topAlaska Health Policy Review
comprehensive, authoritative, nonpartisan

May 22, 2012 - Vol 7, Issue 15
In This Issue
Important Information about this Newsletter
Interview with Pat Luby of AARP Alaska
Please Respect Our Copyright
Alaska Health Policy Calendar
Health Policy-Related Bills Passed by the 27th Alaska Legislature
Final Results of Other Health Policy-Related Legislative Bills
Bill Watch: Drugs
Bill Watch: Health Professional Workforce and Education
Bill Watch: Medical Assistance and Health Insurance
Bill Watch: Mental Health Issues
Bill Watch: State Boards and Issues
Bill Watch: Family Health Issues
Bill Watch: Workers' Compensation
Bill Watch: Public Safety
Bill Watch: General Health Policy
Bill Watch: Bill Tracking Methodology
AHPR Staff and Contributors
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From the Editor

Dear Reader,

Perhaps this issue of AHPR should be labeled the "transitions" issue. For the last year I have been slowly easing into retirement. Last year I stepped down as executive director and was replaced a few months ago by Bob Lohr ... welcome Bob! I wrote about Bob in the January issue of AHPR, but note that among his accomplishments, he was the executive director at Rural Alaska Community Action Program, one of the largest non-profits in Alaska; director of the Alaska Division of Insurance; and executive director of the Alaska Public Utilities Commission.

This month, as part of my journey into life's next phase,
Jacqui Yeagle succeeds me as AHPR managing editor. She has worked with ACPP, and Alaska Health Policy Review in particular, longer than any other person aside from myself. Over the years, Jacqui has held a variety of responsibilities regarding editing, production, and distribution of AHPR. I can think of no more qualified person to sit in the AHPR driver's seat. Yay, Jacqui!

And there is more! Earlier this month Senior Policy Analyst Kelby Murphy was promoted to director of health policy. Kelby and I have worked together for several years at ACPP on health policy issues and a variety of other policy projects. Kelby has more experience as a policy analyst at ACPP than any other staff person in the history of the organization. Yay Kelby!

Finally, late last month I had the great pleasure of interviewing Pat Luby for this issue of AHPR. Pat is an extraordinarily knowledgeable and insightful health policy analyst, activist, and lobbyist. As advocacy director for AARP in Alaska since 2001, his contributions to the people of Alaska are legendary. Pat is leaving the state in the fall as part of his transition into retirement. Many of us will deeply feel his absence.

Meanwhile, I have been occupying my pod at the downtown offices of ACPP on a reduced schedule to wrap up some projects and work with Bob and staff on transition issues. My last day at ACPP will be August 31, but this letter from the editor will be my last to you. I thank you most sincerely for the financial and personal support over the years. I will miss my interactions with you through the pages of AHPR, but I do look forward to my new life as a retired codger. I bid you well in the coming years.

Lawrence D. Weiss PhD, MS
Former Editor, AHPR

 

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Interview with Pat Luby of AARP Alaska

Pat Luby
For this issue of the Alaska Health Policy Review, Larry interviewed Pat Luby, advocacy director for AARP Alaska and ACPP board member. They discussed Luby's work as a lobbyist for AARP, recent legislative "wins" and "losses," how the Affordable Care Act may impact health care in Alaska, health policy players in Alaska, and Luby's impending retirement. The interview was conducted on April 27, 2012, and it has been edited for length and clarity.

linksLinks to selected topics

Lobbying in Alaska
Back to the beginning
Recent legislative victories
Denail KidCare expansion effort hopes dashed
The Affordable Care Act and possible impacts in Alaska
Health policy players in Alaska
Relocation not retirement
Meandering down memory lane
Challenging ourselves to address the problems

lobbyingLobbying in Alaska
 
AHPR: Would you please tell us a bit about yourself? What is your position here at AARP, how long have you had it, and what do you do?

Luby: I'm the advocacy director for AARP here in Alaska, which means I'm a lobbyist. I work with Congress. I work with the [Alaska] State Legislature, and sometimes I work with municipal assemblies or borough assemblies on different issues of interest to older people, and their families. I have been with AARP -- this November it will be 40 years. I came up here in 2001 to help open the Alaska office. We'd never had a staffed office here before.

