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January 23, 2009 Vol 3, Issue 2


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Alaska Trauma Systems Review Results in Critical Recommendations
Please Respect Our Copyright
Alaska Health Policy Calendar
Bill Watch: Second Set of Prefiles and Committee Assignments
Bill Watch: Drugs
Bill Watch: Education
Bill Watch: General Health Policy
Bill Watch: Medical Assistance and Health Insurance
Bill Watch: Mental Health
Bill Watch: State Boards and Issues
Bill Watch: Family Health Issues
AHPR Staff and Contributors
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From the Editor

Dear Reader:

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The name may be ungainly, but the message is critical for the people of Alaska. We are pleased to include in this issue of Alaska Health Policy Review a copy of the full executive summary of Trauma System Consultation State of Alaska, November 2nd-5th, 2008 American College of Surgeons Committee on Trauma.

This study of Alaska's trauma system finds serious deficits in the system of care for those with serious traumas in the state, and provides critical policy recommendations to begin to address the problems. The study finds, for example, that
  • No trauma system strategic plan has been developed.
  • Few incentives exist for hospitals to participate in the trauma system.
  • No statewide evaluation of system performance is conducted.
The researchers who participated in this study have outlined a comprehensive series of policy recommendations that would begin to address the enormous scope of the problems and deficits.

In this issue of AHPR we also report on the growng number of health-related bills tumbling into the hopper, and we reveal the legislation committees are beginning to consider. Get ready for a short, intense session. We can catch up on our sleep in May.

Lawrence D. Weiss PhD, MS
editor, AHPR
[email protected]

Alaska Trauma Systems Review Results in Critical Recommendations

The American College of Surgeons, Trauma Systems Evaluation and Planning Committee (TSEPC) is honored to have been invited to the largest state in the nation and to have listened as the state's impassioned health care providers and public servants discussed their success and remaining challenges. We are pleased to provide this report and to encourage you to implement the key recommendations to improve the system of trauma care for all Alaskans and visitors, regardless of where that injury may occur.

It is clear that Alaska recognizes the significance of its injury problem as witnessed both by epidemiological descriptions of fatal and non-fatal injury and by the extensive focus on injury prevention programs across the state. Alaska's current trauma system is a testament to the adage that "necessity is the mother of invention". Clearly the "Last Frontier" is challenged with issues of geography, remoteness, inclement weather and limited health care resources.

State and regional leaders, along with a wide ranging cadre of health care providers are to be congratulated for their efforts to achieve the trauma system mantra of "getting the right patient to the right place in the right amount of time". Whether this has involved training a hunting buddy to be an Emergency Trauma Technician, or a local aviation service has figured out how to carry a litter in a small aircraft, or a rural Critical Access Hospital has strived to become certified or designated as a Level IV trauma center, clear progress has been demonstrated toward the betterment of trauma care in Alaska.

The achievements to date have largely been unplanned with limited coordination. As a result, incongruity exists within the current trauma system. Several Alaska Native facilities have sought and achieved verification/designation as trauma centers. These facilities are to be commended for their dedication and commitment to trauma care and the trauma system. To date, few of the facilities serving the majority population have made a similar commitment to achieving nationally recognized standards of trauma care.

The current leadership of the Alaska Department of Health and Social Services recently made a commitment to trauma system development by making this a priority project in the 2009 work plan. This represents an opportunity to begin the process to coordinate, systematize and institutionalize these efforts so that, regardless of where someone is injured in Alaska or what their racial and ethnic heritage might be, all have equal access to optimal trauma care.

Alaska must make a commitment of resources, both fiscal and human, to achieve the recommendations outlined in this document. The consultation team encourages the state to retain the opportunity for system ingenuity when addressing the challenges that Alaska�s geography and environment impose when increasing the standardization of trauma system processes.

Advantages and Assets of the Alaska Trauma System
  • The lead agency for trauma is identified. Statute designates the AlaskaCouncil on EMS (ACEMS) as an advisory group with responsibility for trauma.

  • The state has very committed individuals who use their time and expertise every day to serve Alaska citizens.
  • The state has extensive and creative networks for transport.

  • Three large medical centers with extensive subspecialty expertise exist within the state.

  • A large Level I trauma center in Seattle freely accepts adult and pediatric trauma patients.

  • One medical center maintains ACS Level II verification standards and other facilities have obtained consultation and are working toward verification.

