Alaska Health Policy Review

There are wonderful opportunities across this state to engage in regular health policy discussions with like-minded interested persons, to learn a lot from our very own locally grown knowledgeable experts, and to network. I would like to tell you about one of these opportunities you may not know about.

Commonwealth North likes to say they are "Alaska's premier non-partisan public policy forum." Their membership is a tad pricey, with standard annual membership at $575 per year, but lots of variations up and down. Their membership is heavily business-oriented, and they tend to have a conservative bent. They have been interested in health policy issues for years.

In the summer of 2005, Commonwealth North published Alaska Primary Health Care - Opportunities & Challenges. This report was the result of a 9-month long study of the primary health care system of Alaska. It details issues surrounding the cost, access and quality of primary health care in Alaska and makes many suggestions for improvement. It was chaired by board members Marvin Swink and Dr. Tom Nighswander.

Since then, Commonwealth North has created a Health Care Action Coalition to address Alaska's critical health needs. This group is chaired by Duane Heyman and Tom Nighswander. It meets periodically to track the activities and issues affecting major health care policy in Alaska. The meetings are free and open to the interested public. In my experience, the presentations are always very good, and the networking opportunities are excellent. The next meeting is Thursday, February 18, from 7:00-9:00 AM in the Alaska Native Tribal Health Consortium building at 4000 Ambassador Drive, near the intersection of Tudor and Elmore.

Contact Joshua Wilson, program manager at Commonwealth North, at events@commonwealthnorth.org or 907-258-9522 for more information.

Now, on to the rest of this issue of Alaska Health Policy Review. Your comments about content and format always appreciated.

Lawrence D. Weiss PhD, MS

Editor, AHPR

ldweiss@acpp.info

Strategies to Attract and Keep Health Care Providers in Alaska

Alaska, like the rest of the nation, is facing an increasing health care workforce shortage. Last week, a group of state organizations known as the "Alaska Health Care Professional Loan Repayment and Incentives Program Workgroup," held a half-day workshop in Juneau, addressing this issue. The workshop, "Solutions to get and keep health care providers in Alaska," included presenters from the Alaska Primary Care Association, Alaska State Hospitals and Nursing Home Association, Health Planning and Systems Development, UAA, and AARP. Key speakers gave presentations including an overview of the health care workforce shortage problem in our state, the current strategies to improve the shortage, and comparison summaries of existing bills in the state Legislature that address this issue. Below are the highlights and key points from two of the workshop presentations, followed by a detailed description of current loan repayment options for health care providers in Alaska. The workshop will also be held in Anchorage on February 15.

Vacancies, Unequal Distribution, and High Turnover

Alaska's health care workforce shortage problem involves not only vacancies, but also an unequal distribution of occupational groups. Major differences in provider-patient ratios exist between urban and rural areas, with rural areas experiencing a much greater vacancy rate in psychologists, dentists, and physicians. Overall, the number of vacancies continues to rise and is most prevalent among physicians and dentists.

Employee turnover is a primary contributor to the health care workforce shortage, increasing costs for recruitment and leaving many areas with vacancies for long periods. Citing the American Association of Medical Colleges, the Health Planning and Systems Development (HPSD) presentation notes that national competition for physician positions will increase substantially over the next 15 years, with an estimated physician shortage of 124,400 in 2025. Thus, states will be competing to recruit and retain physicians and will have to utilize strategies that entice physicians to practice, especially in health professional shortage areas (HPSAs). However, provider recruitment is expensive: a 2006 Physician Supply Task Force Report for Alaska found that recruitment for a family medicine physician averaged $126,000.

To recruit and retain health care providers, states are increasingly relying on Support-for-Service-Programs (SFSPs), a group of strategies that target health professionals at different stages in their careers. Competitive pressure is building nationally, with states utilizing multiple types of SFSPs. For example, a state might utilize a federally funded loan repayment program, along with one or more state-sponsored loan repayment, direct incentive, or scholarship programs. The states that utilize multiple strategies tend to have greater success in health care provider recruitment and retention, and programs that target ready-to-work professionals often reap the most success.

