Alaska Health Policy Review 
comprehensive, authoritative, nonpartisan
February 29, 2008  Vol 2 Issue 8
Click Title to Read Section
Summary of SB 160 Hearing in Senate Labor & Commerce
A Closer Look at SB 160 Individual Mandates
Please Respect Our Copyright
Alaska Health Policy Calendar
Bill Tracking: Bills on the Move
Bill Tracking: Certificate of Need
Bill Tracking: Drugs
Bill Tracking: Education
Bill Tracking: General Health Policy
Bill Tracking: Medical Assistance and Health Insurance
Bill Tracking: Mental Health
Bill Tracking: State Boards and Issues
Bill Tracking: Women's Health Issues
Bill Tracking: Workers Compensation
AHPR Staff
Subscription Information
Certificate of Need Links
CON in Missouri
From the Editor  

Dear Reader:

On February 26, the Senate Labor & Commerce Committee held its first hearing on Senate Bill 160 Mandatory Universal Health Care. We have compiled a summary for your review. Some of the highlights include: the director of the Division of Insurance has a great many concerns, Senator Bunde wants a Volkswagen instead of a Cadillac, Senator Stevens wants to know about the relationship between SB 160 and Native health care institutions, and the Christian Science Committee on Publications for Alaska is well represented. There is more in this committee hearing that you will want to know, and we have included it just below in this issue of Alaska Health Policy Review.

The Progressive States Network is a nonprofit organization that "provides coordinated research and strategic advocacy tools to state legislators and their staffs, empowering these decision-makers with everything they need to engineer forward-thinking change." In February 2008, the Progressive States Network released a report entitled Individual Health Care Mandates and the Problem of Affordability. Since individual health care mandates are at the heart of SB 160, we are pleased to present a summary of this important report along with a link to the full report. We believe that this important analysis needs to inform future discussions of SB 160.

The Bills on the Move section reflects the frenzy of a 90-day session. Health related bills are being heard in groups, and bussed from one committee to another with great alacrity. There is movement on bills dealing with drugs, flight safety, workers' compensation, establishing a health commission, dentists, eyeglasses, health reform, and health care for veterans, to name a few. It's quite exciting.

Finally, I would be remiss if did not direct you to a couple of new resources. The Anchorage Daily News has invited me to become an official ADN blogger. It is a difficult balancing act, but I am trying to blend practical advice with health policy. The "Free and Cheap Health Care" in Alaska series collides with discussions of health care in foreign countries, and the activities of cogitating legislators in Juneau. The name of the blog is Health4all. Yes, I know, it is too cute, but it had to fit in with the others blogs.

In addition, I am pleased to say that we have replaced the rather ugly former Alaska Health Policy Review website with a brand new shiny one. It is a bit Spartan at the moment, but we contemplate some interesting features in the coming months. For example, we have already started collecting electronic copies of documents, which will be included in an Alaska health policy library to be housed at the AHPR site. You can see the new site at akhealthpolicy.org.

Lawrence D. Weiss PhD MS
Editor

Summary of SB 160 Hearing in Senate Labor & Commerce

On February 26, 2008, the Senate Labor & Commerce (L&C) Committee held its first hearing on Senate Bill 160 Mandatory Universal Health Care, sponsored by Senators French, Ellis, and Wielechowski. SB 160 has already been heard several times in Health, Education, and Social Services. The members of HESS transferred their committee substitute to Senate Finance last week. This week's L&C hearing marked the beginning of that committee's examination of the bill, and featured a presentation from Senator French, as well as public testimony.

Committee Chair Senator Ellis led the hearing, with committee members Senators Bunde and Stevens present. Also present were Senators Davis and Hoffman.

More information on SB 160 can be found at Senator French's website for the bill: Healthy Alaskans.

Senator Hollis French, bill sponsor

Senator French discussed the bill, addressing its key components as well as the larger problems with health insurance. He outlined the underlying concern about the number of people who do not have health insurance, noting that it's not because they don't work -- "Sixty percent of the people who do not have health insurance have full-time jobs" -- but rather because they do not receive health insurance as a benefit with their jobs. Larger businesses are able to offer health insurance, but smaller businesses often have trouble providing any coverage to their employees due to rising costs in policies and premiums.

He outlined the bill. SB 160 would create the Alaska Health Care Board to oversee a health care fund, and to recommend essential health care services and certify private health care plans. These plans would rest in a health care clearinghouse, a virtual warehouse where an individual using a voucher, also created by the bill, could purchase individual plans certified by the board.

