Alaska Health Policy Review

Dear Reader:

I am very pleased this week to present an exclusive "interview" with Senator Lisa Murkowski on key health policy issues. But first, this week has been National Public Health Week. Haven't heard too much about it? That is not unusual. Public health almost always takes a back seat to medical care in our society. Not really sure what public health is? Then I have a very nice little video for you to see and pass around. It is just a couple of minutes long and is very well done. Even if you are a public health professional, I urge you to see this video presentation because you will likely use it in your health education activities. Here are some examples of public health, courtesy of a website sponsored by the American Public Health Association:

local clinics · healthy mothers and healthy babies · breastfeeding · vaccinations · clean, fluoridated water · car seats · seatbelts · traffic laws · prepared communities · clean air · mental health services · school nutrition programs · tobacco-free environments · safe workplaces · green communities · medical research · sex education · jogging trails and bike paths · safe and clean places to play · sidewalks · elderly services · city planning · healthy homes

Public health is: the promotion of good health and the prevention of disease. Unfortunately, we're not there yet. The United States may spend more on health care than any other country, but even our best efforts have failed to make America a healthier nation. Check the facts:

* U.S. life expectancy ranks 46th in the world, behind Japan, most of Europe, and even countries such as South Korea and Jordan. * A baby born today in the U.S is more likely to die before its first birthday than in almost any other developed country.

And there is more. Internationally, war is a huge public health issue but we rarely view it in that way. An excellent reader on the subject, War and Public Health, was written by one of my former professors at the Harvard School of Public Health, Dr. Levy, and a former president of the American Public Health Association, Dr. Sidel. Climate change is another emerging public health issue of immense proportions.

Now, in honor of National Public Health Week, here is an exclusive "interview" with Alaska's very own Senator Lisa Murkowski ...

Lawrence D. Weiss PhD, MS
editor, AHPR
ldweiss@gmail.com

Interview with Senator Lisa Murkowski

Senator Lisa Murkowski was elected to three terms in the Alaska State House of Representatives, beginning in 1998, and was named House Majority Leader during the 2003-2004 term. While serving in the state House, Murkowski sat on the Alaska Commission on Post Secondary Education and chaired both the Labor and Commerce and the Military and Veterans' Affairs Committees. In 1999, she introduced legislation establishing a Joint Armed Services Committee, where she also served. After being appointed to the US Senate on December 20, 2002, Senator Murkowski was elected to a full six-year Senate term in November 2004. She serves on the following committees: Energy & Natural Resources, Health, Education, Labor & Pensions, Appropriations Committee, and Indian Affairs. The questions below were submitted to Senator Murkowski in writing, and her answers were returned in writing. None of the responses have been edited.

AHPR: At the recent White House health care summit, President Obama outlined his goals for national health care reform. One key component is "a government-sponsored insurance option" for people who do not have coverage. Would you please comment on your vision of national health reform, and comment in particular on the concept of a government-sponsored insurance option?

Murkowski: I don't think a government-run plan is sustainable and I don't think Congress is looking to enact a single-payer system. Medicare is a really great example, particularly in our state, of how a government payor system doesn't work. So, in response to your question, based on Alaskan seniors' experience with Medicare, I can't support another Federal government-sponsored insurance option where the Federal government sets reimbursement rates that hurt access to health care providers.

My vision for health care reform is to provide more people with access to care and to make sure that it's affordable. The statistics tell us that 70 percent of all health care spending in the U.S. goes to treat chronic disease conditions, such as diabetes and hypertension.

I believe we must first focus on how we cover individuals with chronic disease conditions, thereby reducing our overall healthcare spending. Over 16.2 percent of our Gross Domestic Product was spent on healthcare costs in 2007, more so than any other developed nation, yet we have 46 million Americans who are uninsured and our health care spending continues to rise -- $2.2 trillion in 2007 and slated to rise to $3.1 trillion by 2012.

We must get our health care costs under control and the best way I believe that we can achieve this is through focusing on individuals with chronic disease conditions and utilizing the Medical Home model -- such as the one used by the Southcentral Foundation at the Anchorage Native Medical Center. This is a great example of how we can use physicians and mid-levels such as nurses or physician's assistants as well as ancillary services such as a dietician for someone with diabetes, to care for their patients.