The National Health Service Corps, an entity providing federal funding for SFSPs, recently increased its loan repayment program by 4,000 practitioners, and awarded Alaska with $1.2 million for a state loan repayment program. The Health Planning and Systems Development section of the Division of Health Care Services is responsible for implementing this program, which is described in detail below. [Source: Robert Sewell and Alice Rarig of HPSD and Rod Betit of the Alaska State Hospital and Nursing Home Association]

Health Care Workforce Proposals from the Alaska State Legislature

Currently, there are five bills in the state Legislature that address the health care workforce shortage crisis in Alaska. The bills (tracked below in "Bill Watch") differ in their targeted professional type and career stage, as well as in the number of estimated practitioners added to the state. SB 174 and its companion bill, HB 235, sponsored by Sen. Menard and Rep. Munoz, respectively, propose a service loan option for students pursuing careers in pharmacy, optometry, and dentistry. Support is provided during graduate professional training, and the estimated time until practitioners are employed in Alaska is four to seven years. Thus, the short-term impact on the health care workforce for those selected providers is minimal. The estimated number of providers working in Alaska because of this option is unknown. SB 174 remains untouched (in (S) FIN committee) since last year's legislative session, and HB 235 was heard and held in (H) EDC on February 1.

SB 18 (Wielechowski), and its companion bill, HB 204 (Dahlstrom), also propose a service-loan option for students, but specifically target the number of students in the WWAMI medical school program. The bills propose a gradual increase in the number of students enrolled in the program, from current enrollment of 20 students, to 24, effective July 1, 2010. The service-loan proposed in these bills includes partial costs for medical school through the University of Washington, but students will still accrue debt. It is estimated that this option would result in 50 percent of medical students returning to practice in Alaska following their medical education. Both of these bills remain in their respective Finance committees, since April of last year.

The final bill addressing the health care workforce shortage problem in Alaska is SB 139, sponsored by Senator Olson. This bill differs substantially from the previous four, as it proposes a loan repayment program and direct incentives for providers who are ready to work in Alaska. The targeted professionals are licensed practitioners, and loan repayment or direct incentives are provided on a quarterly basis and at the time of service. It is estimated that the short-term increase in the number of providers in Alaska will be almost immediate, and could result in an increase of 90 or more practitioners within one year, and 360 in four years. Additionally, it is expected that the return on investment (i.e. providers practicing in Alaska) is 100 percent, with this support-for-service-program. SB 139 was referred to the Senate Finance committee during last year's session, where it currently remains. There is overwhelming support for this bill from several organizations in Alaska. See the list below.

All of the bills described above address the unequal geographical distribution of providers, as well as "priority patients," such as Medicare and Medicaid recipients, and the uninsured. SB 18, HB 204, and SB 139 all contain financial loss protections for the state should participants fail to provide service according to their specific contracts. [Source: Robert Sewell of HPSD, and Rod Betit of the Alaska State Hospital and Nursing Home Association]

There are additional strategies and options for increasing the practitioner supply to Alaska, including scholarships for undergraduate education. To date, the most successful programs are those that target ready-to-work practitioners using direct incentives and loan repayment programs. Below are brief descriptions of the three loan repayment options for licensed practitioners in Alaska.

Current Health Care Workforce Loan Repayment Programs in Alaska

Combined State-Federal Loan Repayment Programs

Recently, the state of Alaska's Health Planning and Systems Development (HPSD) initiated a loan repayment program for selected health care professionals. The program began in August 2009, after the state received a grant from the federal Health Resources and Services Administration, a section of the U.S. Department of Health and Human Services. The approved grant lists the Alaska Mental Health Trust Authority and Alaska employers as the source of matching state funds to initiate the program (State of Alaska, HPSD, 2009).