"The genius of this idea, if you will, is to not obliterate the private insurance landscape and replace it with a single insurance plan. The idea is to maintain the competition that promotes lower costs and better products, the same competition that works so well in many other aspects of our economic life. Maintain that competition within the health care clearinghouse so that you have individual corporations offering health insurance, competing for the consumer voucher and competing to win that voucher and succeed in business."

He explained that the voucher system would help individuals buy one of several plans. Most people who would need the voucher, he said, would have incomes that fell between 100% and 300% of the Federal Poverty Line (FPL), and thus a sliding scale voucher system would best address the needs of the people. Senator French also explained the specified beneficiary fund, which would allow employers who want to offer subsidized health care to their employees but cannot afford the full price, to put money into the fund designated for their employees to help their employees purchase individual plans. Once a person has acquired their voucher, they may purchase the plan of their choice from the clearinghouse.

Linda Hall, director of the Division of Insurance

Hall had concerns about the L&C committee substitute because it put the oversight of the proposed program under the Division of Insurance. She said she wasn't sure it was the most appropriate division to oversee SB 160.

"We're a regulatory agency, we don't administer programs. Consequently, I am concerned about that. I think there is somewhat of a conflict in our regulatory role if we look at our responsibility to oversee the health insurance companies in our state and how they function and how they charge rates -- in some cases we don't regulate all of that -- adjudicate claims, various issues like that, versus if we're involved in the oversight of the Health Care Board helping the administration of the program, I see something of a conflict in that." She said she doesn't believe that a department currently exists that can fully oversee the program.

Hall described a federal grant the Division of Insurance and the Department of Health and Social Services received to study the uninsured population. She was part of an HSS team that went to different Alaska communities and hosted regional forums to try and find out what the uninsured were looking for and what they were willing to pay. The people who participated in the forums expressed a willingness to pay for health insurance, but they did not have the means to do so. They also were not looking to be a part of a Medicaid-type system and preferred to have private insurance.

She drew the committee's attention to a particular issue. "I approved last week an almost 32% increase in the premium for individual health insurance policies written by [a] primary carrier. Those are based on increases in two things: [the] cost of health care [which we know] increases at about what we see [with] inflation; [and] even more, that increase [in premiums] was based on increased utilization."

Hall continued, "I think we can work with the individual responsibility that the bill's sponsors talked about. Disease management programs for chronic conditions -- diabetes, heart disease -- there are programs to do that. To talk about evidence based medicine: optimizing care, suggesting maybe there are alternative treatments or generic drugs. Consumer education: questioning treatments. We do consumer bulletins -- I do a whole newspaper-type thing for consumers about how to do things. We can expand our efforts in those areas to avoid emergency room visits, to encourage you to look at the bill you got from your doctor."

Senator. Bunde questioned whether it would be better to have a "Volkswagen" plan as opposed to SB 160's seeming "Cadillac plan." He clarified, asking if it would be more beneficial to provide health insurance for catastrophic issues and have people pay out of pocket for colds and the like. Hall replied that she believed SB 160 was the "parameters of a program." She said it was an outline, and gave Montana's plan as an example for a differently structured program.

Senator Stevens noted the extensive Native health care system in the state. He asked how SB 160 would mesh with such an existing system. Senator French answered, saying that the bill in essence exempts individuals who are receiving health care benefits under a medical care program of the Indian Health Service that meet or exceed the benefits for essential health care services.

Lynn Harts, Legislative Committee of the Alaska Nurses Association

Harts said that the Alaska Nurses Association (ANA) supported SB 160. "Our members voted in favor of supporting innovative legislation that would make health insurance affordable for businesses and individuals, and this bill meets those goals.

"It is a complex bill, although there is an excellent website that Senator French has set up to make sense of it; and as he says, it is a work-in-progress. The most recent amendment, having the health care board look to potential expansion of the Alaska Medicaid program as needed, is a good one. Each refinement will bring us closer to the goal of legislation that will work, and a bill that will allow me, as a health care provider, to worry less when I have patients who are not getting critical testing because they do not have health care insurance.

"After 30 years of delivering health care in this state, I would really like to see the 25th Legislature make a change, and would urge passage of this bill."