The home model results have been impressive -- 91 percent patient satisfaction rates and a 40 percent drop in urgent care and emergency room visits. These are the tools we need to utilize, particularly for our chronic disease population, to ensure that the patients who are the biggest cost drivers -- individuals with chronic disease conditions -- are the target group we must address first.

AHPR: Community Health Centers offer a cost-effective, "primary care safety net" in Alaska, with 141 clinic sites statewide providing access for more than 80,000 Alaskans. With limited success, CHC advocates have been "urging" state support for energy assistance, workforce development, and senior access. Do you believe that a stronger state/federal partnership supporting Alaska's and the nation's CHCs is desirable, possible, and achievable? If so, what would you propose?

"As I've said in a few of my addresses to the Alaska State Legislature, we must fund our safety-net providers like Community Health Centers and our hospitals ... "

Murkowski: I have consistently supported Federal funding of Community Health Centers and I'll give the previous administration due credit for elevating the profile of Community Health Centers by more than doubling their Federal funding between 2000 and 2009. These safety-net providers, particularly in an economic downturn like we are currently facing, care for all men, women, the elderly and children so that all Americans have access to a medical provider, regardless of their ability to pay.

In addition, I want to point out that Alaska's 14 critical access hospitals -- the hospitals in our smaller and our rural HUBs like Bethel, Wrangell and Barrow -- also do an excellent job of providing care in both emergency and non-emergency situations, particularly when the patient needs a higher level of care than can be provided in a clinic setting.

As I've said in a few of my addresses to the Alaska State Legislature, we must fund our safety-net providers like Community Health Centers and our hospitals, because under Federal law [EMTALA for Hospitals and Public Health Service Act for CHCs] they are required to provide care, regardless of a patient's ability to pay.

"Certainly I have always viewed these safety-net providers [Community Health Centers] as an essential piece to the health care reform puzzle."

AHPR: [Follow up question] What role do you envision CHCs could play in the emerging national health reform package?

Murkowski: Earlier I mentioned the elderly being served at Community Health Centers -- which may make you ask why the elderly would need to be seen at a safety net facility since they are typically covered by Medicare. But in Alaska, the latest statistics show that only one in 10 primary care physicians are accepting Medicare.

The only place in Anchorage accepting new Medicare patients right now is the Anchorage Neighborhood Health Center. Therefore even if we are able to get some of our primary care providers -- physicians, nurse practitioners or physicians' assistants -- to accept new Medicare patients, our Medicare population will still face a provider shortage.

In response to your question, the crisis Alaska is facing seems like it's heading south to the Lower 48, which means Community Health Centers and other safety-net providers will be more heavily relied upon. Certainly I have always viewed these safety-net providers as an essential piece to the health care reform puzzle.

"We turn away nearly 80 percent of National Health Service Corps applicants because the program is woefully underfunded."

AHPR: A public health crisis is emerging in Alaska and nationwide because of primary care workforce vacancy rates between 10-40 percent in many of the primary care occupations. The National Health Services Corp loan repayment program is limited as far as sites, eligibility, and NHSC slots. What solutions are you and your colleagues in the Senate Health, Education, Labor, and Pensions Committee considering to address this issue?

Murkowski: I think that our long-term solution for health care must include addressing the reimbursement issue for primary health care professionals, who are poorly reimbursed by Medicare. In addition, the hours are so demanding that many medical students want to go into the more lucrative specialties like dermatology or ophthalmology.

We must reform our payment systems so that medical students don't enter primary care fields such as general practice, family medicine or internal medicine, out of the kindness of their hearts or because they want to serve in small or remote communities. Our Medical residents should do it because they are able to make a solid living while enjoying their profession.

I spoke with about a dozen primary care providers last month and they feel strained; they are oftentimes seeing 20 or 30 patients a day and at the end of the month when they look at their bottom line, they make decisions based on the insurance reimbursement from the patients they see.