The program is open to health care professionals in three fields with provider shortages: primary care, dental services and behavioral health. Alaska's Health Planning and Systems Development anticipated that the program would begin accepting applications in December 2009. The program provides up to $35,000 per year to primary care physicians and dentists, and up to $20,000 per year to other eligible providers. Their website lists 14 eligible provider types for this state-federal loan repayment program:

Primary care:

physicians (medical doctors (MD) or doctors of osteopathy (DO) who are family practitioners,
internists,
pediatricians or obstetrician-gynecologists,
nurse practitioners, and
physician assistants.

Dental services:

dentists, and
registered clinical dental hygienists.

Behavioral health:

psychiatrists,
clinical or counseling psychologists (CPs),
clinical social workers (CSWs),
psychiatric nurse specialists (PNSs),
mental health counselors (MHCs),
licensed professional counselors (LPCs),
marriage and family therapists (MFTs).

This program would provide loan repayment for ready-to-work clinicians, following each quarter of work. It is estimated that yields on investment would be almost immediate, adding up to 23 additional health care professionals by fiscal year 2011. This program addresses geographical areas of need and priority patients. In addition, it is expected that 100 percent of professionals would practice in Alaska, and the state would be protected from any financial loss. [Source: Dr. Robert Sewell, HPSD]

More information on Alaska's new State Loan Repayment program is available on the Health Planning and Systems Development website.

National Health Service Corps Loan Repayment Program

The National Health Service Corps (NHSC) describes their loan repayment program, which is available to Alaska practitioners. To be eligible, an individual must be a U.S. citizen or national, with the approved training and credentials for the following primary care disciplines:

Allopathic (MD) or Osteopathic (DO) Physician
Primary Care Nurse Practitioner
Certified Nurse-Midwife
Primary Care Physician Assistant
Dentist
Dental Hygienist
Health Service Psychologist
Licensed Clinical Social Worker
Psychiatric Nurse Specialist
Marriage and Family Therapist
Licensed Professional Counselor

Recipients of the National Health Service Corps loan repayment contracts are committed to serve two years at an approved site in a Health Professional Shortage Area (HPSA). These sites are approved by the NHSC, and close to half of NHSC clinicians carry out their service commitment at federally supported health centers. The NHSC approves additional practice sites, including rural health clinics, Indian Health Service clinics, public health department clinics, hospital-affiliated primary care practices, managed care networks, prisons, and U.S. Immigration, Customs & Enforcement sites.

See the National Health Service Corps website for more information on the NHSC Loan Repayment Program.

Indian Health Service Loan Repayment Program

Applicants must be health or allied health professionals who:

Are US citizens.
Agree to sign a contract to practice at an Indian health program priority site.
Can begin service on or before September 30 for two continuous years of full-time clinical practice.
Are able to begin service on or before September 30.
Have a degree in a health profession.
Have a valid state license.

The Indian Health Services (IHS) selects sites for loan repayment program awards using a ranking system based on the program goal to fill staff vacancies in Indian health programs. Thus, rankings are based on specific program staffing needs and shortages of specific health profession disciplines. The IHS gives priority consideration to applications made by American Indians and Alaska Natives and to individuals recruited through the efforts of Indian Tribes, Tribal or Indian organizations. The IHS Loan Repayment Program awards up to $20,000 per year for participants who sign a two-year service contract. For more details on the IHS Loan Repayment Program, visit the program's website.

Brand New: 2010 Nursing Education Loan Repayment Program

The Nursing Education Loan Repayment Program (NELRP) assists in the recruitment and retention of professional Registered Nurses (RNs) in facilities with a critical nursing shortage. NELRP encourages practice in these facilities by decreasing economic barriers associated with the rising cost of obtaining a nursing degree. The program offers RNs economic assistance through educational loan repayment in exchange for full-time service at a health care facility with a critical shortage of nurses.