Garvan Bucaria

Bucaria raised concerns about the mandatory aspect of SB 160. He said that he's found over the last several years that increasing costs have greatly affected the amount of expendable money that he has. "I would like to say that many of these Medicaid programs are supported by taxpayers, of which I am one, and I'm finding that the increases are limiting my ability to maintain any kind of a standard of living since my retirement rate is not the highest. I am very concerned that this does eliminate the emergency medical service treatment for uninsured residents. I am a little concerned that there's no upper limit for this health care fund. I find that health care costs are unlimited based on technological advances, new equipment, physicians' diagnostic needs, and so forth, and the trend is for most costs to be up."

He gave a personal example of how diagnostic needs and testing costs can vary greatly, as well as a personal example of varying provider costs in the dental field.

"I would appreciate this education business -- I'd like to see advertised costs for treatment for the various medical services so that the client can level questions at these physicians and other professionals that are offering this service, and I feel very strongly that the education and the preventative maintenance of individuals is probably a very high priority. And I do not see the need at this point for a mandatory health program when we are not effectively providing for the individual to question some of the services that are given, and we would perhaps benefit from those kinds of services at the state level."

Beverly Smith, Christian Science Committee on Publications for Alaska

Smith testified that one of her jobs as the Committee on Publications for Alaska is to "review proposed legislation to ensure that it preserves the choice of Alaskans to pursue spiritual means for the prevention and cure of disease, including Christian Science treatment and care. I also want to ensure that you have accurate information concerning spiritual healing as practiced in Christian Science, so that this cost effective, reliable, and effective form of care is not overlooked or restricted in the state's health care reform efforts."

She continued, "To provide health care coverage that is truly affordable, preventative, and lasting, and to meet the health care needs of all Alaskan residents, this legislation should include coverage for spiritual care, similar to the coverage offered by the federal government and other state plans that currently do so. And for state employees and retirees in Alaska, insurance coverage is provided for payment to Christian Science practitioners."

Smith explained that Christian Science healing is available to anyone, regardless of their membership in the church, and that it provides physical healing through prayer. She said that she was not there to take a position on mandated health insurance, and noted that several states have considered opt outs based on a person's religious beliefs.

"However, I do feel it's important that any reform discussion include an acknowledgement that spiritual care is a significant part of people's approach to maintaining health, and that costs associated with such care are deserving of inclusion in health care reform so that those relying on spiritual means for healing may have access to their preferred method of treatment."

Smith said her group requested that SB 160 include non-medical health care services for individuals relying on spiritual means for healing as part of its definition of "essential health care services." She referred to the proposed amendment she had given to the committee members the day before the hearing.

"I'm open to further change," she concluded, "if you think there's a better way, and I'm happy to work with lawmakers to make sure the language is included, so that insurance coverage is provided for those Alaskans choosing spiritual care to meet their health care needs. This care is both reliable and effective, and makes bodies and communities healthier. If people are achieving complete healing through spiritual care without incurring large medical bills, society is benefited."

Patricia Boyle

"I read SB 160 and I see some problems that I have to take issue with on a personal level. The devil is always in the details, and my impression is that the insurance industry has had quite a hand in developing much of the criteria that's been spelled out in this bill."

Senator. Bunde questioned that assertion, to which Boyle replied, "You're going by their concepts and everything." She continued:, "Section 21.54.240, where it lines out the essential health care services eligibility, the very first thing it says is you're excluded if you have coverage, regardless of how expensive it may be. It does say if it's not as good you can get something different, but it doesn't say 'what if it as good?' It doesn't matter how expensive it is. Then it goes on to say that anyone covered by ACHIA (Alaska Comprehensive Health Insurance Association, the state's high risk insurance pool) is also excluded."

Boyle related a personal experience of trouble with finding and maintaining affordable health care. While previously covered by her employer's group plan, that coverage was terminated through no fault of her employer, and her employer was unable to find affordable replacement group coverage. Boyle said that although she did not consider herself unhealthy, she fell into the category of women over age 50 who are denied coverage, and that the insurance company's only avenue for appeal was to send her entire medical record to them for evaluation, something Boyle considered an "intolerable invasion of privacy. So I settled for the ACHIA plan." She detailed the high out-of-pocket expenses she would be forced to pay in the event she needs medical care, despite the fact that she is covered by an insurance plan.

"I have worked for the same employer for 20 years, and to find myself in this predicament is unsettling, to say the least. To go without any insurance at all, however, puts my family and my future at incredible risk."