"Our membership starts at age 50 on up, so in some cases we have three different generations who all belong to AARP, and they all have different expectations."

AHPR: I think a lot of people would be interested to know, just in general terms, what a lobbyist who represents a non-profit organization [does]. What do you do as such?

Luby: We are a non-profit that represents our membership, so we might get involved in consumer issues. We might get involved in health issues. We might get involved in utilities, anything that really has some kind of an impact -- pro or con -- on our members.

Our membership starts at age 50 on up, so in some cases we have three different generations who all belong to AARP, and they all have different expectations. The oldest ones are very concerned about long-term care. Some of the younger ones are concerned about housing and utilities. And the real young ones, in their early 50s, are very concerned about workforce issues, and health insurance, and age discrimination in employment, and some of those issues. So, all those different people have very different expectations of "their" AARP.

AHPR: So, you might give testimony, for example, during hearings, or you might talk to individual legislators, that kind of thing?

Luby: Certainly, we do a lot of testimony. Alaska is very unusual in that we have this series of legislative information offices - what we call the "LIOs." There are over 20 of them spread throughout the state, and any Alaskan can testify before the Legislature on an issue that they are concerned about.

It makes it very easy for someone like me, who is based in Anchorage, to just drive downtown, and to give testimony on a particular bill that we are concerned about, either pro or con. We also have volunteers in Juneau, and sometimes I go down to Juneau to testify. But we also meet, like last week we met with the congressional office here for Senator Murkowski to talk about an age discrimination bill that was a result of a Supreme Court decision, and we are trying to get that reversed.

So, we work with the district offices. Sometimes we will go to D.C., sometimes we'll go to Juneau, and sometimes we just drive downtown to the LIO to take a position on a bill. Back to selected topics list

beginningBack to the beginning

AHPR: I remember you telling kind of an interesting story about how you actually came to work for AARP, and it had something to do with where the grants were for your education or something. Could you tell that story?

Luby: Yes. I had just returned. I was in the army, got out of the army, came back home from Vietnam, and I had taken the GRE in Saigon. And I had good grades on the GRE, and I was interested in going to graduate school [and I] came back and actually went to the secretary at the graduate school at the University of North Carolina and asked her which programs were open.

"[I] did my internship, graduate student internship, with AARP in Washington. And 40 years later I'm still there."

And she was telling me about this one about gerontology, which I had no idea what that meant. So I went over the school of -- it was actually in the School of Adult Education, and they said "Well, you know we have these grants if you would like to study gerontology." And I said, "I don't know if I want to work with older people, you know I got the GI Bill, I'm going to be working part-time, and I'll probably be okay."
 
And then, after the first summer semester, I went back to the school and I said, "You know, I have developed this sudden interest in older people. Tell me more about that grant program." It was a wonderful program. The Administration on Aging funded several graduate school programs throughout the United States. I think at that point, they had started out with four, and the University of North Carolina was one of them. And they would basically pick up all your cost, you got a free ride.

There weren't that many instructors who could teach gerontology courses -- and so we had some professors from UNC, but we also had professors from Duke University. And we would study the psychology of aging, the biology of aging, social gerontology. There weren't that many courses that they could teach, because there simply wasn't that much expertise within the teaching community. 

AHPR: And what period of time was it?

Luby: That was '71 to '72, and I ended up with the master's in Gerontology, and did my internship, graduate student internship, with AARP in Washington. And 40 years later I'm still there. Back to selected topics list

victoriesRecent legislative victories

AHPR: You are still here. Amazing. Earlier this month, we wrapped up the regular legislative session in Alaska. From the point of the view of the health of Alaskans, were there any victories? And what do you think were the high points, if there were any?

Luby: Certainly, we had a couple that we worked on from the health standpoint that we were very pleased to finally see accomplished. There is a group of probably 10 or 12 different organizations who have been working on HB 78. It was for loan repayment or financial incentives for health professionals to either come to Alaska or to stay in Alaska.

