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February 6, 2009 Vol 3, Issue 4


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SCHIP: The Struggle for Healthy Children in Alaska, Part Two
Please Respect Our Copyright
Policy Victory for Public Health
Alaska Health Policy Calendar
Bill Watch: Bills on the Move
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
Bill Watch: Worker's Compensation
AHPR Staff and Contributors
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Resources

Alaska Health Assurance Advocacy Team: What You Need to Know: Health Care Reform for Alaska - Seminar for Legislators Audio File

Commonwealth Fund Health Care Quality Improvement Resource

Coverage for Children in a Recession

Medicaid and SCHIP in a Recession

Partnership for Prevention: Shaping Policies/Improving Health Website

From the Editor

Dear Reader:

These are exciting times in terms of the potential of health reform in Alaska and nationally. President Obama just signed legislation expanding health insurance for low-income children across the nation.

Companion bills in the Alaska House and Senate intend to do the same in our state specifically. Senator French has reintroduced his bill promoting a more far-reaching health financing reform in Alaska. We now have a statewide health commission established by executive order by Governor Palin, and there is the likelihood of additional legislative action on the same topic. And this is just scratching the surface nationally and in Alaska since our session just started, and Obama just took office.   

This week, the U.S. Senate is scheduled to consider S. 336, the American Recovery and Reinvestment Act of 2009. This bill contains $5.8 billion in funding for public health. According to the American Public Health Association, the funding will be used for:  

public health and prevention that will create jobs at the state, local and community levels that work to prevent disease and reduce the health care costs associated with treating many costly conditions and diseases. This funding will strengthen immunization programs, provide training and education to our public health workforce and fund community-based wellness programs and activities. A recent study by the Trust for America's Health found that for every $1 spent on proven community-based disease prevention programs, the country could net a return of $5.60 in health care costs within five years. 

The funding will also be used for:

addressing the public health workforce shortage, improving and expanding the services provided by community health centers, improving health information technology as well as for critical safety net programs including the Medicaid program and food stamp program. 

In this issue of AHPR we continue to provide analysis about a selection of these issues, we track key bills, we provide easy access to key resources, and we provide information about important committee meetings. Your feedback about the content of this and every issue always appreciated.

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

SCHIP: The Struggle for Healthy Children in Alaska, Part Two

...since it was created more than 10 years ago, the Children's Health Insurance Program has been a lifeline for millions of children whose parents work full-time and don't qualify for Medicaid, but, through no fault of their own, don't have and can't afford private insurance. - President Obama at the signing of H.R. 2

Options for More Alaskans Ahead?

Some exciting changes in legislation are happening at the state level regarding Medicaid eligibility. Legislative actions at the state level are a primary influence on the number of uninsured children eligible for assistance through SCHIP. In part one of this article (Vol. 3 Issue 3), two bills affecting health care coverage for Alaska's children were presented. Another bill has surfaced that could increase the number of children eligible for medical assistance through Denali KidCare.

Last week, Senator Wielechowski proposed SB 87, giving the bill a short title of "No Child Left Uninsured Act." This bill is similar to HB 62 (Denali KidCare Accountability Act), in that it offers medical assistance to more children in Alaska by increasing the number who are eligible for assistance. Senate Bill 87 expands coverage to children in families up to 300% of the federal poverty level, with the requirement that recipients pay a yearly premium. Premiums are set on a sliding scale based on family income, starting at $240 per year and going no higher than $1200 per year.

The addition of SB 87 creates three bills in the state legislature that address specifically the income eligibility requirements for medical assistance. House Bill 61 proposes raising the eligibility requirements for children in families up to 200% of the federal poverty level. This category requires no yearly premiums from recipients. House Bill 62 adds an eligibility category of between 175% and 250% of the federal poverty level, with a required yearly premium of no more than 2% of a family's income. Senate Bill 87 creates an even broader eligibility category, individuals in families with incomes between 200% and 300% of the federal poverty level, with a sliding scale premium required. In the event that these bills pass, the number of insured children in Alaska will increase substantially.