She continued, "Small businesses in Alaska are having a particularly hard time in today's market. They are not allowed to discriminate against their employees based on age or sex, and they are required to abide by the Americans with Disabilities Act if and when it applies. Yet, when they go to purchase insurance for their employees, the quotes they get back are based entirely on the ages, the sex, and the past medical history of their employees.

"This is wrong, and Alaska needs to step up to the plate and stop the insurance industry from making its profits off the relatively healthy, while leaving those with maturity and experience scrambling to protect their homes, their life savings, and their financial security. Alaska needs to address the dual standards that force businesses to be equal opportunity employers, yet denies them the ability to offer their employees affordable health care coverage. The Act, the way it's written, needs more tweaking. All Alaskans regardless of what coverage they have currently should have the option to improve their situation."

Boyle concluded her testimony, "The point and purpose of government is to provide and protect the health, education, and welfare -- meaning 'well-being' -- of its people. Forcing them into poverty and bankruptcy because we deny them the benefit of affordable health care does not serve our state or our society. Even though I love the whole concept behind Senate Bill 160, there's just something in it that makes me think we're just jumping on the same bandwagon. The problems in health care, the problems with the cost of health care, are also dictated by an industry whose corporate bottom line is all that matters to them. They are not selling policies because they think they're doing some beneficial thing to us. They're doing it to make money, and the state of Alaska is letting them do it."

Andy Modorow, legislative aide to Senator French

Modorow finished the presentation from where Senator French left off. He directed the committee to Senator French's website dedicated to SB 160, "Healthy Alaskans." He explained that the site had bill documents, news links, and an interactive calculator to help people figure out how, if Alaska were to adopt a similar program to Massachusetts, the legislation would affect them.

He showed the committee a final chart from a report issued in Massachusetts showing that they've had an increase of 256,000 people with private coverage as a result of their plan, putting a big dent into their uninsured population.

Senator Bunde said that the bill would be held over until Thursday, February 28, and adjourned the meeting.

A Closer Look at SB 160 Individual Mandates

The individual mandate is at the heart of Senate Bill 160 Mandatory Universal Health Care. This involves the requirement that, "A resident with an income between 100 percent and not more than 300 percent of the most recent federal poverty guidelines ... who is required to participate in the Alaska health care program shall pay premiums for health care insurance for essential health care services on a sliding scale established by the board." Further, "A resident with an income of 300 percent or more of the most recent federal poverty guidelines ... shall pay the premium for health care insurance ... "

Nothing in SB 160 provides specific protection to families for whom the required premium payments, deductibles, and copayments are 20% or even 30% of family income. In a similar plan in Massachusetts, 65,000 residents have been exempted from the individual mandate because it presented a financial hardship, but now they have no health insurance.

If a similar tactic were employed in Alaska, the result would likely be thousands of the most economically marginal Alaskan families would not be required to pay health insurance premiums. At the same time, the result would be that thousands of Alaskan families who desperately need health care services would continue to be denied. Ultimately, health care coverage for unknown thousands of Alaskans under the provisions of SB 160 would be neither "mandatory" nor "universal." For these residents little will have changed. They will still not have regular access to high quality health care, neither for themselves nor for their families.

The Progressive States Network

The Progressive States Network is a nonprofit organization that

... provides coordinated research and strategic advocacy tools to state legislators and their staffs, empowering these decision-makers with everything they need to engineer forward-thinking change. Progressive States also works with non-profits and a variety of constituent groups to build a swath of support for coordinated progressive policy. The overarching goals: to get good policy passed into law and change the way issues are debated in the states.

In February 2008 the Progressive States Network released a report entitled, Individual Health Care Mandates and the Problem of Affordability. Below is a summary of this important report, along with links to the PSN website and the full report. This important analysis needs to inform future discussions of SB 160.

Executive Summary

This new PSN report, which updates a fall 2007 edition of the Stateside Dispatch, discusses the growth of legislative measures to protect consumers from unaffordable health care costs and uses the experience of Massachusetts' individual mandate as a case-study to demonstrate the need for strong language ensuring affordability. As the report emphasizes, health care reform should have the goal of limiting families' exposure to potentially catastrophic health care costs, including premiums, deductibles, co-pays, and total out of pocket costs. This can be achieved by limiting all potential family health care costs to a proportion of family income. Such limits should allow for other family living expenses, including housing, transportation, education, food and clothing, and the ability to accrue savings.