  • All 24 acute care hospitals provide data to the Alaska trauma registry.

  • Injury prevention activities are well established.

  • The EMS Goals document categorizes communities by size and remoteness and identifies the resources that should be available for health care and trauma care.

  • The state created the Emergency Trauma Technician program to prepare community members to provide initial trauma care.

  • Initial efforts have been made to obtain legislative change.
Challenges and Vulnerabilities of the Alaska Trauma System
  • The state has many challenges due to geography, weather, and remote and isolated communities.

  • No trauma system strategic plan has been developed.

  • No standards exist for scene trauma triage or trauma inter-facility transfers.

  • Trauma system issues receive limited attention by the Alaska Council on EMS, and thus little visibility within the Department of Health and Social Services.

  • The general public is not aware of trauma system issues.

  • The state has limited human resources for the provision of trauma care. The lead agency also has limited human resources for trauma system management.

  • The ACEMS has no formal trauma representatives.

  • There are two healthcare systems for trauma care, one for Native Alaskans and one for other Alaskans.

  • Few incentives exist for hospitals to participate in the trauma system.

  • No statewide evaluation of system performance is conducted.

  • The trauma registry data are not current.
Priority Recommendations Summary

This report contains more than seventy recommendations. Of these, the TSEPC team felt that the following were the most critical to the system�s short and long-term success.

Statutory Authority and Administrative Rules
  • Enact legislation to expand the membership of the ACEMS to represent the trauma system and to include the following members appointed as follows:
    • One member, appointed by the Governor, shall represent the Alaska Chapter of the American College of Surgeons Committee on Trauma.
    • One member, appointed by the Governor, shall be a general surgeon who routinely participates in the care of injured patients.
    • One member, appointed by the Governor, shall represent the Alaska Chapter of the American Academy of Pediatrics.
    • One member, appointed by the Alaska Legislature, upon the recommendation of the Speaker of the House of Representatives.
    • One member, appointed by the Alaska Legislature, upon the recommendation of the President of the Senate.
  • Require participation of all acute care hospitals in the trauma system within a 2 year time frame.

    • Facilities should seek trauma center designation at a level appropriate for their capabilities.

    • Other facilities, such as remote health care clinics, should participate with rapid patient assessment and stabilization and by following guidelines for trauma triage and transfer.
System Leadership
  • Form an Alaska Technical Advisory Committee (ATAC) and task it with providing the Alaska Council on Emergency Medical Services (ACEMS) with recommendations regarding the following functions: data systems, trauma system planning, system-wide performance improvement and patient safety, trauma education (Advanced Trauma Life Support [ATLS], Trauma Nurse Core Curriculum [TNCC], Prehospital Trauma Life [PHTLS], etc), trauma center review and certification, injury prevention and control, public policy, and research.
Coalition Building and Community Support
  • Develop and disseminate public information about the challenges in providing trauma care and the status of the trauma system in the state for Alaskans.
Lead Agency and Human Resources Within the Lead Agency
  • Develop an appropriate position classification and duty statement for a 1.0 full time equivalent (FTE), permanent trauma system manager that specifies education as a health professional, experience in trauma or emergency health care, and the administrative skills and clinical understanding necessary to support trauma system development.
Trauma System Plan
  • Develop a comprehensive trauma system strategic plan consistent with the Health Resources and Services Administration (HRSA) Model Trauma System Planning and Evaluation document.
System Integration
  • Ensure that the Injury Prevention and Emergency Medical Services (IPEMS) Section is engaged in planning with disaster preparedness, emergency management, and public health functions for integration of the trauma system.
Financing
  • Provide state funding to hire a fulltime trauma system manager.
Emergency Medical Services
  • Develop a central coordination center for statewide air medical resources that will maintain an updated registry of all medical aircraft to include medical services and flight characteristics (e.g., load capacity, instrument rating, landing requirements, etc); and to monitor the availability and location of air resources in near real-time.
Definitive Care Facilities
  • Establish, as soon as practical, a second Level II Trauma Center in Anchorage in accordance with American College of Surgeons Committee on Trauma (ACS-COT) verification criteria to meet the existing volume and acuity demands.
  • Mandate participation of all acute care hospitals in the trauma system within a 2 year time frame with trauma center certification/designation appropriate to their capabilities.
  • Study pediatric trauma care needs with the goal of establishing one or more centers of excellence in pediatric trauma care.
System Coordination and Patient Flow
  • Implement standardized prehospital triage and trauma activation protocols customized to the three response areas (Anchorage, Southeast, and the bush).
Disaster Preparedness
  • Integrate all components of the trauma system into state and local disaster planning activities.
System-wide Evaluation and Quality Assurance
  • Develop an initial set of 3-5 statewide system performance indicators from among the list of nine provided in the Pre-Review Questionnaire.
Trauma Management Information Systems
  • Ensure that all elements considered essential to system development, evaluation and performance improvement in the State of Alaska are included and functional in the new trauma registry and are consistent with the National Trauma Data Standard definitions.
[A full copy of the report is available online]

