Alaska Health Policy Review
comprehensive, authoritative, nonpartisan
February 27, 2009 Vol 3, Issue 7
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From the Editor
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Attention Legislators and Advocates!
Alaska needs a new law to help unemployed workers. The
new Recovery Act allows involuntarily unemployed workers to continue their
employer-based coverage by paying 35 percent of premiums, and the federal government
pays a 65 percent subsidy. Unemployed workers can get this assistance for up to nine
months if they lost their jobs between September 1, 2008 and December 31, 2009.
This is an enhancement of federal legislation known as COBRA , which requires many
employers to offer laid-off employees continued group health insurance if they pay for it
entirely. Most unemployed workers cannot afford to do so.
Unemployed workers who lost jobs in firms of 20 or more
will get this help in Alaska because they are eligible for COBRA benefits under
federal law. However, in order for workers in firms with fewer than 20 workers
to get this help, Alaska must have a "state continuation coverage law" known as
a "mini-COBRA law" in place. Alaska is one of only 10 states that does
not have this type of law.
This is easy to fix. Our Division of Insurance can get model bill language
from the National Association for Insurance Commissioners. A report by
FamiliesUSA, Protecting Unemployed Workers' Health Coverage: What States Can Do, is very useful -- especially the table on page
7. Finally, a good model is available from the state of Minnesota.
(Thanks to
FamiliesUSA staff for their assistance with this issue)
Lawrence D. Weiss PhD, MS editor, AHPR [email protected]
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Interview with Jeff Jessee |
Jeff Jessee is the chief executive officer of the Alaska Mental Health Trust Authority. In this interview hediscusses critically important home and community-based services legislation, the success of initiatives like Bring the Kids Home, and the future of the Trust in light of the global financial crisis. This interview was recorded February 19, 2009. It has been edited for length and clarity.
AHPR: What health-related legislation is of particular interest to you in the current session, and why? Jessee: Well, there are a couple of things this session that I think are pretty important. One is the [Medicaid] Home and Community-Based Services (rate review) Bill, SB 32. In my view, as far as home and community-based services, this is probably the most significant legislation I've seen in my career, actually. The problem historically has been that although hospitals and nursing homes have regular rate reviews and adjustments to their rates, we have not had that kind of a process for home and community-based services. The result has been that the rates that are available to those community-based services are often not adjusted for many years at the time -- in some cases, over nine years. Of course, as costs continue to escalate, [and] if the reimbursement rates don't change, it continues to erode the capacity and quality of services over time. Last year, with Representative [Mike] Hawker's leadership, we were able to get some rates adjusted, and that was a very good thing. But this bill would actually build in a regular rate review process. Now, that doesn't guarantee an appropriation, but at least it puts the issue of cost reimbursement on the table in a regular manner. I consider this to be a huge potential positive impact on health care. AHPR: What do you think is the likelihood that it will be passed? Jessee: I think it stands a good chance. Of course with Senator [Johnny] Ellis' leadership, there's a good chance it will get through the Senate. Although I certainly wouldn't speak for Representative Hawker or indicate what his position on the bill is -- because I don't know that -- he gets it. He clearly understands that having a strong home and community-based system of care is a cost-effective way of dealing with many of these issues and that a failure to do so often pushes people into higher levels of care, which are more expensive for the state. I think that we have the potential for him to be open to this as well. So that's a good sign. AHPR: One last question about that particular bill: What occupations does it affect directly? Jessee: Primarily, in seniors and developmental disability areas. So it would cover personal care attendants, assisted living homes, some home health care rates. So it's not the whole universe of home and community-based services. For example, it doesn't currently cover behavioral health or foster care or some of those areas. It would cover assisted living homes, personal care attendants, and other senior disability wavered service rates as well. AHPR: Thinking of maybe your top three pieces of legislation, what would be number two? Jessee: Probably the dental bill sunset extension [SB 82]. Three years ago, we were successful in working with the Legislature to get the Medicaid dental program expanded to include preventative and restorative services, which are so critical to everyone on the Medicaid program -- but particularly to our beneficiaries. We set a financial target, again with Representative Hawker's leadership, that the department has managed towards and has been very successful. We set up a sunset on that expansion so that we could look with the Legislature as to whether we've been able to stay in the box if you will. I think that by all accounts, there's been a lot of success, and people have gotten a lot