Eligible Recipients are:

Nurses who meet the following criteria:
Hold a degree in nursing (associate, baccalaureate or graduate level);
Have outstanding educational loans (nursing loans only);
Is a U.S. citizen, U.S. national, or lawful permanent resident of the United States;
Is employed full-time (32 hours or more per week) at a critical shortage facility; and
Have a current permanent unrestricted license as an RN in the State in which he/she intends to practice.

Additional information about this program, including detailed eligibility requirements and application forms, see the program flyer. [Source: excerpted from an Alaska Primary Care Association News Article, on February 4, 2010]

Alaska Organizations Supporting Senate Bill 139 Incentives for Certain Medical Providers

Alaska State Medical Association
Alaska Dental Society
Alaska Primary Care Association
Alaska Osteopathic Medical Association
Alaska State Hospital and Nursing Home Association
Alaska Mental Health Trust Authority
Alaska Native Health Board
Alaska Pharmacists Association
Alaska Physical Therapy Association
AARP-Alaska
Advisory Board on Alcoholism and Drug Abuse
Alaska Behavioral Health Association
Alaska Mental Health Board
Alaska Public Health Association
Alaska State Dental Hygienists' Association
Commonwealth North
Iliuliuk Family and Health Services, Inc.
Maniilaq Association
Municipality of Anchorage Senior Citizens Advisory Board
Mary Willard, DDS, Clinical Site Director, Alaska Native Tribal Health Consortium
Nome Eskimo Community
SEARHC
School of Social Work-UA
Dental Hygiene Program-UA
Sunshine Community Health Center

[Source: Shelley Hughes, Alaska Primary Care Association] Back to article

Editorial note: We thank Dr. Robert G. Sewell and Dr. Alice Rarig of the State of Alaska Health Planning and Systems Development, Rod Betit of the Alaska State Hospital and Nursing Home Association, as well as Shelley Hughes of the Alaska Primary Care Association, for providing information about and presentation documents from the Legislative workshop mentioned above. Selected documents from the Legislative workshop are available. HPSD Power Point Presentation: Alaska's Health Care Workforce: Shortages and Possible Support-for-Service Strategies.

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New State-Based Health Reform Resources

The Cost of Failure to Enact Health Reform: Implications for States
By: Garrett, B., Holahan, J., Doan, L. and Headen I.
Publisher: Urban Institute
Published: September 30, 2009

Researchers from the Urban Institute used their Health Insurance Policy Simulation Model to estimate how coverage and cost trends would change between now and 2019 if the health system is not reformed. The report shows that under the worst-case scenario, within 10 years:

The number of people without insurance would increase by more than 30 percent in 29 states.

In every state, the number of uninsured would increase by at least 10 percent.

Businesses would see their premiums increase-more than doubling in 27 states.

Even in the best case scenario, employers in 46 states would see premiums increase by more than 60 percent.

Every state would see a smaller share of its population getting health care through their job.

Half of the states would see the number of people with ESI fall by more than 10 percent.

Every state would see spending for Medicaid/Children's Health Insurance Program (CHIP) rise by more than 75 percent.

The amount of uncompensated care in the health system would more than double in 45 states.

For extended details on the simulation model, see the full report. [Source: excerpted from the Robert Wood Johnson Foundation on February 2, 2010]

Physicians' Views of the Massachusetts Health Care Reform Law - A Poll
By: SteelFisher, G.K., Blendon, R.J., Sussman, T., Connolly, J.M., Benson, J.M. and Herrmann, M.J.
In: The New England Journal of Medicine (Online First)
Publisher: Massachusetts Medical Society
Published: October 21, 2009

Three years after Massachusetts enacted its health insurance reform law, the state boasts the lowest rate of uninsured individuals nationwide. Yet, the model is still surrounded by public controversy, especially as the nation explores health reform. This article gathers physician opinions about the Massachusetts health reform legislation and its implementation.