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Alaska Health Policy Calendar

This week, the 26th legislature met for the first time, and began scheduling committee meetings for standing committees. The start of the session includes primarily House Finance Committee Meetings, with departmental budgets on the agenda.

This calendar of health policy-related legislative meetings is current as of January 20, 2009 at 1 PM. Please visit the Alaska State Legislature's list of committee hearings for the most current listings, as they are subject to change.

January 23, 2009, 3:00 PM
What: Labor and Commerce Standing Committee
Where: Capitol 17, Juneau
Other Information: In-state Labor &Workforce Development; Presentations by Dept. of Labor, Commissioner Bishop, and University of Alaska Anchorage; teleconferenced

January 26, 2009, 1:30 PM
What: House Finance Committee
Where: House Finance 519, Juneau
Other Information: Budget overview- Office of Management and Budget

January 27, 2009, 1:30 PM
What: House Finance Committee
Where: House Finance 519, Juneau
Other Information: Budget overviews- Legislative Finance Division; Alaska Mental Health Trust Authority; teleconferenced

January 28, 2009, 1:30 PM
What: House Finance Committee
Where: House Finance 519, Juneau
Other Information: Budget overviews- Dept. of Health & Social Services; Military & Veterans Affairs; teleconferenced

January 29, 2009, 1:30 PM
What: House Finance Committee
Where: House Finance 519, Juneau
Other Information: Budget overviews- Dept. of Administration, Dept. of Revenue; Alaska Court System; and Dept. of Law-Civil; teleconferenced

February 3, 2009, 1:30 PM
What:  House Finance Committee
Where: House Finance 519, Juneau
Other Information: Budget overviews- Dept. of Education & Early Development; University; Labor & Workforce Development- workforce development; Commerce, Community & Economic Development; Labor & Workforce Development- regulatory; teleconferenced

February 4, 2009, 1:30 PM
What: House Finance Committee
Where: House Finance 519, Juneau
Other Information: Budget overviews- Dept. of Transportation & Public Facilities

February 5, 2009, 1:30 PM
What: House Finance Committee
Where: House Finance 519, Juneau
Other Information: PERS/TERS Update; teleconferenced

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Bill Watch: Second Set of Prefiles and Committee Assignments

It was an exciting week as the second set of prefiles was released and the 26th legislative session met for the first time to review all submitted prefiles. As you will see below, we start this legislative session with bills that focus on significant health policy issues. Senator French introduced SB 61, a bill that has the potential to bring health insurance to all Alaskans, following up on last year's SB 160 (which did not pass in the legislature). Senator Davis is sponsoring SB 21, a bill that would create mental health parity in health insurance coverage for Alaskans. Lastly, we see bills in both the house and senate that propose changing the eligibility requirements for Medicaid, allowing health care coverage for more Alaskans.

As we mentioned last week, house and senate members have two opportunities to issue a list of bills for the start of the legislative agenda. Often, these bills (referred to as prefiles) focus on issues or bills that did not pass during the previous session (i.e. a second attempt), or are additions/appeals to previous legislative action. This year, the house and senate issued their first set of prefiles on January 9, with a second set issued on January 16. These prefiles were introduced to the house and senate for the first time this week, and were assigned to committees. We reported the first set of health policy-related prefiles in the last issue of AHPR. This week, we add the second set of health-policy related prefiles, and update committee assignments for each bill. Bills are current as of January 21 at 1 PM.