It's geared so that if you work in a remote area that has severe shortages of health professionals, you can get more of your loans repaid than if you are working in Anchorage, but it really makes it attractive for people to come here from Outside. It also makes it attractive for people who may have been thinking, Alaskans who may have been thinking about practicing in Oregon, to stay here and have some of their loans reduced.

About 36 states already do this, and we didn't do anything, and so we definitely lost people. And it varies from physicians and advanced nurse practitioners and RNs and pharmacists, right on down to psychologists and clinical social workers, and everybody in between, so it really is a gamut. There are about 10 different positions that people can come from the different fields that they might come from. And they are all people that we need working here in Alaska.

"[HB 78] really makes it attractive for people to come here from Outside. It also makes it attractive for people who may have been thinking, Alaskans who may have been thinking about practicing in Oregon, to stay here and have some of their loans reduced."

There was another bill, too [HB 310]. We lost a lot of federal money for immunizations. Senator Stevens made sure that Alaska had a wonderful immunization program. It was primarily paid by federals. And when Senator Stevens died, and with Congress saying, "No more earmarks," we lost about $4 million out of a $4.7 immunization budget. So we were only going to have $700,000 left.

It was interesting because Senator Cathy Giessel, who is a conservative Republican, but also an advanced nurse practitioner, and Senator Donald Olson, who is a Democrat and a physician, they introduced a bill together that really put a spotlight on the immunization arena and where our shortages were going to be. The Senate bill didn't end up passing, the House bill did that Representative Herron sponsored, the same bill.

But we did get that funding in there for a three-year period to try to make up for those federal losses, and then Senator Giessel and Senator Olson and Representative Herron have all committed to trying to figure out, after that three years, we will try to figure out how to keep this going. But it really indicated, because we had these health professionals, who are also legislators, who could talk to their colleagues about how important immunizations and vaccines were. Immunizations for older people -- like shingles and the flu vaccine -- but there were also 19 different immunizations for children. All that funding has been restored.

AHPR: Are these immunizations, I mean eligibility for them, something that means-tested?

Luby: No. Most of them actually are distributed through the community health centers. And many of the folks who go to the community health centers are folks who are more moderate income, or lower income. That's where they get their primary care, that's their medical home. And, you don't find that many private physicians who are going to be giving vaccines, and not having some type of a fee associated with it.

AHPR: So HB 78 and the immunization bill. Were there any others that were of note, in terms of victories for the health of the people of Alaska? Back to selected topics list

hopesDenail KidCare expansion effort hopes dashed

Luby: Not particularly victories. We have been working with the faith community, in particular with AFACT [Anchorage Faith & Action Congregations Together]. It's an organization of different denominations, as well as United Way, as well as the Mat-Su Health Foundation, to try to get expansion of Denali KidCare through [the legislature].

We failed miserably on that one, primarily because the governor said he will not sign any expansion. But, one of the things that that did do is it energized everybody to say, "Okay, well let's take a look at everybody who is currently qualified, but not enrolled in the program."

And we will be meeting, actually in the AARP offices in early May, to talk about what we might be able to do to expand the program under the current eligibility rules. Let's find those people whose kids are eligible, or young women who may be pregnant who would be eligible, and let's make sure that we get them enrolled.

AHPR: My recollection is that there were thousands of eligible children who were not enrolled?

Luby: Right. The State of Alaska used to have a tremendous outreach program, and under Governor Murkowski, a lot of that was reduced and eliminated. What we need to do is, as organizations -- we will never have those state employees again -- but our organizations can make sure that the word is getting out, whether it is through churches or United Ways.

We are concerned about it from the standpoint of -- many grandparents raise their grandchildren. And if you are over 65 and you're raising your grandchildren -- and now we even have people raising their great-grandchildren -- you are on Medicare. Medicare is not going to pay for those dependents. So we want to make sure that older people understand -- your grandchildren might be eligible for Denali KidCare.

"AARP has worked with organized labor and NEA [Alaska], and actually with the Alaska Center for Public Policy, for several years to try to bring back a defined benefit retirement plan for our public employees, who don't participate in Social Security. So they basically have a 401K and their fingers crossed."