Researchers from the Harvard School of Public Health designed and analyzed a survey of 2,135 physicians in Massachusetts in August and September of 2009. The researchers examined physician perceptions of overall Massachusetts Health Reform Law, and views on both personal practice impact and statewide health care impact.

Key Findings:

Seventy percent of physicians surveyed were in support of the legislation; 13 percent opposed it.
Similar levels of support were reported by primary care doctors and specialists.
More physicians give the Massachusetts health care system an excellent or good rating as compared to the national system.
Seventy-five percent of physicians wanted to continue the law; 29 percent wanted to keep the law as is; while 46 percent wanted to continue it with some changes.

For more on the findings of this poll, see the full report online. [Source: excerpted from the Robert Wood Johnson Foundation, February 2, 2010]

A State Policymaker's Guide to Federal Health Reform
Publisher: National Academy for State Health Policy, funded by the Robert Wood Johnson Foundation
Published: November 18, 2009

With federal health reform potentially on the horizon, state governments will face new opportunities and challenges to improve local health care delivery systems-and ultimately, the health status of their residents. Exploring the effects of health reform on states is essential, as states play critical roles in financing, organizing, and regulating local health care systems.

Three documents released by the National Academy for State Health Policy (NASHP) and funded by the Robert Wood Johnson Foundation identify the most challenging and pressing health policy issues that states are currently addressing. They describe the array of tools states have to improve their health care systems and look at how federal health reform may affect those tools. In addition, they examine the support states will need to implement the changes contemplated in federal health reform legislation.

All three parts this research are available online. Access Part One: Anticipating How Federal Health Reform Will Affect States Roles. Access Part Two: State Policymakers' Priorities for Improving the Health System. Access Part Three: Supporting State Policymakers' Implementation of Federal Health Reform. [Source: excerpted from the Robert Wood Johnson Foundation, February 2, 2010]

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Will Alaska Legislators Support Community Health Centers?

Alaska is one of a dozen states that does not include regular support for its CHCs [Community Health Centers] in its annual budget. Other states recognize the value of ensuring primary care access to their residents for public health purposes and economic advantages. They support CHCs as important facilities in communities, as catalysts to help lower health care spending and to improve health outcomes, as economic drivers, and as necessary resources for workers and businesses. Gone is the misconception that CHCs are free federal clinics for poor people; present is the reality that CHCs provide needed services to all residents, that CHCs are revenue generators, and that CHCs are a valuable asset they should support and promote.

Alaska legislators are called to recognize the importance of CHCs this session. The question is: Will they? The APCA [Alaska Primary Care Association] will be working hard to educate legislators and communicate this message. With 26 CHCs operating 142 clinics, serving 1 in 9 Alaskans (over 81,000 patients each year) and with clinic budget challenges other states don't face to the same degree, it is time for Alaska to step up to the plate.

The APCA is requesting $2 million in the operating budget to assist CHCs in providing direct patient care services. The APCA is also requesting $8 million in capital to assist the 142 clinics with facility, health internet technology and equipment needs. Yes, $2 million is a large number to add to the operating budget as is an $8 million inclusion in the capital budget, but for illustration purposes, divide those numbers by the number of clinics sites and by the number of patients served and the amounts cease to loom large. The breakdown is $14,000 operating per clinic or $25 per patient, both extremely modest amounts. For capital spending, the breakdown for the long term investment is $56,000 per clinic and $99 per patient.

[Source: excerpted from the Alaska Primary Care Association Legislative Update, February 1, 2010]

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Future of Alaska Health Care Commission

The current Alaska Health Care Commission, established by Governor Palin on December 4, 2008, expires in April of this year. The commission's primary duty, as established under Administrative Order #246, is to serve as the state health planning and coordinating body. Specifically, the commission is to "provide recommendations for and foster the development of a statewide plan to address the quality, accessibility, and availability of health care for all citizens of the state."