Bills listed here were selected based on a series of subjective criteria to determine their applicability to health policy issues. After a thorough examination of each bill, any that obviously dealt with non-health-related issues were eliminated. After determining the full set of health-related bills pre-filed for the new session, the remaining bills 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) HSS: House Health and Social Services Committee
  • (S) HSS: Senate Health and Social Services Committee
  • (H) L&C: House Labor & Commerce Committee
  • (S) L&C: Senate Labor & Commerce Committee
  • (H) EDC: House Education Committee
  • (S) EDC: Senate Education Committee
  • (H) FIN: House Finance Committee
  • (S) FIN: Senate Finance Committee
  • (H) JUD: House Judiciary Committee
  • (S) JUD: Senate Judiciary Committee
  • (H) STA: House State Affairs Committee
  • (S) STA: Senate State Affairs Committee
Bill Watch: Drugs

HB 17
Full Title: Raising the age for purchase, sale, exchange, or possession of tobacco to age 21.
Sponsor: Representative Crawford
Committee(s) and date of last action: Read and referred to (H) L&C, 01/20/09
Description: This bill requests to change the legal age from 19 to 21 for the purchase, sale, exchange, and possession of tobacco. Specifically, it requests that any statute listing the legal age as 19 for the above activities be amended to the age of 21.

SB 52
Full Title: Relating to scheduling Salvia divinorum and Salvinorin A as controlled substances.
Sponsor: Senator Therriault
Committee(s) and date of last action: Read and referred to (S) HSS, 01/21/09
Description: Salvia divinorum and Salvinorin A are compounds of a plant used for medicinal purposes and with hallucinogenic properties. There has been an increase in its use, and has the potential for misuse and abuse. This bill requests that it be listed as a controlled substance.

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Bill Watch: Education

HB 58
Full Title: Relating to a student loan repayment program for specified occupations or fields in which a shortage of qualified employees exists.
Sponsors: Representatives Thomas, Wilson, Millett, Harris
Committee(s) and date of last action: Read and referred to (H) EDC, 01/20/09
Description: This bill requests that general funds be set aside for incentive use to recruit individuals in occupations facing a shortage. Dentists and licensed practical nurses are among the occupations listed that would have access to these funds and incentive programs. Allocation of these funds is grouped by geographical location, with more funding available to professionals who are employed in rural areas of the state. A minimum of one year of employment is required for eligibility, and the amount of funding increases incrementally with the number of years of employment.

SB 18
Full Title: Increasing the number of students pursuing a medical education who are provided postsecondary educational services and programs; and providing for an effective date.
Sponsors: Senators Wielecheowski, Thomas, Ellis
Committee(s) and date of last action: Read and referred to (S) HSS, 01/20/09
Description: This bill proposes to raise the number of new students enrolled in medical education through the WWAMI program from 20 to 24 by 2010, and from 24 to 30 by 2012.

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Bill Watch: General Health Policy

HB 71
Full Title: Relating to a registry for advance health care directives.
Sponsors: Representatives Holmes, Dahlstrom, Millett, Kawasaki
Committee(s) and date of last action: Read and referred to (H) HSS, 01/20/09
Description: This bill amends a previous statute by adding that a health care facility will not be subject to civil or criminal liability in the event that they act in reliance to an advance health care directive or fail to check an advance health care directive registry for a patient in their facility. In addition, HB 71 proposes the establishment of an advance health care directive registry within the Department of Health and Social Services, where individuals or their guardians can file advance health directives. This registry would be confidential and may not be used for another purpose.

HB 26
Full Title: Repealing the repeal of preventative and restorative adult dental services reimbursement under Medicaid; providing for an effective date by repealing the effective date of sec. 3, ch. 52, SLA 2006; and providing for an effective date.
Sponsors: Representatives Hawker and Munoz
Committee(s) and date of last action: Read and referred to (H) HSS, 01/20/09
Description: As indicated by the title, this bill is a repeal for a previous repeal of Medicaid reimbursement for preventative and restorative adult dental services. It requests that reimbursement for these services by Medicaid be returned immediately.

HB 28
Full Title: Relating to the licensing of clinical laboratory science professionals; and providing for an effective date.
Sponsor: Representative Crawford
Committee(s) and date of last action: Read and referred to (H) L&C, 01/20/09
Description: This bill outlines the definitions related to "clinical laboratory scientist," including the allowable duties of a phlebotomist under the supervision of certain medical professionals, and the criteria for licensure and removal of license for laboratory scientists. It also establishes the composition and duties of a volunteer advisory board for clinical laboratory science professionals, to be effective October 1, 2009.