A cornerstone of the 2006 Massachusetts health care reform law was a requirement that all individuals have health insurance, a so-called individual mandate. To help, the law put forth several initiatives to expand eligibility for public programs, bring more affordable insurance options to market, and provide premium subsidies to individuals and families with incomes up to 300% of the poverty line. The law has so far generated mixed success. While 300,000 previously uninsured residents now have coverage, a profound achievement, there are growing concerns about rising costs and the affordability of the health care coverage that residents could be required to purchase.

As we document, an individual earning just over 300% of poverty, or $31,000, and who is not eligible for subsidies, could face total health care costs of $7,100 when you include premiums and all out-of-pocket costs. This would amount to a whopping 23% of the individual's income. Accordingly, the state has exempted at least 65,000 residents from the individual mandate.

To address these affordability concerns, particularly in light of an individual mandate, several states have presented model legislation that would limit total annual health care costs to a percentage of family income. An early version of the recent California reform effort would have limited costs to 6.5% of income and, like Massachusetts, exempted individuals from financial hardship imposed by high health care costs. Increasingly, legislators are developing plans for reform that limit families' exposure to potentially catastrophic health care costs, including premiums, deductibles, co-pays, and total out-of-pocket costs. As the report proposes, this can be achieved by making all health care costs proportional to a family's income through a "percentage-of-income limit" on family health care costs. [Source: http://www.progressivestates.org/content/777/]

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Alaska Health Policy Calendar

This calendar of health policy-related legislative meetings is current as of February 28, 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 29, 2008, 1 PM
What: House Judiciary Committee
Where: Capitol 120, Juneau
Other information: HB 364 Notice & Consent for Minor's Abortion; teleconferenced

March 3, 2008, 1:30 PM
What: House Finance Committee
Where: House Finance 519
Other information: HB 200 Workers' Comp: Disease Presumption; teleconferenced

March 3, 2008, 1:30 PM
What: House Health Education and Social Services Committee
Where: Butrovich 205, Juneau
Other information: SB 267 Document Prenatal Alcohol Exposure; teleconferenced

March 3, 2008, 3 PM
What: House Labor & Commerce Committee
Where: Capitol 17, Juneau
Other information: HB 319 Dentists & Dental Hygienists; teleconferenced

March 4, 2008, 9 AM
What: Senate Finance Committee
Where: Senate Finance 532
Other information: SB 249 Capstone Avionics Fund/Loans; teleconferenced

March 4, 2008, 3 PM
What: House Health Education and Social Services Committee
Where: Capitol 106, Juneau
Other information: HB 337 Health Care: Plan/Commission/Facilities; teleconferenced

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

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

March 5, 2008, 1:30 PM
What: Senate Health Education and Social Services Committee
Where: Butrovich 205, Juneau
Other information: Medicaid Behavior Health presentation by Mary Thorton, BSRN, MBA; 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

March 7, 2008, 1:30 PM
What: Senate Health Education and Social Services Committee
Where: Butrovich 205, Juneau
Other information: HESS confirmation hearing; Best Beginnings report and presentation by Abbe Hensley; teleconferenced

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

April 2, 2008, Noon
What: Senate Joint Legislative Health Caucus
Where: Butrovich 205, Juneau
Other information: "High Quality, Low Cost"; teleconference

Bill Tracking: Bills on the Move


There was lots of movement among health policy bills this week. Several hearings were held on a wide variety of legislation, one bill was read for the first time, and one bill passed the Legislature and is awaiting transmittal to the governor.

SB 287 Workers' Compensation was read for the first time and referred to Senate L&C and Judiciary on February 19.
SCR 17 Brain Injury Awareness Month: March 2008 passed the House on February 27, 33-0, with four legislators excused and three legislators absent, and was sent back to the House on February 27, and currently awaits transmittal to the governor.

HB 345 Medical Facility Certificate of Need was heard in House HES on February 23, and was scheduled but not heard on February 26. HB 400 Mitigating Factors: Care for Drug Overdose was heard and held by Senate Judiciary on February 25. SB 181 Anatomical Gifts was heard and held by Senate State Affairs on February 26. SB 249 Capstone Avionics Fund/Loans was heard and held by Senate Finance on February 22, and is scheduled for another hearing on March 4. SB 160 Mandatory Universal Health Care was heard in Senate L&C on February 26 and 28. HB 407 Health Reform Policy Commission was heard and held by House HES on February 26. HB 364 Notice & Consent for Minor's Abortion was heard by House Judiciary on February 28, and is scheduled for another hearing on February 29.