of very needed preventative and restorative services. I think that there are a couple of bills in. For sure, Representative Hawker has a bill in, and that is certainly a priority. AHPR: Do you have one or two others that you'd like to mention? Jessee: One that is pretty timely is the extension of the Suicide Prevention Council. I certainly don't have to tell you about the suicide problem in the state. I think that continuing the work of the council is pretty important. It's time to get some focus on that issue and some strategies to try to deal with it. I'm sure that there are couple of others out there, but those are the ones that are coming to mind right now. AHPR: One more question about the Suicide Prevention Council. Is the legislative issue that it costs money to operate the council? Are resources expended? I'm not exactly sure why there might be an issue there about extending the council? Jessee: Well, I don't know that there is. In a 90-day session though, a lot of good bills could not get dealt with. There are some resources expended on a part-time position to help run the council, and they do have some travel expenses. As these types of boards and commissions and councils go, it's a pretty cheap, low-budget operation. So, I don't really think the fiscal issue is going to be a particular barrier. AHPR: I did want to ask you about one bill in particular. Senator French has introduced SB 61 [Mandatory Universal Health Insurance], which as you know would establish a statewide health insurance and financing plan similar to the one currently in operation in the state of Massachusetts. Of course this is kind of a repeat of the bill introduced last year. I wonder if you have any interest in this bill or any comments about this particular bill? Jessee: No, I haven't actually studied the bill. I'm not familiar enough with it to comment. "Although it's been a challenge and will continue to be a challenge in
the out years, I think, overall, the Trust is pretty well positioned to
weather the storm."
AHPR: Here is something that I think you'll have some comments about. In light of the national and global financial crisis as a whole, and in light of the emerging state budget for the fiscal year 2010, how do you assess the Trust's [Alaska Mental Health Trust Authority] likely resources for the next few years? Jessee: I guess there is bad news and good news. The bad news is, like many other endowments, we lost quite a bit of ground. In fact, the Mental Health Trust endowment lost in the neighborhood of $100 million. That has reduced our payout of the percentage of that endowment that we have available to spend each year by close to $5 million for 2010. The good news is that, unlike the state, which tries to make money while it's spending money, the Mental Health Trust actually deposits an entire fiscal year's budget resource into what we call our checking account, at the beginning of the fiscal year. So for the current 2009 fiscal year, we're fine, because that money was all deposited at the beginning of the year. Now, we have gone through that budget and have pushed as many projects forward as we could into 2010. If they didn't really need to be started this year, or we were having trouble getting them going, we've looked at other projects that we could defer. We've looked at the 2010 budget and tried to make some reductions there. So we've actually closed substantially the 2010 gap with trust funding without jeopardizing achieving the programmatic goals that we've set. Although it's been a challenge and will continue to be a challenge in the out years, I think, overall, the Trust is pretty well positioned to weather the storm. Of course we do have a four-year income reserve so that we can continue to make the payouts even if the Permanent Fund is not generating positive income. The other thing I try to remind people of is that the 2010 payout, and probably the payouts for the next several years, really just take us back to what we had available ... say in 2004, 2005. We were certainly able to achieve our programmatic goals then. So I don't really see us unable to continue to meet our objectives. Some things will slow down, some things will be deferred, but, all in all, I think that I'd rather be where the Mental Health Trust is than where a lot of other foundations are -- or frankly where the state is. AHPR: Moving on to another issue. By executive order, Governor Palin recently established the first statewide health commission. While the body has not yet met, would you comment on whether or not you believe this commission can and will live up to its mission, which is "to provide recommendations for, and foster the development of, a statewide plan to address the quality, accessibility, and the availability of health care for all citizens of the state"? Jessee: Well, we hold out a lot of hope. I think that a lot of lessons were learned from the Health Strategies Council experience. Hopefully, that will inform this process. I also think that the leadership at the Department of Health and Social Services with Commissioner Bill Hogan and his team bodes well for a positive result. We certainly will be working as closely as we can with them to make sure that of course behavioral health and the other interests of our beneficiaries are represented. I'm cautiously optimistic. I suppose that we will get somewhere. "I think that what it [the ISER report] has done is provide that
evidence-based platform from which now I think there will be some
energy around putting together an overall strategy to implement this
kind of policy direction."