HB 50
Full Title: Relating to limitations on mandatory overtime for registered nurses and licensed practical nurses in health care facilities; and providing for an effective date.
Sponsors: Representatives Wilson, Gara, Tuck, Petersen, Lynn, Seaton, Gatto, Cissna, Munoz, Gardner, Ramras
Committee(s) and date of last action: Read and referred to (H) HSS, 01/20/09
Description: This bill cites the frequent overtime work schedules among nursing professionals as contributors to employee turnover and inadequate health care. It requests that a previous statute be amended to include limitations related to overtime among nursing schedules. These limitations include that no nursing professional is to work more than 80 hours during a 14 day period, and that time between each shift should be no less than 10 hours. Other amendments incorporate the availability of an anonymous complaint system in the workplace of nurses, and mandatory adoption of these provisions by all entities employing nursing professionals.

HB 51
Full Title: Relating to limitations on mandatory overtime for registered nurses and licensed practical nurses in health care facilities; and providing for an effective date.
Sponsor: Representative Gardner
Committee(s) and date of last action: Read and referred to (H) HSS, 01/20/09
Description: This bill is identical to HB 50.

SB 8
Full Title: Relating to the practice and licensing of psychologists.
Sponsor: Senator Hoffman
Committee(s) and date of last action: Read and referred to (S) EDC, 01/20/09
Description: This bill proposes an amendment to a previous statute regarding the ability of a psychological professional to take a psychological associate examination for licensure. Specifically, it adds that an individual in ineligible for examination if they failed an exam within the last six months and that this amendment is not applicable to a psychologist employed in a school district or a psychologist employed by the U.S. government while in the discharge of that employee's service.

SB 12
Full Title: Relating to limitations on mandatory overtimes for registered nurses and licensed pratical nurses in health care facilities; and providing for an effective date.
Sponsor: Senator Davis
Committee(s) and date of last action: Read and referred to (H) HSS, 01/20/09
Description: Identical to HB 50, this bill cites the frequent overtime work schedules among nursing professionals as contributors to employee turnover and inadequate health care. It requests that a previous statute be amended to include limitations related to overtime among nursing schedules. These limitations include that no nursing professional is to work more than 80 hours during a 14 day period, and that time between each shift should be no less than 10 hours. Other amendments incorporate the availability of an anonymous complaint system in the workplace of nurses, and mandatory adoption of these provisions by all entities employing nursing professionals.

SB 41
Full Title: Relating to cardiopulmonary resuscitation and first aid training for initial applicants for driver's licenses and instruction permits; and providing for an effective date.
Sponsor: Senator Ellis by request of the Governor
Committee(s) and date of last action: Read and referred to (S) HSS, 01/20/09
Description: This bill requests that new applications for driver's permits or licenses only be issued to individuals who have completed cardiopulmonary resuscitation and first aid training in the one year prior to the application. This does not apply for individuals who have already obtained a driver's license or permit in Alaska or another state, and is to be effective January 1, 2010.

SB 49
Full Title: Relating to an awareness fund and monetary donation program for blood donations.
Sponsor: Senator McGuire
Committee(s) and date of last action: Read and referred to (S) STA, 01/20/09
Description: This bill requests that the opportunity to donate $1 or more to the Blood Donation Fund be made available to all applicants for motor vehicle or identification documents. These donations would be place in the Blood Donation Awareness Fund, and would be used to promote blood donation activities throughout Alaska.

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Bill Watch: Medical Assistance and Health Insurance

SB 61
Full Title: Establishing an Alaska health care program to ensure insurance coverage for essential health services for residents of the state, the Alaska Health Care Board to administer the Alaska health care program and the Alaska health care fund, the Alaska health care clearinghouse to administer the Alaska health care program under the direction of the Alaska Health Care Board, and eligibility standards and premium assistance for health care coverage of persons with low incomes; creating the Alaska health care fund; providing for review of actions and reporting requirements related to the health care program; and providing for an effective date.
Sponsors: Senators French, Ellis
Committee(s) and date of last action: Read and referred to (S) HSS, 01/20/09
Description: This bill proposes the establishment of the Alaska Health Care Program (AKCP), a program given the task of ensuring that all Alaskans have access to affordable health care insurance covering all essential services. The AKCP will be monitored and managed by an Alaskan Health Care Board of 13 members, 12 of which are to be appointed by the governor. Similar to SB 160 (25th legislative session), this bill includes
  • 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
If passed, this bill is to take effect by January 1, 2010.