For example, if they see 20 Medicare patients and get reimbursed the same as they would seeing only 10 private patients or half the number of Medicare patients, then we, the Federal government, are actually creating a disincentive for primary care providers to see Medicare patients; thus reform of the Medicare reimbursement system is the first thing we must do.

The National Health Service Corps, according to the American Association of Medical Schools, needs double the amount of funding that it currently gets -- from $135 million to $300 million in order to get primary care providers into their vacancy slots. We turn away nearly 80 percent of National Health Service Corps applicants because the program is woefully underfunded.

Last Congress I introduced a bill that would have doubled the funding for the National Health Service Corps, increased funding for Community Health Centers and allowed for Integrated Rural Training Tracks (IRTT) so that we could train medical residents in rural areas for up to six months, which has been demonstrated to increase the number of medical providers who decided to stay in those fields of practice.

"The 35 percent fix is helping to keep former patients who become Medicare eligible with their respective primary care provider. Where we've had less of an impact is with getting the new Medicare beneficiaries under the care of a primary health provider, particularly in Anchorage."

AHPR: The recent increase of Medicare Part B reimbursement -- that you spearheaded -- to health care providers by 35 percent for Alaskans is an important step forward, but seems to be having limited success by itself opening up access for new Medicare patients, particularly in Anchorage. Do you expect Congress to make significant changes to Medicare policy in the near future? What changes would you like to see, and how would these changes positively impact senior access to health care in Alaska?

Murkowski: I had a phone call with about a dozen primary care providers and then subsequently had a conversation with over 4,000 AARP members because I wanted to hear from both the providers and the patients about the Medicare crisis in our state. What I learned is this: The 35 percent fix is helping to keep former patients who become Medicare eligible with their respective primary care provider. Where we've had less of an impact is with getting the new Medicare beneficiaries under the care of a primary health provider, particularly in Anchorage.

I posed this question to U.S. Department of Health and Human Services Secretary-Nominee Kathleen Sebelius at her confirmation hearing in March and she committed to working with me to help solve Alaska's Medicare problem. I believe Congress must make significant changes to Medicare and it needs to do it quickly because this problem has moved from Alaska to the Lower 48. MedPAC, the Payment Advisory Committee for Medicare, says that 17 percent of Medicare beneficiaries nationwide are facing "big problems" trying to find primary care physicians.

What I heard from constituents is "how do we allow Medicare eligibles to stay on private insurance?" What if Medicare eligible simply want to pay for their own private insurance and not take Medicare upon retirement? This is something that many of my constituents want to do and it's something worth looking into although I am concerned about how this would impact the Medicare beneficiaries who are unable to pay for private insurance. What will Medicare mean for them? Aside from dismantling a Medicare system, we will need to find ways to have Medicare reimbursements keep up with those of the private insurers.

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For all related matters, please contact the editor, Lawrence D. Weiss, health.policy.review@gmail.com.

Alaska Health Policy Calendar

This calendar of health policy-related legislative meetings is current as of April 8, 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.

April 10, 2009, 8:30 AM
What: House Finance Standing Committee
Where: House Finance 519; Juneau

April 10, 2009, 9:00 AM
What: Senate Finance Standing Committee
Where: Senate Finance 532; Juneau
Other Information: SB 35 Extend Suicide Prevention Council; teleconferenced

April 10, 2009, 1:30 PM
What: Senate House and Social Services, Standing Committee
Where: Butrovich 205; Juneau
Other Information: HJR 10 Veterans' Health Care; teleconferenced

April 11, 2009, 2:00 PM
What: (H) & (S) Confernce Committee on HB 81 & HB 83
Where: Senate Finance 532; Juneau
Other Information: HB 83 Approp: Mental Health Budget; conference committee

April 11, 2009, 3:00 PM
What: House Health and Social Services, Standing Committee
Where: Capitol 106; Juneau
Other Information: No meeting scheduled

April 13, 2009, 8:00 AM
What: (H) & (S) Conference Committee on HB 81 & HB 83
Where: Senate Finance 532; Juneau
Other Information: HB 83 Approp: Mental Health Budget;conference committee

April 14, 2009, 8:00 AM
What: (H) & (S) Conference Committee on HB 81 & HB 83
Where: Senate Finance 532; Juneau
Other Information: HB 83 Approp: Mental Health Budget; conference committee

