alaska Health Care Commission and the Alaska health care information office, and would repeal or annul certain regulations of the Certificate of Need program. The Alaska Health Care Commission would exist within the Alaska Department of Health and Social Services and would promote the development of a statewide plan to address the quality, accessibility, and availability of health care in the state, and would review and approve facility health care information to be placed in a database maintained by the Alaska health care information office. The Alaska health care information office would be responsible for maintaining an internet database of all health care facilities in the state to provide objective, unbiased, and factually-based information on such facilities.

HB 407 HEALTH REFORM POLICY COMMISSION
Sponsor: Representatives Hawker and Kawasaki
Committee(s) and date of last action: (H) HES and (H) FIN, 02/19/08

HB 407 would establish the Alaska Health Reform Policy Commission in the Department of Health and Social Services. The purpose of the commission is to consider the entire spectrum of health care related issues in the state and formulate targeted and specific policy recommendations to be considered by the legislature and by the executive branch.

HCR 1 PUBLIC HEALTH AND HEALTH COMPACT
Sponsor: Representative Cissna
Committee(s) and date of last action: (H) HES, 04/17//07

"Alaska faces a health crisis. The availability of accessible and affordable health care in our great state is challenged by a forecast of shrinking provider ranks and increased need for care, rising costs and limited funds to meet them."

"The Health Compact encourages all Alaskans to make healthy choices to promote their own health and well being, and to share their experiences and ideas with one another. It dedicates the remainder of the year 2007 as a time to join the Compact, and dedicates 2008 as a year for sharing ideas and taking action." -Rep. Cissna

SB 188 EXTEND ALASKA COMMISSION ON AGING
Sponsor: Senator Therriault
Committee(s) and date of last action: (S) L&C and (S) FIN, 01/16/08

SB 188 would extend the termination date of the Alaska Commission on Aging to June 30, 2016.

SB 209 EXTEND ALASKA COMMISSION ON AGING
Sponsor: Senator Davis
Committee(s) and date of last action: awaiting next committee, then (S) FIN, 02/21/08

SB 209 would extend the termination date of the Alaska Commission on Aging to June 30, 2016.

SCR 14 PERIANESTHESIA NURSES WEEK: FEB 2008
Sponsor: Senator Green
Committee(s) and date of last action: (S) HES, 01/18/08

SCR 14 would proclaim February 14-10, 2008 as Perianesthesia Nurses Week.

SCR 17 BRAIN INJURY AWARENESS MONTH: MARCH 2008
Sponsor: Senator McGuire
Committee(s) and date of last action: (H) HES, 02/21/08

SCR 17 would establish March 2008 as Brain Injury Awareness Month.
Women's Health Issues
HB 190 NURSING MOTHERS IN WORKPLACE
Sponsor: Representative Cissna
Committee(s) and date of last action: (H) HES and (H) L&C, 04/25/07

This bill would add a new section to AS 23.10 Employment Practices and Working Conditions to specifically address break time in the workplace for nursing mothers. HB 190 calls for reasonable unpaid break time each day for employees who are the nursing mothers of children to either breastfeed or express milk. The timing of such activities must occur at times during the workday that would reasonably ensure the health and comfort of the mother and child, and would allow the employee to maintain breast milk supply. The bill also calls for the employer to provide a private, secure, and sanitary room, or other location in close proximity to the work area, other than a toilet stall, where the employee can express milk or breastfeed the child, only so long as this provision would not create a substantial and undue hardship on the employer. The Department of Labor would enforce this section, and would be responsible for regulating the process by which an employee may register a complaint, and would also be able to issue civil fines to employers.

HB 301 PARTIAL-BIRTH ABORTION
Sponsors: Representatives Keller and Coghill
Committee(s) and date of last action: (H) RLS, 01/22/08

This bill would define the term "partial-birth abortion," as well as define several acts which are related to the larger definition.

SB 58 JURY DEFERRAL FOR BREAST-FEEDING WOMEN
Sponsor: Senator Elton
Committee(s) and date of last action: (S) JUD, 01/19/07

SB 58 would excuse breastfeeding women from jury duty. A woman may claim such legal exemption provided the child is less than three years of age. The bill would amend Rule 15 (1) of the Alaska Rules of Administration.