HB 62
Full Title: Relating to eligibility requirements and premium requirements for medical assistance coverage for children; and providing for an effective date.
Sponsors: Representative Hawker
Committee(s) and date of last action: Read and referred to (H) HSS, 01/20/09
Description: This bill, also known as the "Denali Kid Care Accountability Act," amends a previous Alaska Statute on medical assistance eligibility requirements. Specifically, it adds sections requiring recipients of medical assistance in families whose income is between 175 and 250 of the federal poverty level to pay premiums, on a sliding scale, for medical assistance. The Department of Health and Human Services is required to set the premium at no less than 2% of the recipient's income, and establish a system of collecting premiums from recipients. This bill requests that these changes go into effect following the approved revisions and funding to make these changes.

HB 61
Full Title: Relating to eligibility requirements for medical assistance for certain children, pregnant women, and disabled persons.
Sponsors: Representatives Cissna and Gruenberg
Committee(s) and date of last action: Read and referred to (H) HSS, 01/20/09
Description: This bill requests many changes to medical assistance eligibility for Alaskans. Among the changes are 1) disabled persons: increasing the eligibility for those in a family whose income does not exceed 250% of the official poverty level for Alaska; 2) individuals under the age of 19: increasing the family income eligibility from 175% to 200% of the federal poverty level for Alaska; 3) pregnant women: increasing the family income eligibility from 175% to 200% of the federal poverty level for Alaska.

SB 10
Full Title: Requiring health care insurers to provide insurance coverage for medical care received by a patient during certain approved clinical trials designed to test and improve prevention, diagnosis, treatment, or palliation of cancer; directing the Department of Health and Social Services to provide Medicaid services to persons who participate in those clinical trials; relating to experimental procedures under a state plan offered by the Comprehensive Health Insurance Association; and providing for an effective date."
Sponsor: Senator Davis
Committee(s) and date of last action: Read and referred to (S) HSS, 01/21/09
Committee(s) and date of last action: Read and referred to (S) HSS, 01/21/09
Description: This bill requests that a health insurance company be required to provide coverage for any medical expenses incurred during the course of participation in an approved clinical trial.

SB 11
Full Title: Relating to health care insurance coverage of a dependent child who is less than 26 years of age and making a conforming age amendment in the statute describing health insurance policies that may be delivered or issued in this state.
Sponsor: Senator Davis
Committee(s) and date of last action: Read and referred to (S) HSS, 01/21/09
Description: This bill requests that among health insurance policies covering dependents of enrollees, the defined age for "dependent child" be raised from 23 to 26 years of age.

SB 13
Full Title: Relating to eligibility requirements for medical assistance for certain children and pregnant women; and providing for an effective date.
Sponsor: Senator Davis
Committee(s) and date of last action: Read and referred to (S) HSS, 01/21/09
Description: This bill requests that the family income eligibility requirements for medical assistance among children and pregnant women be raised from 175% to 200% of the federal poverty level, effective immediately.

SB 32
Full Title: Relating to medical assistance payments for home and community-based services.
Sponsor: Senator Ellis
Committee(s) and date of last action: Read and referred to (S) HSS, 01/21/09
Description: This bill requests an amendment to a previous statute outlining medical assistance among health facilities, adding medical assistance eligibility for home and community-based services.

SB 38
Full Title: Relating to insurance; removing references, definitions, and confidentiality of information provisions relating to managed care entities, substituting health care insurers in the former role of managed care entities, and amending the definitions of "covered person," "managed care plan," and "utilization review," as those terms relate to the administration of managed care insurance plans; authorizing persons to act as pharmacy benefits managers subject to oversight by the division of insurance; and amending the definition of "health care insurer" as it relates to health care insurance.
Sponsor: Senator Elton
Committee(s) and date of last action: Read and referred to (S) HSS, 01/21/09
Description: This bill proposes to change language in a previous statute, amending "managed care entity" to "health care insurer."
Bill Watch: Mental Health

HB 52
Full Title: Authorizing psychological counseling for jurors serving in criminal trials who are traumatized by graphic evidence or testimony.
Sponsor: Representative Kerttula
Committee(s) and date of last action: Read and referred to (H) JUD, 01/20/09
Description: This bill proposes to make available up to 10 hours of psychological counseling for any juror serving in a criminal trial where graphic images or content are presented.