HB 319 Dentists & Dental Hygienists is scheduled to be heard by House Labor & Commerce on March 3.
HB 337 Health Care: Plan/Commission/Facilities is scheduled to be heard in House HES on March 4.

SB 149 Redistribution of Used Eyeglasses was moved out of Senate L&C as a committee substitute on February 26, and was referred to Senate HES on February 27.
SJR 11 Supporting US Veterans' Health Care was moved out of Senate Military & Veterans' Affairs on February 26, and currently awaits transmittal to Senate HES. HB 312 Approp: Mental Health Budget was moved out of Senate Finance as a committee substitute on February 27. SB 147 Workers' Comp Employer Liability was moved out of Senate L&C on February 28, and is currently awaiting transmittal to its next committee.

SB 209 Extend Alaska Commission on Aging was referred to Senate Finance on February 25.


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


Bill Tracking: 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, 02/26/08

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.

Bill Tracking: 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 PRESCRIPTION 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, 02/25/08

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) HES, 01/15/08

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.

Bill Tracking: 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

Bill Tracking: 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, 02/15/08


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 149 REDUSTRIBUTION OF USED EYEGLASSES

Sponsor: Senator Therriault
Committee(s) and date of last action: (S) HES, 02/27/08

SB 149 would amend the current statute relating to the redistribution of used eyeglasses, as well as amend the language to refer to the Board of Dispensing Opticians. The bill would give the Board the power to approve nonprofit organizations for the redistribution and fitting of used eyeglasses. It would also limit the authority of a nonprofit organization approved by the department to distribute and fit used eyeglasses if the eyeglasses are distributed and fitted free of charge and the fitting of the eyeglasses conforms, to the extent possible, with a written prescription from a licensed physician or optometrist.


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 249 CAPSTONE AVIONICS FUND/LOANS
Sponsor: Rules by request of the governor
Committee(s) and date of last action: (S) FIN, 02/19/08

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: (H) STA, and (H) FIN, 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

Bill Tracking: Medical Assistance and Health Insurance

HB 140 MEDICAL ASSISTANCE ELIGIBILITY
Sponsor: Representative Gara
Committee(s) and date of last action: (H) HES, 03/15/07

"HB 140 raises the eligibility level for Denali Kid Care to 200 percent of the federal poverty guideline. It extends optional coverage to children of families that earn between 200 and 350 percent of the federal poverty guideline by offering coverage at a sliding scale fee of between $200 and $1200. Families that earn above 200 percent of the federal poverty guideline would have to certify that health insurance is not offered through their work." -Rep. Gara

HB 198 SENIOR BENEFITS/MED. ASSISTANCE ELIG.
Sponsor: Representative Hawker
Committee(s) and date of last action: (H) RLS, 04/10/07

"HB 198 establishes the Alaska Senior Assistance Program to provide cash assistance payments to low-income Alaska seniors.

"The existing Senior Care Program, which is scheduled to sunset June 30, 2007, is amended to remove the little used prescription drug benefits and increase monthly cash payments to Alaskans, age 65 and older, based on their incomes related to federal poverty level guidelines adjusted for Alaska (FPL-A). Monthly payments are:
�    $250 per month to individuals with income less than 75% of FPL-A
�    $175 per month to individuals with income from 75% to less than 100% of FPL-A
�    $125 per month to individuals with income from 100% to less than $135% of FPL-A

"The Alaska Senior Assistance Program combines desirable features of both the Longevity Bonus and Senior Care programs into a single needs based structure that delivers real help to low-income seniors across Alaska. Program enrollment is open to all qualifying seniors.

"The new Alaska Senior Assistance Program sunsets June 30, 2011 if not reauthorized." -Rep. Hawker

HB 231 MEDICAL ASSISTANCE: KIDS/DISABLED/PREGNANT
Sponsor: Representative Doll
Committee(s) and date of last action: (H) HES and (H) FIN, 04/02/07

This bill would amend the eligibility guidelines for medical assistance for needy persons (AS 47.07.020 [b]). Specifically, the bill seeks to change language that affects eligible disabled persons by specifying the official poverty line in question would be Alaska-specific, and clarifies that such information would come from the United States Department of Health and Human Service. The bill would also specify that persons under 19 years of age and pregnant women who are not otherwise covered under other sections of the law would only be eligible for assistance must come from households with incomes that do not exceed 200 percent of the federal poverty line for Alaska, as set by the US DHHS.