CHIPRA 2009: Four and a Half Years of Healthier Children

Last year, Congress passed bills for the reauthorization of SCHIP twice, but faced vetoes both times by President Bush. SCHIP is currently operating on temporary federal funding, which ends March 31 of this year. With the hope of support from the new administration, reauthorization of SCHIP became a top priority this year, and Congress released SCHIP bills in both the House and Senate as one of their first actions of the legislative session. The House and Senate have passed amended versions of CHIPRA 2009 back and forth since January. As we write this, President Obama has just signed HR 2, reauthorizing SCHIP for 4 1/2 more years.

In a decent society, there are certain obligations that are not subject to tradeoffs or negotiations, and health care for our children is one of those obligations. - President Obama at the signing of H.R. 2

The Children's Health Insurance Reauthorization Act of 2009 contains significant changes from previous SCHIP legislation. First, it expands coverage until 2013, or 4 1/2 after March 31, 2009. An increase in the federal tobacco tax (i.e. 62 cents) will provide additional funding for SCHIP. Health coverage options are expanded to include dental and mental health services (note: these services are already included in Medicaid coverage for Alaska's children). Additionally, increased federal matching rates are proposed, and states have the option to waive the five-year waiting period for medical assistance among legal immigrants.

So what does this mean for our nation's children? Recent reports by Kaiser and others project that CHIPRA 2009 will expand coverage to more than four million uninsured children. These children will now be covered for doctor's visits, immunizations, emergency room visits, and hospitalizations. Additionally, the increased federal matching rate will keep programs alive in states that are experiencing budget shortfalls.

Health Care Coverage When We Need It Most    

No child in America should be receiving his or her primary care in the emergency room in the middle of the night. No child should be falling behind at school because he can't hear the teacher or see the blackboard. - President Obama at signing of H.R. 2

Recently, the Alaska Department of Labor and Workforce Development reported the highest rate in unemployment in five years, with an additional 5,000 Alaskans facing unemployment between December 2007 and December 2008. As Alaskans lose their jobs, they may almost certainly lose their health insurance coverage. Additionally, the state is facing a budget shortfall, and it is possible that funding for programs like Medicaid could be reduced to compensate.

According to a recent report released by Families USA, many states are experiencing this trend. They estimate that for every one percent increase in the national unemployment rate, an additional 600,000 children become uninsured. Therefore, at a time when people are losing their jobs and health care coverage, states may have to cut back on programs like those that offer medical assistance. This leaves families with an alarming dilemma: the choice between paying bills and going to the doctor. In Alaska, we haven't seen Medicaid cutbacks yet, but with more unemployed Alaskans, the impact on our children's health and well-being remains.

The Food Bank of Alaska recently submitted a report based on a 2006 Hunger Study, highlighting some of the effects of unemployment on health care. They cite poor health as the most common reason people seek food assistance. More than half of soup kitchen clients in Alaska have to choose between purchasing food and health care or medicine.

In 2008, 19,000 children in Alaska were uninsured. The reauthorization of SCHIP will provide over 22 million dollars per year for SCHIP services in our state. Because Alaska's SCHIP is a Medicaid expansion program, reauthorization means an additional 8,400 children will be eligible for coverage through either Medicaid or SCHIP. That translates to a 44 percent reduction in uninsured Alaskan children.

Medical Assistance as an Economic Stimulus

Kaiser recently issued a report titled "Turning to Medicaid and SCHIP in an economic recession: conversations with recent applicants and enrollees."  This report, issued in December 2008, describes the benefits of a program such as SCHIP in improving the nation's current state of economic insecurity. Kaiser suggests many ways to improve assistance programs like SCHIP, including:
  • Increasing the number of enrollment specialists
  • Expanding enrollment settings to include locations other than social services offices and finding ways to make it easier for eligible families to obtain Medicaid and SCHIP
  • Expanding Medicaid and SCHIP the eligibility so that parents can qualify along with their children
  • Disregarding unemployment benefits when determining income so that families are not disqualified for this reason
Alaska is ahead of other states regarding ease of enrollment in Medicaid programs. With additional federal funding for SCHIP, it is possible that the above recommendations will see fruition and increase enrollment for Alaskans.

Ultimately, increasing health care coverage has the net effect of ensuring that health care workers keep their jobs in an uncertain economy. In fact, new jobs may become available as these programs enroll more children. More jobs means more spending, which only improves the state of the economy. Therefore, as President Obama said at the signing of H.R. 2 on Wednesday, this investment in our children's health is the first step in prevention and wellness for everyone.