SB 21
Full Title: Requiring health care insurers to provide coverage for treatment of mental health, alcoholism, and substance abuse conditions, and requiring parity between health care insurance coverage for mental health, alcoholism, and substance abuse benefits and other medical care benefits; eliminating different treatment for mental health conditions from the minimum benefits of the state health insurance plan; removing an exclusion for mental health services or alcohol or drug abuse from the definition of basic health care services in the law relating to health maintenance organizations; repealing a provision that allows optional insurance coverage for treatment of alcoholism and drug abuse based on the number of employees and the duration of employment; repealing a definition of costs applicable solely to treatment for alcoholism and drug abuse, including a provision that allows the cost for treatment of alcoholism and drug abuse to be determined by the insurance contract or by a contract between the treatment provider and the health care insurer; repealing a definition of mental health benefits that excludes treatment of substance abuse or chemical dependency; and providing for an effective date.
Sponsor: Senators Davis and Ellis
Committee(s) and date of last action: Read and referred to (S) HSS, 01/21/09
Description: This bill proposes to implement parity in the types of medical services covered under existing health insurance plans. Specifically, it proposes that health care insurance policies be prohibited from denying coverage or discriminating health care services related to mental health, alcoholism or substance abuse; that there be no difference in coverage between physical and mental health coverage; and that these changes take effect no later than July 1, 2009.
 
Bill Watch: State Boards and Issues

HB 75
Full Title: Establishing the Alaska Health Commission; relating to health planning; requiring a certificate of need study; and providing for an effective date.
Sponsors: Representatives Cissna and Gruenberg
Committee(s) and date of last action: Read and referred to (H) HSS, 01/20/09
Description: This bill requests the establishment of the Alaska Health Commission, whose purpose is to provide policy recommendations ensuring quality, accessibility, and affordability of health care throughout the state. The commission is to have 15 members, of the following composition: one member from the Alaska Mental Health Trust Authority, one member from the University of Alaska Health Education and Training Program, one member representing the Alaska Native Tribal Health Consortium, one member from the Alaska Primary Care Association, one member from the Alaska State Hospital and Nursing Home Association, one member from the health industry, one member from the Alaska Nurses Association, two health care consumer members/advocates, and six members of the Alaska legislature. This act is to take effect by July 1, 2009.

HB 63
Full Title: Relating to the Council on Domestic Violence and Sexual Assault
Sponsors: Representatives Fairclough, Holmes, Coghill, and Wilson
Committee(s) and date of last action: Read and referred to (H) STA, 01/20/09
Description: This bill requests that the number of members of the Council on Domestic Violence and Sexual Assault be changed from three to four, and that at least one of the four members is a representative of a rural area of the state. In addition, this bill amends the length of term for public members from two to three years of eligible service. Other changes include adding the Department of Corrections as a regular collaborator with the council.

HB 25
Full Title: Establishing the Alaska Health Reform Policy Commission in the Department of Health and Social Services, and establishing the position of the executive director of that commission in the partially exempt service; and providing for an effective date.
Sponsor: Representative Hawker
Committee(s) and date of last action: Read and referred to (H) HSS, 01/20/09
Description: This bill proposes that issues related to health care and health care policy be given high priority among government officials. Specifically, it proposes the addition of a new chapter in the Alaska Statute 18, establishing the Alaska Health Reform Policy Commission, outlining the composition and duties of that commission, to be effective immediately.

SB 35
Full Title: Extending the termination date of the Statewide Suicide Prevention Council; and providing for an effective date.
Sponsors: Senator, Davis, Ellis, Therriault
Committee(s) and date of last action: Read and referred to (S) HSS, 01/21/09
Description: This bill amends a previous act to extend the termination of the Statewide Suicide Prevention Council from June 30, 2009 to June 30, 2013.

SB 40
Full Title: Extending the termination date of the Statewide Suicide Prevention Council; and providing for an effective date.
Sponsor: Senator Therriault
Committee(s) and date of last action: Read and referred to (S) HSS, 01/21/09
Description: This bill is identical to SB 35.

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Bill Watch: Family Health Issues

HB 2
Full Title: Relating to the issuance of a certificate of birth resulting in a stillbirth.
Sponsors: Representatives Gatto, Gruenberg, Dahlstrom, Lynn Gatto
Committee(s) and date of last action: Read and referred to (H) HSS, 01/20/09
Description: This bill proposes that in the event that a birth results in a stillbirth, parents of the stillborn child are to be notified of their eligibility and procedures for obtaining a birth certificate for that child.