HB 398 MEDICAL ASSISTANCE FOR INFUSION SERVICES
Sponsor: Representatives Gruenberg and Lynn
Committee(s) and date of last action: 02/19/08

HB 398 would authorize medical assistance programs to cover home infusion services. It also lists optional services that DHSS may offer, as well as provides a definition of home infusion services.

HB 242 MANDATORY UNIVERSAL HEALTH CARE
Sponsor: Representative LeDoux
Committee(s) and date of last action: (H) HES, (H) L&C, and (H) FIN, 04/26/07

"This bill establishes a framework mandating and ensuring affordable health coverage for all Alaskans. A board of 11 stakeholders will oversee the plan, making certain that residents are able to choose and purchase coverage that provides adequate care. The bill also provides:
�    A framework for personal choice: This bill facilitates a relationship between health insurance providers and individuals, and doesn't assume that a one size fits all solution will meet the health care needs of all Alaskans.
�    A unique voucher system: By pooling money from all stakeholders, a sliding scale voucher system will ensure that every Alaskan can take personal responsibility for acquiring health insurance coverage. The system will also make it easy for multiple entities to contribute towards a health plan for an individual.
�    A health care clearinghouse: The clearinghouse will disseminate information about quality health care products, assisting Alaskans who are utilizing vouchers under the Alaska health care plan.
�    The Alaska health care fund: This fund will receive contributions from individuals, businesses and government to ensure that all interested parties contribute to the health of Alaskans." -Rep. LeDoux

HCR 2 HEALTH INFORMATION & REFERRAL SYSTEM
Sponsor: Representative Cissna
Committee(s) and date of last action: (H) HES, 01/22/07

This resolution seeks to recognize the need for an integrated state-wide health-related information and referral system. It addresses the need for basic and accurate information in an effective market-based health care system, and it recognizes need for consumers and residents of the state to have accurate, informed information about health care costs in order to make accurate decisions on health-related expenditures.

The resolution also recognizes certain growing health care trends: that a growing number of Alaskans cannot afford or access health insurance; that a growing number of people over the age of 65 who are covered by Medicare are having trouble finding doctors who will keep or accept them as patients; and that the state already has a shortage of physicians and that the percentage of medical doctors over the age of 50 is increasing, a trend that will worsen as the state's population continues to age.

In an effort to address these issues, this resolution of seeks government and private sector partners to investigate and build an integrated statewide information and referral system using like systems created in other states that use state-of-the-art software and well-maintained databases so state residents can maximize their health purchases within the state. This integrated statewide information and referral system be used to create an information system for health volunteerism options and a network of community health contacts that in times of natural disasters or statewide emergencies could be used to coordinate services and to disseminate information.

HJR 10 MEDICAL ASSISTANCE FOR CHILDREN
Sponsor: House Health, Education, and Social Services committee
Committee(s) and date of last action: (H) FIN, 03/05/07

This joint resolution would formally ask the Alaska Legislature to urge the Alaska Congressional delegation to "work diligently to achieve a timely reauthorization of the State Children's Health Insurance Program (42 U.S.C. 1397aa - 1397jj, Title XXI of the Social Security Act) to continue federal medical assistance percentages for the Denali KidCare program," and to also urge "Governor Palin to work with the Alaska Congressional delegation to ensure reauthorization of the State Children's Health Insurance Program in a timely manner." The resolution would also proclaim that "all components of state government should work together with educators, health care providers, social workers, and parents to ensure that all available public and private assistance for providing health benefits to uninsured children in the state be used to the maximum extent possible," and that the Alaska Legislature would urge Governor Palin to "work to provide meaningful assistance to help identify and enroll children who qualify for medical assistance or Denali KidCare." -House HESS

SB 87 MEDICAL ASSISTANCE ELIGIBILITY
Sponsor: Senator Wielechowski
Committee(s) and date of last action: (S) FIN, 03/14/07

"SB 87 raises the eligibility limit for participation in the Denali KidCare program to 200% of the federal poverty level (FPL), currently $27,000/year for a single parent and child ... SB 87 would also allow families with incomes up to 350% of the FPL to buy into Denali KidCare using a sliding fee scale for premiums and a 20% co-pay. Those with the greatest means would reimburse the state roughly 90% of its costs. Participants would have to certify that they don't have access to health insurance at work." -Sen. Wielechowski

SB 106 APPROP: COMMUNITY HEALTH CENTERS
Sponsor: Senator Davis
Committee(s) and date of last action: (S) FIN, 03/07/07

This bill would give a special appropriation to DHSS for payment of a grant to the Alaska Primary Care Association to create a community health centers program. APCA is a non-profit organization.