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Bill Watch: Bills on the Move

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, then (H) FIN, 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: 03/18/09 (S) Referred to Finance
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: 04/01/09 Referred to (H) FIN
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 (S) FIN on 03/16/09
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

ensures that the confidentiality of individually indentifying health information of a patient is secure and protected;
improves health care quality, reduces medical errors, increases the efficiency of care, and advances the delivery of appropriate, evidence-based health care services;
promotes wellness, disease prevention, and management of chronic illnesses by increasing the availability and transparency of information related to the health care needs of an individual for the benefit of the individual;
ensures that appropriate information needed to make medical decisions is available in a usable form at the time and in the location that the medical service is provided;
produces greater value for health care expenditures by reducing health care costs that result from inefficiency, medical errors, inappropriate care, and incomplete information;
promotes a more effective marketplace, greater competition, greater systems analysis, increased choice, enhanced quality, and improved outcomes in health care services; and
improves the coordination of information and the provision of health care services through an effective infrastructure for the secure and authorized exchange and use of health care information.

SB 139 INCENTIVES FOR CERTAIN MEDICAL PROVIDERS
Sponsors: Senators Olson, Wielechowski, Meyer, Davis
Committee(s) and date of last action: 04/07/09 Moved out of (S) HSS, to (S) FIN
Description: "An Act establishing a loan repayment program and employment incentive program for certain health care professionals employed in the state; and providing for an effective date."

SCR 1 BRAIN INJURY AWARENESS MONTH: MARCH 2009
Sponsor: Senator McGuire
Committee(s) and date of last action: Transmitted to the governor on 03/11/09
Description: This bill proposes that the month of March be "Brain Injury Awareness Month," effective for 2009.

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Bill Watch: Medical Assistance and Health Insurance

HB 61 MEDICAL ASSISTANCE COVERAGE
Sponsors: Representatives Cissna and Gruenberg
Committee(s) and date of last action: Read and referred to (H) HSS, then to (H) FIN,
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.

HB 62 MEDICAL ASSISTANCE ELIGIBILITY/PREMIUMS
Sponsors: Representative Hawker
Committee(s) and date of last action: Read and referred to (H) HSS, then to (H) FIN,
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 87 MED BENEFITS OF DISABLED PEACE OFFICERS
Sponsors: Representatives Millett, Dahlstrom, Gardner, Gara, Kerttula, Kawasaki
Committee(s) and date of last action: Heard and held in (H) L&C, then (H) STA, then (H) FIN,
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.

HB 118 MEDICAL ASSISTANCE ELIGIBILITY
Sponsor: Representative Gara
Committee(s) and date of last action: Referred to (H) HSS, then to (H) FIN, 02/25/09
Description: "An Act expanding, and relating to advertising about, medical assistance coverage for eligible children and pregnant women; relating to the poverty guideline and cost sharing for certain recipients of medical assistance; having the short title of the 'No Child Left Uninsured Act'; and providing for an effective date."

HCR 9 HOME HEALTH AIDES FOR SENIORS
Sponsors: Representatives Cissna and Gruenberg
Committee(s) and date of last action: Introduced and referred to (H) HSS, then to (H) FIN, 02/25/09
Description: This bill promotes the expansion of home health services to older Alaskans and adults with disabilities by requesting that the governor direct the Department of Health and Social Services to apply to the federal government for additional waivers under the home and community-based waiver program to better serve older Alaskans and adults with disabilities through a federally reimbursable service either as a separate service or as a service that may be combined with other waivers.

SB 10 MEDICAID/INS FOR CANCER CLINICAL TRIALS
Sponsor: Senator Davis
Committee(s) and date of last action: Read and referred to (S) FIN, 3/13/09
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: 03/20/09 Referred to (S) L&C, then (S) FIN
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: 04/07/09 Read for first time and referred to (H) HSS, then to FIN
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: 04/08/09 Read for first time, referred to (H) HSS, then to (H) FIN
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: 04/06/09 (S) L&C, then FIN
Description: This bill proposes to change language in a previous statute, amending "managed care entity" to "health care insurer."