The current commission consists of 10 members, whose requirements are specified in the administrative order. The members include the state's chief medical officer (who also serves as chairperson of the commission), an Alaska health care provider and an Alaska health care consumer, and one representative each from the Alaska Tribal Health System, the Alaska health insurance industry, the Alaska State Chamber of Commerce, and the Alaska State Hospital and Nursing Home Association. Three nonvoting members are representatives from the state Senate, House of Representatives, and executive branch.

Because the current commission is not a permanent entity, many organizations in Alaska have been working to ensure that the progress of the current commission is maintained, and that state health care reform is a priority for all Alaskans. Extending the life of the commission, and establishing it as a permanent entity, are critical to the future of health care in Alaska, and are the focus of three bills currently in the state Legislature.

SB 172 Alaska Health Care Commission, HB 25 Alaska Health Reform Policy Commission, and HB 75 Alaska Health Commission differ slightly in their recommendations for the commission's purpose, membership, duties, and provisions. Last August, a document comparing each of the bills was provided during a regular meeting of the Health Care Commission. Below is a summary of the document, "Comparison of Health Commission Authorizing Language."

Health Care Commission Purpose

All three bills include a primary commission purpose to provide recommendations that are specific to the health care needs in the state. House bills 25 and 75 are more specific in their descriptions of the purpose, with HB25 stating that policy recommendations are to be considered by the Legislature and by the executive branch. HB 75 includes the most detailed definition of the commission's purpose, incorporating both of the definitions from each of the other two bills. SB 172 defines the purpose of the commission as being identical to that in the original administrative order, noted above.

Health Care Commission Location and Dates of Establishment

All three bills, as in the original Administrative Order #246, establish the commission's organizational location as existing within the Department of Health and Social Services. The current commission members' terms expire April of this year. SB 172 would establish a new commission immediately upon the governor's signature, expiring June 30, 2014. HB 25 also establishes the commission upon the governor's signature, with an authorizing legislation to be repealed on July 1, 2015. HB 75 states that the commission would take effect July 1, 2009, with no sunset date for expiration of the commission.

Health Care Commission Membership

The majority of the differences between the three health care commission bills can be found in the constitution of the members. SB172 proposes a membership most similar to the current commission: 10 members (seven voting and three non-voting), and the DHSS medical director as the chair of the commission. HB 25 recommends sixteen members (11 voting and 5 non-voting), with the DHSS commissioner or designee as chair of the commission. In addition, HB 25 recommends that the non-voting members include two members from the Senate, two members from the House, and one member appointed by the governor. HB 75 recommends that the commission be comprised of fifteen members, all eligible to vote. Also, HB 75 recommends that members elect the commission chair annually. SB 172 and HB 75 propose member terms of three staggered years, whereas HB 25 proposes that members serve five-year terms.

Health Care Commission Duties

The duties outlined for the Commission are quite similar among all three bills, and include:

1. Serve as the state health planning and coordinating body
2. Make recommendations regarding health policy, based on targeted needs of Alaskans, including recommendations and strategies for

Containing health care costs and preventing fraud
Improving health care quality
Developing a sustainable health care workforce
Promoting healthy lifestyle choices and responsibility of individuals
Increasing the number of Alaskans who are covered by health insurance

2. Submit an annual report to the Governor and the Legislature, by January 15 of each year

House bills 25 and 75 stipulate that the first report include "a 5-year strategic plan with prioritized, targeted, and defined objectives as well as an evaluation of the strengths, weaknesses, and relative performance of health care services and conditions in the state," with subsequent reports including any revisions to the plan and progress updates.

SB 172 was heard and held in (S) HSS committee on February 3. House bills 25 and 75 were never heard in committee last year, although they were referred to (H) HSS at the time of their introduction. Additional details and comparisons of the three health care commission bills are available in the original document distributed to HCC members in August 2009.