Sources:

Kaiser Commission on Medicaid and the Uninsured (January 2009). Challenges of Providing Health Coverage for Children and Parents in a Recession; A 50 State Update of Eligibility Rules, Enrollment and Renewal Procedures, and Cost-Sharing Practices in Medicaid and SCHIP in 2009.

Kaiser Commission on Medicaid and the Uninsured (December 2008). Turning to Medicaid and SCHIP in an Economic Recession: Conversations with Recent Applicants and Enrollees.

Personal communication with staff at the Department of Health and Social Services, February 4, 2009.

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Alaska Health Policy Review is sent to individual and group subscribers for their exclusive use. Please contact us for information regarding significant discounts for multiple subscriptions within a single organization. Distributing copies of the Alaska Health Policy Review is prohibited under copyright restrictions without written permission from the editor; however, we encourage the use of a few sentences from an issue for reviews and other "Fair Use."

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For all related matters, please contact the editor, Lawrence D. Weiss, [email protected].
Policy Victory for Public Health

The following is a slightly edited excerpt from a communication from Danny McGoldrick, vice president, Research, Campaign for Tobacco-Free Kids, dated February 4, 2009. The Alaska information was added from an attachment to the communication.

Today, the United States Congress passed, and President Obama will sign (scheduled for 4:30) the SCHIP legislation, which includes a 61.66-cent increase in the federal tax on cigarettes (to just over $1 per pack), with significant increases to the federal tax rates on all other tobacco products. This is a tremendous victory for public health and tobacco control.   

This victory would not have occurred without the work of tobacco control advocates across the country year after year. Today is the culmination of years of work from the local to the national level by advocates, program leaders, researchers, and funders. It is the result of local advocates and state programs educating their communities, the media, and policy makers about the deadly toll of tobacco and the solutions to the problem. It is the result of work by the research community producing the evidence base for tobacco taxes. It is the result of local, state, and national advocacy groups who have educated and pressured policy makers to buck the tobacco industry and do what's right for public health.

Together, we have convinced policy makers from local councils to the White House that they can and should increase tobacco taxes. Hundreds of thousands of lives and billions of health care dollars will be saved as a result. Thank you to everyone for all you have done to make this happen!   

These are conservative estimates of just some of the public health benefits and related health care cost savings Alaska would receive from a 61.66-cent federal cigarette tax rate increase:
  • 3,800 fewer kids becoming addicted adults,
  • 1,700 fewer current adult smokers,
  • 1,600 future smoking deaths prevented,
  • $82.7 million future state health care savings,
  • $12.7 million Medicaid share of future health savings.  
Nationally we estimate that the resulting increase in price will produce the following public health benefits:
  • Increase in total number of kids alive today who will not become smokers: 1,992,000
  • Number of current adult smokers in the US who will quit: 1,020,000
  • Number of smoking-affected births avoided over next five years: 248,000   
  • Number of total smokers saved from future smoking-caused death: 905,000   
  • 5-year health care savings from fewer smoking-affected pregnancies & births: $423.2 million 
  • 5-year health care savings from fewer smoking-caused heart attacks & strokes: $493.3 million   
  • Long-term health care savings in the US from adult & youth smoking declines: $44.5 billion
    • Share of healthcare savings in federal-state Medicaid program: $7.5 billion 
    • Share of healthcare savings in federal Medicare program: $8.6   
By decreasing consumption nationally, the increase in the federal tax will reduce state tobacco tax revenues unless the state increases its tobacco tax rate. This can be used as yet another reason to increase state cigarette and other tobacco product taxes. The decrease in consumption (and related revenue loss) for any state will depend on the state's current pack prices and tax rates. It's important to note that the federal tax also applies to sales on tribal lands. Just as the current federal tax is paid on tribal lands, this increase will be as well.  

Other Tobacco Products   

Of important significance is that the taxes on small cigars, which are really just thinly disguised cigarettes designed to avoid the cigarette tax, and RYO (roll your own) tobacco are not only getting the 61 cent or equivalent increase but will also now be taxed at a rate that parallels cigarettes. Previously, these products were taxed at a much lower rate. This was a big fight, but with the help of Senators Blanche Lincoln (AR) and Richard Durbin (IL), special interests were overcome to avoid a provision that would have phased in the tax for little cigars over a six-year period.   