AHPR: Jumping to another thing that I'm certain is of interest to you. ISER (UAA's Institute of Social and Economic Research) just released a study entitled, "The Cost of Crime: Could the State Reduce Future Crime and Save Money by Expanding Education and Treatment Programs?" How would you characterize the findings of this study, and what are the policy implications of the study? Jessee: I think the study documents what many of us have believed for a long time and what the data has substantiated. Many of our beneficiaries and many people in general that are caught up in the criminal justice system -- when they get out of corrections, if they are actually supported in the community with housing and support services -- we can significantly reduce their recidivism. That's not only good for them, but good for the community in reduced criminal behavior and reduced cost of corrections. One of the things that I've tried to impress upon policymakers in Juneau is that we've seen the ability of the state to address these types of issues: the almost exponential growth in institutional placement by using a data-driven, informed, evidence-based approach to making systems change. The example is the "Bring the Kids Home" initiative, where we've been able to reinvest dollars into in-state service components that otherwise would have gone to pay out-of-state psychiatric residential facility providers to take care of Alaska kids. This has reduced the number of kids out of state since 2006 from a high watermark of 439 down to 164 as of last Wednesday. [We accomplished this] not by dumping them back on their families and communities, but by truly providing supportive services in the community. Many of us have believed for a long time that we could do the same thing to address the ever-burgeoning budget and incarceration rate in the Department of Corrections. When you look at what the state projects to have to spend for additional correction facilities, both on the capital and operating sides, and then you look at the evidence-based practices that could be put in place -- it's very clear. In a number of jurisdictions like Washington [State], they have demonstrated that you can -- by investing in these other services -- turn the curve on that growth. I think that what it [the ISER report] has done is provide that evidence-based platform from which now I think there will be some energy around putting together an overall strategy to implement this kind of policy direction. AHPR: Other than just expanding the budget in certain areas, would that require additional legislation to fully implement that? Jessee: No, I don't think so. Although, I've been very clear in my testimony before the Legislature that just making budget adjustments alone would not be the best course. I think there needs to be some structure put in place to manage an effort like this, because you have to continuously review the data from the strategy that you're implementing, determine which ones are meeting their goals and which ones are not. When they're not, they need to be either modified or abandoned, and other strategies need to be implemented. Without active management, I'm frankly doubtful that just adding to the budget is going to get them where they want to go. That concerns me, because, if an effort like this fails to achieve its desired result, it throws policymakers into a position of having a lack of confidence in their ability to affect outcomes -- when in fact, a well-managed effort clearly can and has demonstrated that it can achieve the results they want. AHPR: Is is there anything else you would like to say to the readers of Alaska Health Policy Review? Jessee: Only this: out of challenge often comes opportunities. I think that both nationally and within the state, we're facing a lot of challenges right now, particularly in the area of health care and health care financing. I think that that generates more of a sense of urgency for us to look at some of the fundamental underlying principles that we use for health care and health care financing. And out of that may come opportunities to really make some changes that in the long run will not only provide better health care to Alaskans but a health care system that is sustainable. In the end, of course, that's what we all want. Back to top
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Alaska Health Policy Calendar |
This calendar of health policy-related legislative meetings is current as of February 25, 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.
February 27, 8:00 AM Meeting Canceled What: House Health and Social Services Finance Subcommittee Where: House Finance 519, Juneau Other Information: Closeout; teleconferenced
February 27, 8:00 AM What: Senate Education Standing Committee Where: Beltz 211, Juneau Other Information: SB 18 Postsecondary Medical and Other Educ Prog; teleconferenced
February 27, 1:30 PM What: Senate Health and Social Services Standing Committee Where: Butrovich 215, Juneau Other Information: Bills previously heard/scheduled; 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 4, Noon What: House and Senate Joint Legislative Health Caucus Where: Fahrenkamp 203, Juneau Other Information: Keeping it Clean, Keeping Alaskans Healthy
March 5, 2009, 8:00 AM Meeting Canceled 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
March 10, 2009, 3:00 PM What: Senate Health and Social Services Finance Subcommittee Where: Fahrenkamp 203, Juneau Other Information: Rescheduled; Governor's amendments, Q&A session; testimony; by invitation only; teleconferenced
March 19, 3:00 PM What: Senate Health and Social Services Finance Subcommittee Where: Senate 532, Juneau Other Information: Budget closeout; testimony; by invitation only; teleconferenced
March 27, Noon What: House and Senate Joint Legislative Health Caucus Where: Location TBA Other Information: Week of the Uninsured
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Bill Watch: Bills on the Move
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Activity among health policy legislation increased substantially this week. No new health policy bills were introduced, yet several bills were heard and referred to other committees. One resolution passed the Senate, and five bills are scheduled to be heard in committee meetings as well.