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Health Policy Calendar

Bill Watch: Bills on the Move

Health policy bills received much attention this past week, with several making their way into committees, and several with assignments to committees and scheduled dates for hearings.

Additionally, two existing bills deserve tracking due to their relevance to health insurance coverage for Alaska's fishers. HB 207 Maximum Benefit from Fishermen's Fund, and its companion bill, SB 163 Maximum Benefit from Fishermen's Fund, are now being tracked in the Bill Watch section below. HB 207 was heard in (H) RLS on February 4. In addition, two new health policy bills were introduced this week, and three bills were heard in committees.

HB 283 Purchase/Consumption of Alcohol was heard in (H) L&C on January 27, and is scheduled to be heard in (H) JUD on February 11.

HB 110 Psychologists' Licensing & Practice was heard in (H)HSS on January 28, and amended and referred to (H) L&C on January 29. HB 235 Prof Student Exchange Loan Forgiveness is scheduled to be heard in (H) EDC on February 8.

SB 238 Medicaid for Medical and Intermediate Care was heard in (S) HSS, amended, and is scheduled to be heard in (S) FIN on February 3. SB 172 Alaska Health Care Commission was heard and held in (S) HSS on February 3. HB 314 Workers' Compensation was heard in (H) L&C and moved out of committee on February 3.

HJR 35 Const Am: Health Care and HB 168 Trauma Care Centers/Fund are scheduled to be heard in (H)HSS on February 9. SB 168 Trauma Care Centers/Fund and SB 169 Approp: Trauma Care Fund are scheduled to be heard in (S) HSS on February 10.

The following is a list of all health-related bills recently proposed or sitting in various legislative committees. For a description of the process of selecting and tracking health policy bills, as well as the full names of committees and their abbreviations, refer to the end of the Bill Watch section.

Bill information is current as of February 3 at 8:00 PM.

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Bill Watch: Drugs

HB 17 Prohibit Tobacco Use Until Age 21
Sponsor: Rep. 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.

HB 277 Certify Emergency Use of Epinephrine
Sponsor: Rep. Peggy Wilson
Committee(s) and date of last action: Referred to (H) HSS, 01/19/10
Description: This bill proposes the addition of a state program in the Department of Health and Social Services that would provide prescriptions to eligible individuals for emergency use of epinephrine.

HB 283 Purchase/Consumption of Alcohol
Sponsor: Rep. Crawford
Committee(s) and date of last action: Heard in (H) L&C on 01/27/10, and is scheduled to be heard in (H) JUD on 2/11/10
Description: This bill amends a previous statute concerning the legalities of purchasing, soliciting, or drinking alcohol among underage individuals and those with alcohol-related felonies. Specifically, it clarifies the conditions under which a person would be committing an alcohol-related crime.

HB 284 Pioneer Home Rx Drug Benefit
Sponsor: Rep. Gara
Committee(s) and date of last action: Referred to (H) HSS, 01/21/10
Description: This bill proposes a law requiring the Department of Health and Social Services to accept federal prescription drug benefits or to provide comparable benefits for residents of the Alaska Pioneers' Home.

SB 52 Salvia Divinorum As a Controlled Substance
Sponsor: Sen. 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.

SB 197 Emergency Contraceptives
Sponsor: Sen. Dyson
Committee(s) and date of last action: Referred to (S) HSS, 01/19/10
Description: This bill proposes to allow pharmacists in Alaska the "right to refuse to refer, recommend, or dispense emergency contraceptives." In addition, it would provide immunity for pharmacists from any civil liability resulting from such a refusal.

SB 215 Pioneer Home Rx Drug Benefit
Sponsors: Senators Wielechowski, Olson, Kookesh, Ellis, and Davis
Committee(s) and date of last action: Referred to (S) HSS, 01/19/10
Description: This is the Senate companion bill to HB 284.

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Bill Watch: Health Professional Workforce and Health Education

Bill Watch: Medical Assistance and Health Insurance

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.