The taxes on smokeless and regular cigars are also increasing but are still at levels much lower than the tax on cigarettes. State advocates can continue to work to increase state taxes on all of these OTP's to equal the state rate on cigarettes.   

Promoting Cessation Around the Tobacco Tax   

The federal tax increase will be effective March 31, 2009. This provides a great opportunity to promote quitting. Several states have developed resources to promote quitting around state tobacco tax increases. We will be sharing those moving forward and would appreciate hearing how other states have done this. States will obviously have to prepare for a surge in demand for quitline and other cessation services. It would have course have been extremely helpful had the bill included funding for cessation services, but it does not. We must continue to work every avenue at the state and national level to try to secure additional funds for our programs to help smokers quit.

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Alaska Health Policy Calendar

This calendar of health policy-related legislative meetings is current as of February 5, 2009 at 3 PM. Please visit the Alaska State Legislature's list of committee hearings for the most current listings, as they are subject to change.

February 6, 2009, 8:00 AM

What: House Health and Social Services Finance Subcommittee
Where: House Finance 519, Juneau
Other Information: Division of Health Care Services: Medicaid and Alaska Pioneer Homes; teleconferenced

February 9, 2009, 8:00 AM
What: House Health and Social Services Finance Subcommittee
Where: House Finance 519, Juneau
Other Information: Division of Senior and Disabilities Services, teleconferenced

February 9, 2009, 1:30 PM
What: Senate Health and Social Services Standing Committee
Where: Butrovich 205, Juneau
Other Information: SB 13 Medical Assistance Eligibility; SB 87 Medical Assistance Eligibility; teleconferenced

February 9, 2009, 3:15 PM
What: House Labor and Commerce Committee
Where: Barnes 124, Juneau
Other Information: HB 104 Worker's Comp. Medical Treatment Fees; teleconferenced

February 10, 2009, 8:00 AM

What: Senate Health and Social Services Finance Subcommittee
Where: Fahrenkamp 203, Juneau
Other Information: Department budget overview continuation; testimony; by invitation only; teleconferenced

February 11, 2009, 8:00 AM
What: House Health and Social Services Finance Subcommittee
Where: House Finance 519, Juneau
Other Information: Office of Children's Services; Child Advocacy Centers;
teleconferenced

February 11, 2009, 1:30 PM
What: Senate Health and Social Services Finance Subcommittee
Where: Butrovich 205, Juneau
Other Information: Returning Kids from Out of State, Jeff Jessie, Mental Health Trust; SCR 1 Brain Injury Awareness Month March 2009, SB 52 Salvia Divinorum as Controlled Substance; teleconferenced

February 12, 2009, 8:00 AM
What: House State Affairs Committee
Where: Capital 106, Juneau
Other Information: HB 63 Council Domestic Violence: Members, Staff; teleconferenced

February 12, 2009, 8:00 AM

What: Senate Health and Social Services Finance Subcommittee
Where: Fahrenkamp 203, Juneau
Other Information: Medicaid, FMAP, Provider Rates; testimony; by invitation only; teleconferenced

February 12, 2009, 9:00 AM
What: Senate State Affairs Committee
Where: Beltz 211, Juneau
Other Information: SB 79 Medical Benefit of Disabled Peace Officers; teleconferenced

February 13, 2009, 8:00 AM

What: House Health and Social Services Finance Subcommittee
Where: House Finance 519, Juneau
Other Information: Division of Public Assistance, Departmental Support Services; teleconferenced

February 16, 2009, 8:00 AM
What: House Health and Social Services Finance Subcommittee
Where: House Finance 519, Juneau
Other Information: Division of Behavioral Health; teleconferenced

February 17, 2009, 8:00 AM
What: Senate Health and Social Services Finance Subcommittee
Where: Fahrenkamp 203, Juneau
Other Information: Office of Children's Services, Bring the Kids Home; testimony; by invitation only; teleconferenced

February 18, 2009, 8:00 AM
What: House Health and Social Services Finance Subcommittee
Where: House Finance 519, Juneau
Other Information: Division of Public Health (until 9:15 AM); Alaska Native Tribal Health Consortium (15 minutes); teleconferenced

February 19, 2009, 8:00 AM
What: Senate Health and Social Services Finance Subcommittee
Where: Fahrenkamp 203, Juneau
Other Information: Division of Public Assistance, including heating assistance; testimony; by invitation only; teleconferenced