SB 52 Salvia Divinorum as a Controlled Substance was heard in (S) HSS for the second time and moved to (S) JUD on February 25. SB 18 Postsecondary Medical and Other Educ Prog was referred to and scheduled to be heard in (S) EDC on February 27. SB 79 Med Benefits of Disabled Peace Officers was moved out of (S) STA and referred to (S) L&C on February 20. SB 10 Medicaid/Ins for Cancer Clinical Trials was heard and moved to (S) L&C on February 23.
SB 13 Medical Assistance Eligibility was heard and held in (S) FIN on February 25. SB 32 Medicaid: Home/Community Based Services was heard for the second time and held in (S) HSS on February 23. SB 87 Medical Assistance Eligibility was heard and held in (S) FIN on February 25.
SB 35 Extend Suicide Prevention Council was scheduled to be heard in (S) HSS on February 25. SB 49 Blood Donation Awareness Fund was scheduled to be heard in (S) STA on February 26. HB 2 Birth Certificate for Stillbirth was scheduled to be heard in (H) HSS on February 26. HB 63 Council Domestic Violence: Members, Staff was scheduled to be heard in (H) FIN on February 26. HB 104 Worker's Comp. Medical Treatment Fees is pending referral to be heard in (H) L & C February 26.
SCR 1 Brain Injury Awareness Month March 2009 was read a second time and passed in the Senate on February 26.
Bills are current as of February 25 at 1 PM.
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.
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
- (S) RLS: Senate Rules Committee
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Bill Watch: Drugs
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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: Heard (S) HSS Finance and moved to (S) JUD 02/25/09 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
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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: Referred to and scheduled to be heard in (S) EDC on 02/27/09 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
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SCR 1 BRAIN INJURY AWARENESS MONTH: MARCH 2009 Sponsor: Senator McGuire Committee(s) and date of last action: Passed Senate on 02/26/09 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: Scheduled to be heard in (H) HSS, 02/26/09 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: Scheduled to be heard in (S) STA, 02/26/09 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
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SB 79 MED BENEFITS DISABLED PEACE OFFICERS Sponsors: Senators McGuire, Paskvan Committee(s) and date of last action: Heard in (S) STA and referred to (S) L&C on 02/20/09 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: Heard and held in (S) FIN, 02/25/09 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 SERVICESSponsors: 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 OFFICERSSponsors: Representatives Millett, Dahlstrom, Gardner, Gara, Kerttula, Kawasaki Committee(s) and date of last action: Heard and held in (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 INSURANCESponsors: 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/PREMIUMSSponsors: 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 COVERAGESponsors: 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 TRIALSSponsor: Senator Davis Committee(s) and date of last action: Heard in (S) HSS and moved to (S) L&C, 02/23/09 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 LIMITSponsor: 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 ELIGIBILITYSponsor: Senator Davis Committee(s) and date of last action: Heard and held in (S) FIN, 02/25/09 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 SERVICESSponsor: Senator Ellis Committee(s) and date of last action: Heard for the second time and Held in (S) HSS, 02/23/09 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 CARESponsor: 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." Back to top
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Bill Watch: Mental Health
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HB 83 APPROP: MENTAL HEALTH BUDGET Sponsor: Rules by request of the governor Committee(s) and date of last action: Heard and held in (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.
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Bill Watch: State Boards and Issues
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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) FIN on 02/26/09 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: Scheduled to be heard in (S) HSS on 02/25/09 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
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HB 2 BIRTH CERTIFICATE FOR STILLBIRTH Sponsors: Representatives Gatto, Gruenberg, Dahlstrom, Lynn Gatto Committee(s) and date of last action: Scheduled to be heard in (H) HSS, 02/26/09 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
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HB 104 WORKER'S COMP. MEDICAL TREATMENT FEES Sponsor: (H) Labor and Commerce Committee(s) and date of last action: Passed (H) with reconsideration after third reading and awaiting referral to (H) L&C, 02/18/09 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
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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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