AHPR: On the other side of the coin, what would you characterize as the most serious losses, challenges, defeats, however you would characterize it, this most recent session -- from the point of view of the health of Alaska residents?

Luby: It's not just a health issue. It's also a public pension issue. AARP has worked with organized labor and NEA [Alaska], and actually with the Alaska Center for Public Policy, for several years to try to bring back a defined benefit retirement plan for our public employees, who don't participate in Social Security.

So they basically have a 401K and their fingers crossed. That also impacted their health program, because the proposal that they have basically gives them a health savings account, which will probably be exhausted within a couple of years after they actually retire.

And we felt that was inappropriate. People should be given a choice between a defined benefit and a defined contribution plan. But we also need to make sure that, especially for anyone who is retired before age eligibility for Medicare, that we have good health insurance for those people. They don't have it now. Anybody who has been hired since July 1, 2006, really does not have a good health program.

And if they choose to retire early, if they put in a lot of time working, want to get out even just a couple of years before Medicare, they are at risk. So we need to -- we got that bill through the Senate, it was never heard in the House. Everyone who is supporting that program will be back to try to push it again next year.

AHPR: Any other side of the coin issues you wanted to mention?

Luby: Yes -- and this is pure politics because of the sponsor of the bill. We had a couple of bills that failed because the Senate sponsor is going to be running against a House Republican for a Senate seat next year. And one of them was to take the Amber Alert System and have it available for older people who might be frail, and have some type of dementia.

One of the things that you have with dementia, and with Alzheimer's, is what we call "sundowners," and they are people who tend to wander. We've had two people who wandered and died. Two older people -- one in Fairbanks, and one in Anchorage in the last two years. We were working with law enforcement, with Homeland Security folks, and everyone said, "Yeah, we can go ahead and establish what we call a "Silver Alert" to complement the Amber Alert." It wouldn't cost any more money.

That bill died in the House of Representatives, simply because the sponsor was running against a House member next year. Didn't cost anything. So that was one that really put a spotlight on the fact that good public policy sometimes can go down the drain, simply because of partisan politics. Back to selected topics list

acaThe Affordable Care Act and possible impacts in Alaska

AHPR: I wonder if there is anything you can say about the Affordable Care Act at this time regarding its potential or likely impact on Alaska, I mean given the fact that we don't really know what the Supreme Court is going to do with it.

Luby: Yes, one of the things that we have to face, no matter what happens with the Affordable Care Act, is that about 20 percent of Alaskans have no health insurance. Which means 19 percent, actually, of Alaskans between the ages of 50 and 64, [are] not eligible for Medicare, [and] they have no health insurance at all. Now we've already figured out that when those people show up at the emergency room, any of us who come in behind them with an insurance card are helping to pick up their bill, and it comes out to about $1,900 per Alaska family, per year, to pick up the cost of people here in our state that have no health insurance.

"Insurance companies tend to like to take in premium. They don't particularly like to pay out benefits, but under the Affordable Care Act, the insurance companies are going to have to pay out a specific percentage of all the premium that they take in, back to cover their insured people."

That's one of the things that if the Affordable Care Act disappears we are going to have to figure out, "Do we want to continue to keep paying for that?" One of the other things that happened, and I have a friend who is a staffer over at the university who is very interested in this because her kids are involved in it. The Affordable Care Act allowed people to go ahead and enroll their adult children up to age 26 in their employee insurance program. They pay a premium to get those people enrolled, but they have health insurance. Her history with her adult children has been that they have not been able to get insurance, they couldn't find jobs that offered insurance, so now she was finally able to enroll a couple of them on her employee insurance.

She is paying the full tab for it. But it has -- because of the illnesses that they have had in the last year, she has been able to have the insurance pick up much of the tab, and she is very happy to pay her premium because she doesn't sit up at night worrying about the fact that they have no coverage at all.

In June, we are also going to find on a national basis, I'm not sure what the stats will be in Alaska, but on a national basis there will be $3.2 billion that is returned to large businesses, small businesses, and individuals because their insurance companies basically have not been paying out as much as they ought to.