HB 270 MEDICAL FACILITY LICENSING/ABORTION
Sponsor: Representative Coghill
Committee(s) and date of last action: (H) HES and (H) JUD, 01/15/08

This bill would add a type of facility to the list of permissible locations in which to perform abortions. It would add facilities licensed as ambulatory surgical centers that are approved for the purpose by DHSS. HB 270 would also clarify issues regarding the payment for abortion services used by DHSS for such a purpose, and would also clarify what is meant by "ambulatory surgical center" for the purposes of performing abortions.

HB 364 NOTICE AND CONSENT FOR MINOR'S ABORTION
Sponsor(s): Representatives COGHILL, Keller, Meyer, Stoltze, Lynn, Johnson, Dahlstrom, Wilson, Neuman, Roses, Kelly, and Gatto
Committee(s) and date of last action: (H) JUD, then (H) FIN, 02/20/08

This bill would amend the state's abortion laws to require unmarried, unemancipated women under the age of 17 to provide parental consent before obtaining an abortion. It amends the affirmative defense a physician may provide to define the "best clinical judgment of the physician or surgeon" when the abortion was performed because of serious life or physical health risk to the minor. HB 364 also discusses legal avenues that violations might take.

SB 113 NURSING MOTHERS IN WORKPLACE
Sponsor: Senator Ellis
Committee(s) and date of last action: (S) L&C and (S) HES, 02/28/08

SB 113 would require employers to "provide reasonable, unpaid break time to nursing mothers for the purposes of breastfeeding or expressing breast milk. The bill also requires employers to provide a sanitary and safe place for the employee to do so, unless doing it would create an undue hardship for the employer." -Sen. Ellis
Workers Compensation
HB 200 WORKER'S COMP: DISEASE PRESUMPTION
Sponsor: Representative Dahlstrom, Doll, Buch, Kerttula, Crawford, Gatto, Lynn, Hawker, Holmes, Johnson, LeDoux, Ramras, Roses, Gruenberg, Stoltze, Gardner, Johansen, Gara, Keller, Wilson, Kawasaki, Guttenberg, Doogan, Harris, Nelson
Committee(s) and date of last action: (H) FIN, 02/06/08

HB 200 would grant "benefits to firefighters stricken with certain types of cancer and heart disease due to their exposure to toxic chemicals, and high levels of carbon monoxide ... The requirements of this bill are that the claims must be made within five years after the last day of employment ... HB 200 also includes a presumption that compensation for certain disabilities resulting from blood born pathogens be covered." -Rep. Dahlstrom

HB 361 WORKERS' COMPENSATION
Sponsor: Representative Crawford
Committee(s) and date of last action: (H) L&C, then (H) FIN, 02/08/08

HB 361 would require subcontractors without employees acting as independent contractors to secure payment for workers' compensation.

SB 117 WORKER'S COMP: DISEASE PRESUMPTION
Sponsor: Senator French
Committee(s) and date of last action: (S) HES and (S) FIN, 02/19/08

"Senate Bill 117 would create a presumption in the Workers' Compensation program that a firefighter with at least seven years on the job who has passed health screening exams earlier in their careers will be provided with benefits if they contract certain forms of pulmonary or heart disease or cancers, as it will be presumed to be a result of their occupation. This presumption is restricted to diseases known to occur with greater frequency among firefighters, and is also capped so that claims cannot be made after sixty months from the firefighter's last date of employment." - Sen. French

SB 147 WORKER'S COMP EMPLOYER LIABILITY
Sponsor: Senator French
Committee(s) and date of last action: (H) FIN, 02/14/08

This bill seeks to remove the phrase "potentially liable" from the worker's compensation statute. Changes in 2004 to the statute allowed employers who are "potentially liable" for buying worker's compensation policies, but who do not actually do so, can still get the benefit of "exclusiveness of remedy," which means that employers who buy a policy know that there won't be court cases arising out of workplace accidents.
AHPR Staff
Lawrence D. Weiss Ph.D., M.S., Editor
Jacqueline Yeagle, Marketing and Communications Manager
Elizabeth Agi, Associate Policy Analyst

 
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