February 20, 2009, 8:00 AM
What: House Health and Social Services Finance Subcommittee
Where: House Finance 519, Juneau
Other Information: Review governor's budget amendments; Alaska Mental Health Trust;
teleconferenced

March 3, 2009, 8:00 AM
What: Senate Health and Social Services Finance Subcommittee
Where: Fahrenkamp 203, Juneau
Other Information: Public Health initiatives; testimony; by invitation only; teleconferenced

March 5, 2009, 8:00 AM
What: Senate Health and Social Services Finance Subcommittee
Where: Fahrenkamp 203, Juneau
Other Information: Governor's amendments, Q&A session; testimony; by invitation only; teleconferenced

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Bill Watch: Bills on the Move

Activity on health policy bills in the legislature is picking up, as three new health policy bills were introduced this week and are scheduled to be heard in committee meetings. Additionally, some bills were heard in committee meetings or referred to committees, and one resolution was introduced and is scheduled for a hearing.

SB 79 Med Benefits of Disabled Peace Officers was introduced on January 26 and is scheduled to be heard in (S) State Affairs on February 12. SB 87 Medical Assistance Eligibility was introduced on January 28 and is scheduled for a hearing in (S) HSS on February 9.

HB 104 Worker's Comp. Medical Treatment Fees was introduced on January 30 and is scheduled for a hearing in (H) L & C on February 9. SCR 1 Brain Injury Awareness Month March 2009 was read for the first time and is scheduled to be heard in (S) Health and Social Services Finance on February 11.

SB 65 Medicaid for Adult Dental Services was held and heard in (S) HSS on February 2. SB 82 Medicaid for Adult Dental Services was referred to (S) HSS Finance on February 4. SB 32 Medicaid: Home/Community Based Services was heard and held in (S) HSS on February 2. SB 35 Extend Suicide Prevention Council was held and heard in (S) HSS on January 26.


SB 13 Medical Assistance Eligibility is scheduled for a hearing in (S) HSS on February 9. SB 52 Salvia Divinorum as Controlled Substance is scheduled to be heard in (S) Health and Social Services Finance on February 11. HB 63 Council Domestic Violence: Members, Staff is scheduled to be heard in (H) State Affairs on February 12.

Bill Tracking Methodology

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.
 
Bills are current as of January 29 at 5 PM.

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 PROHIBIT TOBACCO USE UNTIL 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 SALVIA DIVINORUM AS A CONTROLLED SUBSTANCE
Sponsor: Senator Therriault
Committee(s) and date of last action: (S) HSS Finance Subcommittee, 02/11/09
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 EDUC LOAN REPAYMENT PROGRAM
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 POSTSECONDARY MEDICAL AND OTHER EDUC PROG  
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

SCR 1 BRAIN INJURY AWARENESS MONTH: MARCH 2009
Sponsor: Senator McGuire
Committee(s) and date of last action: Scheduled to be heard in (S) HSS, 02/11/09
Description: This bill proposes that the month of March be "Brain Injury Awareness Month," effective for 2009.

HB 71 ADVANCE HEALTH CARE DIRECTIVES REGISTRY
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 MEDICAID FOR ADULT DENTAL SERVICES
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 CLINICAL LABORATORY SCIENCE PROFESSIONALS
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 LIMIT OVERTIME FOR REGISTERED NURSES
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 LIMIT OVERTIME FOR REGISTERED NURSES
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 PSYCHOLOGIST'S LICENSING AND PRACTICE
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 LIMIT OVERTIME FOR REGISTERED NURSES
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 NEW DRIVER'S/PERMIT: CPR/FIRST AID
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 BLOOD DONATION AWARENESS FUND
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 79 MED BENEFITS DISABLED PEACE OFFICERS
Sponsors: Senators McGuire, Paskvan
Committee(s) and date of last action: Introduced 01/26/09, Scheduled to be heard in (S) STA, 02/12/09
Description: This bill proposes waiving payment of premiums for major medical insurance for disabled peace officers who have at least 20 years of credited service as peace officers of the public.