HB 34
Full Title: Relating to partial-birth abortions.
Sponsors: Representatives Coghill, Newman, Keller, Dahlstrom
Committee(s) and date of last action: Read and referred to (H) HSS, 01/20/09
Description: This bill proposes to amend the language in a previous statute, requesting that the definition of "partial-birth" abortion include terms indicating intention and deliberation, the presence of partial vaginal birth, and the knowledge that the birth will result in the death of a child.

HB 35
Full Title: Relating to notice and consent for a minor's abortion; relating to penalties for performing an abortion; relating to coercion of a minor to have an abortion; relating to reporting of abortions performed on minors; amending Rule 220, Alaska Rules of Appellate Procedure, and Rule 20, Alaska Probate Rules, relating to judicial bypass for an abortion; and providing for an effective date.
Sponsors: Representatives Coghill, Newman, Keller, Dahlstrom
Committee(s) and date of last action: Read and referred to (H) HSS, 01/20/09
Description: This bill proposes several amendments to a previous statute regarding abortion among pregnant women under 17 years of age. These include the prohibition of a medical professional to perform an abortion without parental notification and consent, with the exception of an immediate and potentially lethal risk to the minor.

SB 5
Full Title: Relating to partial-birth abortions.
Sponsors: Senators Dyson and Therriault
Committee(s) and date of last action: Read and referred to (S) HSS, 01/21/09
Description: This bill is identical to HB 34.

SB 6
Full Title: Relating to notice and consent for a minor's abortion; relating to penalties for performing an abortion; relating to a judicial bypass procedure for an abortion; relating to coercion of a minor to have an abortion; relating to reporting of abortions performed on minors; and amending rule 220, Alaska Rules of Appellate Procedure, and Rule 20, Alaska Probate Rules, relating to judicial bypass for an abortion.
Sponsors: Senators Dyson and Therriault
Committee(s) and date of last action: Read and referred to (S) HSS, 01/21/09
Description: This bill is identical to HB 35.

SB 15
Full Title: Relating to abortion, fetal pain, anesthesia, and informed consent; and providing for an effective date (Short Title: Fetal Pain Awareness and Prevention Act)
Sponsor: Senator Dyson
Committee(s) and date of last action: Read and referred to (S) HSS, 01/21/09
Description: This bill proposes that all pregnant women considering abortion should be given information regarding their options to reduce pain to an unborn fetus prior to the procedure, to take effect immediately.

SB 16
Full Title: Defining "natural person," "human being," "child," "individual, and "born alive." (Short Title: Born-Alive Infants Prevention Act)
Sponsor: Senator Dyson
Committee(s) and date of last action: Read and referred to (S) HSS, 01/21/09
Description: This bill requests to define the above terms to include a human born in any stage of fetal development; it is noted that this bill does not intend to extend the rights of human life to an unborn human.

SB 42
Full Title: Relating to break times for employees who nurse a child.
Sponsors: Senators Ellis and Wielechowski
Committee(s) and date of last action: Read and referred to (S) L&C, 01/21/09
Description: This bill proposes that an employer be required to provide "reasonable" unpaid break time for mothers who are nursing a child, and that a private room or area be made available for nursing mothers. This bill does not require that employers allow children of nursing mothers in the workplace.

SB 44
Full Title: Relating to the safe abandonment of infants.
Sponsor: Senator Menard
Committee(s) and date of last action: Read and referred to (S) HSS, 01/21/09
Description: This bill requests an amendment to a previous statute, proposing that parents who safely surrender an infant 60 days or younger be exempt from prosecution or penalty.
Worker's Compensation

SB 20
Full Title: Limiting the release of employee medical and rehabilitation records held or maintained by the state for purposes of the Alaska Workers' Compensation Act.
Sponsors: Senators French and Thomas
Committee(s) and date of last action: Read and referred to (S) L&C, 01/21/09
Description: This bill proposes that any documents containing personal and confidential information of an employee that is receiving, or has received, worker's compensation, be kept in a confidential location away from the public's view.

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AHPR Staff and Contributors

Lawrence D. Weiss, PhD, MS, Editor
Kelby Murphy, Associate Policy Analyst
Keith Liles, Project Coordinator
Jacqueline Yeagle, Newsletter design and editing

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