SB 61 MANDATORY UNIVERSAL HEALTH INSURANCE
Sponsors: Senators French, Ellis
Committee(s) and date of last action: 04/09/09 Scheduled to be heard (S) L&C at 1:00 pm Beltz 211, then to FIN
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.

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 79 MED BENEFITS DISABLED PEACE OFFICERS
Sponsors: Senators McGuire, Paskvan
Committee(s) and date of last action: Referred to (S) FIN, 03/05/09
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 82 MEDICAID FOR ADULT DENTAL SERVICES
Sponsors: Rules by request of the governor
Committee(s) and date of last action: Referred to (S) FIN, 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."

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 155 MEDICAL ASSIST FOR COGNITIVE DISABILITIES
Sponsor: Senator McGuire
Committee(s) and date of last action: 03/18/09 (S) Referred to (S) HSS, then to (S) FIN
Description: "The department shall establish in regulation a system for setting medical assistance reimbursement rates based on the functional level of care needed by an eligible recipient with a diagnosed cognitive disability, regardless of the recipient's need for medical or personal care support. The system must address eligible recipients' needs for appropriate assessment, rehabilitation, case management, ongoing support and respite or companion services, regardless of whether the services are provided in a health care facility or under a home and community-based waiver granted under 13 AS 47.07.045."

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Bill Watch: Mental Health

HB 52 POST-TRIAL JUROR COUNSELING
Sponsor: Representative Kerttula
Committee(s) and date of last action: Read and referred to (H) JUD, then (H) FIN,
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.

HB 83 APPROP: MENTAL HEALTH BUDGET
Sponsor: Rules by request of the governor
Committee(s) and date of last action: 04/08/09 CONF COM APTD H&S
Description: This bill outlines the specific appropriations for each component of the state's mental health program.

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, then (S) L&C, then (S) FIN, 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.

HJR 10 VETERANS' HEALTH CARE
Sponsor: Representatives Guttenberg Kawasaki, Salmon, Kerttula, Gruenberg, Cissna, Lynn, Wilson, Tuck, Dahlstrom, Doogan, Herron, Gara, Austerman, Johnson
Committee(s) and date of last action: 4/10/09 (S) HSS Scheduled to be heard Friday, April 10, 2009, 1:30 PM, Butrovich 205
Description: This bill urges the United States Congress to improve health care for veterans.

Bill Watch: State Boards and Issues

HB 25 HEALTH REFORM POLICY COMMISSION
Sponsor: Representative Hawker
Committee(s) and date of last action: Read and referred to (H) HSS, then (H) FIN),
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.

HB 63 COUNCIL DOMESTIC VIOLENCE: MEMBERS, STAFF
Sponsors: Representatives Fairclough, Holmes, Coghill, and Wilson
Committee(s) and date of last action: 03/20/09 (S) Referred to Finance
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 75 HEALTH COMMISSION/PLANNING
Sponsors: Representatives Cissna and Gruenberg
Committee(s) and date of last action: Read and referred to (H) HSS, then (H) FIN,
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 123 EXTEND SUICIDE PREVENTION COUNCIL
Sponsor: Representative Flairclough
Committee(s) and date of last action: 04/08/09 (H) FIN AT 1:30 PM HOUSE FINANCE 519
Description: This bill proposes to extend the Suicide Prevention Council to June 30, 2013, effective immediately.

SB 35 EXTEND SUICIDE PREVENTION COUNCIL
Sponsors: Senator, Davis, Ellis, Therriault
Committee(s) and date of last action: 04/10/09 Scheduled to be heard in (S) FIN AT 9:00 am Senate Finance 532
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, then to (S) FIN,
01/21/09
Description: This bill is identical to SB 35.

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Bill Watch: Family Health Issues

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: Signed into Law, CHAPTER 4 SLA 09
03/30/09
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, then (S) JUD,
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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Bill Watch: Bill Tracking Explanation and Acronyms

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

AHPR Staff and Contributors

Lawrence D. Weiss, PhD, MS, Editor
Lisa McGuire MPH, Consulting Policy Analyst
Jacqueline Yeagle, Newsletter design and editing

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