SB 87 MEDICAL ASSISTANCE ELIBILITY
Sponsor: Senator Wielochowski
Committee(s) and date of last action: Introduced 01/28/09, Scheduled to be heard in (S) HSS, 02/09/09
Description: This bill proposes an additional eligibility category for Medicaid services. Specifically, it adds children, pregnant women, and other specified individuals in families with incomes between 200% and 300% of the federal poverty level. Additionally, individuals in this income category would be required to pay a yearly premium for medical assistance. The premiums would be determined by a sliding scale based on annual income. The range for premiums would be set at no less than $240 per year and no more than $1200 per year.

SB 65 MEDICAID FOR ADULT DENTAL SERVICES
Sponsors: Senators Davis and Ellis
Committee(s) and date of last action: Heard and Held in (S) HSS, 02/02/09
Description: This bill is "An Act 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."
 
SB 82 MEDICAID FOR ADULT DENTAL SERVICES
Sponsors: Rules by request of the governor
Committee(s) and date of last action: Referred to (S) HSS Finance, 02/04/09
Description: This bill is "An Act providing for an effective date by delaying the effective date of the change of coverage of adult dental services under Medicaid; and providing for an effective date."

HB 87 MED BENEFITS OF DISABLED PEACE OFFICERS
Sponsors: Representatives Millett, Dahlstrom, Gardner, Gara, Kerttula, Kawasaki
Committee(s) and date of last action: (H) L&C, 02/02/09
Description: This bill proposes waiving payment of premiums for major medical insurance for disabled peace officers who have at least 20 years of credited service as peace officers of the public.
 
SB 61 MANDATORY UNIVERSAL HEALTH INSURANCE
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 MEDICAL ASSISTANCE ELIGIBILITY/PREMIUMS
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 MEDICAL ASSISTANCE COVERAGE
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 MEDICAID/INS FOR CANCER CLINICAL TRIALS
Sponsor: Senator Davis
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 DEPENDENT HEALTH INSURANCE; AGE LIMIT
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 MEDICAL ASSISTANCE ELIGIBILITY
Sponsor: Senator Davis
Committee(s) and date of last action: Scheduled to be heard in (S) HSS, 02/09/09
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 MEDICAID: HOME/COMMUNITY BASED SERVICES
Sponsor: Senator Ellis
Committee(s) and date of last action: Heard and Held in (S) HSS, 02/04/09
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 PHARMACY BENEFITS MANAGERS; MANAGED CARE
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."

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Bill Watch: Mental Health

HB 83 APPROP: MENTAL HEALTH BUDGET
Sponsor: Rules by request of the governor
Committee(s) and date of last action: (H) FIN, 02/02/09
Description: This bill outlines the specific appropriations for each component of the state's mental health program.

HB 52 POST-TRIAL JUROR COUNSELING
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 MENTAL HEALTH CARE INSURANCE BENEFIT
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 HEALTH COMMISSION/PLANNING
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 COUNCIL DOMESTIC VIOLENCE: MEMBERS, STAFF
Sponsors: Representatives Fairclough, Holmes, Coghill, and Wilson
Committee(s) and date of last action: Scheduled to be heard in (H) STA, 02/12/09
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 HEALTH REFORM POLICY COMMISSION
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 EXTEND SUICIDE PREVENTION COUNCIL
Sponsors: Senator, Davis, Ellis, Therriault
Committee(s) and date of last action: Heard and Held in (S) HSS, 01/26/09
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 EXTEND SUICIDE PREVENTION COUNCIL
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 BIRTH CERTIFICATE FOR 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 PARTIAL-BIRTH ABORTION
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 NOTICE & CONSENT FOR MINOR'S ABORTION
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 PARTIAL-BIRTH 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 34.

SB 6 NOTICE & CONSENT FOR A MINOR'S 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 INFO, ANESTHESIA, CONSENT FOR AN ABORTION
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 DEFINITIONS: PERSON/CHILD/HUMAN/ETC
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 NURSING MOTHERS IN WORKPLACE
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 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.

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Bill Watch: Worker's Compensation

HB 104 WORKER'S COMP. MEDICAL TREATMENT FEES
Sponsor: (H) Labor and Commerce
Committee(s) and date of last action: Introduced 01/30/09; Scheduled to be heard in (H) L & C, 02/09/09
Description: This bill is "An act adjusting certain fees for treatment or services under the Alaska Workers' Compensation Act to reflect changes in the Consumer Price Index; and providing for an effective date.

SB 20 WORKER'S COMP MEDICAL/REHAB RECORDS
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, are 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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