SB 160 MANDATORY UNIVERSAL HEALTH CARE
Sponsor: Senator French
Committee(s) and date of last action: (S) FIN and (S) L&C, 02/28/08

"This bill establishes a framework mandating and ensuring affordable health coverage for all Alaskans. A board of 11 stakeholders will oversee the plan, making certain that residents are able to choose and purchase coverage that provides adequate care. The bill also provides:
�    A framework for personal choice: This bill facilitates a relationship between health insurance providers and individuals, and doesn't assume that a one size fits all solution will meet the health care needs of all Alaskans.
�    A unique voucher system: By pooling money from all stakeholders, a sliding scale voucher system will ensure that every Alaskan can take personal responsibility for acquiring health insurance coverage. The system will also make it easy for multiple entities to contribute towards a health plan for an individual.
�    A health care clearinghouse: The clearinghouse will disseminate information about quality health care products, assisting Alaskans who are utilizing vouchers under the Alaska health care plan.
The Alaska health care fund: This fund will receive contributions from individuals, businesses and government to ensure that all interested parties contribute to the health of Alaskans." -Sen. French

SB 170 INSURANCE COVERAGE FOR WELL-BABY EXAMS
Sponsor: Senator McGuire
Committee(s) and date of last action: (S) FIN, 02/20/08

SB 170 would require any health care insurer that offers health insurance that covers a dependent of a covered individual to, initially and at each renewal, provide coverage for the cost of well-baby exams. Such coverage would still be subject to the standard policy provisions applicable to other benefits. The bill also defines certain terms: health care insurer, health care professional, and well-baby exam.

SB 179 DEPENDENT HEALTH INSURANCE; AGE LIMIT
Sponsor: Senator Davis
Committee(s) and date of last action: (S) L&C, (S) HES, and (S) FIN, 05/14/07

SB 179 would prevent health care insurers who provide coverage of a child through family care insurance from denying enrollment for a dependent child of the insured who is less than 26 years of age. Such insurers would also be prohibited from denying enrollment and disenrolling or eliminating coverage for such dependent children.

SB 212 MEDICAL ASSISTANCE ELIGIBILITY
Sponsor: Senator Davis
Committee(s) and date of last action: FIN, 01/30/08

This bill would raise the eligibility level for Denali KidCare from 175 percent of the federal poverty level (FPL) to 200 percent FPL. It would affect eligible persons under 19 years of age and eligible pregnant women. SB 212 would also affect cost-sharing mechanisms for certain eligible recipients by raising the upper eligibility limit from 175 percent FPL to 200 percent FPL.

SJR 11 SUPPORTING U.S. VETERANS' HEALTH CARE
Sponsor: Senator Wielechowski
Committee(s) and date of last action: (H) HES, 02/28/08

This resolution calls for the Alaska State Legislature to ask the federal government for "adequate" funding for veterans' health care.

"The press has documented the neglect of Walter Reed Army Medical Center, and former Secretary of Veterans Affairs Anthony Principi has publicly stated that the Department of Veterans Affairs has been struggling to provide health care to the rapidly rising number of veterans who require it.

"As the state with the largest per capita number of veterans, it is essential that we send a clear signal of our commitment to care for our military personnel both on active duty and as veterans. While our legislature tries to do all we can for our vets and returning soldiers, our federal government has the primary responsibility of meeting the needs of our veterans. We need to call on Congress, as a state, to adequately fund critical veteran services." -Sen. Wielechowski

Bill Tracking: 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, 02/27/08

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.

Bill Tracking: 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, 02/26/08

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: (S) FIN, 02/25/08

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: (S) awaiting transmittal to governor, 02/29/08

SCR 17 would establish March 2008 as Brain Injury Awareness Month.

Bill Tracking: 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, 02/29/08

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

Bill Tracking: 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, 03/04/08

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.

SB 287 WORKERS' COMPENSATION
Sponsor: Senator Wielechowski
Committee(s) and date of last action: (S) L&C, then (S) FIN, 02/19/08

SB 287 would require subcontractors without employees acting as independent contractors to secure payment for workers' compensation.

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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