Insurance companies tend to like to take in premium. They don't particularly like to pay out benefits, but under the Affordable Care Act, the insurance companies are going to have to pay out a specific percentage of all the premium that they take in, back to cover their insured people. If they don't use all that money, then they have to return it to them. So what we are going to find in June is that there is going to be a lot of small businesses, and big businesses, corporations, as well as individuals -- who are self-insured -- who are going to be delighted when they get a refund back from their insurance company -- $3.2 billion -- that's a lot of cash. Back to selected topics list

policyHealth policy players in Alaska

AHPR: Moving on to a different kind of question. How would you assess Alaska's public policy infrastructure? In other words, do we have an adequate public and private policy making infrastructure to make good health policy?

Luby: No. Part of our problem is simply that we don't have health reporters in the media ... even though an organization like the Alaska Center for Public Policy may come out with some recommendations on health care.

There were about 12 different organizations that worked to come up with [the loan repayment] proposal. The Alaska Primary Care Association was the one that actually led the fight to get it through the Legislature. But the university was there. Alaska State Hospital and Nursing Home Association (ASHNHA), the hospital association, was involved in all of that. Many of their providers were involved in it. But no matter what recommendations we might come up with, if they fall on deaf ears, or the public doesn't know about them, they are not going to go anywhere.

The one saving grace is that legislators have families, and right now in the Legislature in Alaska we have what they call the "cancer caucus." They are legislators who have all had cancer themselves, or someone in their family has had cancer, and they are very much aware of what happens. We just lost Representative Gatto to cancer this year. So they are sensitive to the fact that health is something that affects them, their families, as well as the general public, all of their constituents.

But legislators need to read things. They need to have input from their constituents. They need to be looking at articles in the daily paper. They need to see some of the television coverage about these issues. And unfortunately, they don't see it in Alaska unless we can disseminate some of those good recommendations that have been made by our think tanks and our public policy institutes, the word won't get out. And many of those organizations are limited in terms of how much they can actually lobby themselves.

AHPR: How would you compare public health policy in Alaska, in sort of the broadest sense, with other places you have lived?

Luby: Those vary because I lived in Texas and in California -- two very, very different states. In many cases they have some of the same problems -- both of them have a high number of uninsured, but both of them have a fairly sophisticated health care system also.

Texas has a health care commission -- it's a small commission -- just a few people but very sophisticated and very good thinkers. Usually they are physicians or people who are high up in the health care bureaucracies. California has a lot of consumer organizations who are concerned about health care issues, and they can generate people into the Legislature in Sacramento, so there is a lot of interest in that.

The problem is still making sure that everyone has access to quality health care, and even big states like California and Texas have not figured out how to do this. They still have a high number of uninsured. If the Affordable Care Act stays in effect, that will change. In 2014 we are going to see a lot more people who will have comprehensive coverage, and that will make a big difference for all of us who either have coverage now and are paying for the uninsured, or people who simply don't have any coverage and are what the insurance industry calls, "going bare" -- no coverage.

"Commonwealth North is an interesting organization because it's primarily business leaders who are interested in public policy. ...The beauty of Commonwealth North is that when they weigh in on something, the Legislature is going to pay attention. The legislature here, as in many states, pay attention to the business community."

AHPR: And of course, we do have the Alaska Health Care Commission here. I wonder if you would consider commenting on the the mission, the effectiveness, whatever comments you care to make about the Alaska Health Care Commission, which is the latest iteration of a series of them.

Luby: Right. The Alaska Health Care Commission, I think, could be more activist. They have chosen not to be -- they do come up with some very good recommendations and they publish some very good materials. What they haven't done is taken the next step to really say, "Okay, based on our recommendations, we are going to work with the Legislature to see whether we could get that into effect."

Part of that is because they are appointees of the governor, and frankly Governor Parnell has not been that keen on health issues. He is pretty much wrapped up around oil and gas, and health has not been high on his radar screen. But part of it also is [that] within a health care commission, you also have folks who are very oriented toward paying for whatever health care we may need, and you also have people who don't want to pay for the health care that we may need.

Now, it's good that we have them both on the commission, because that gives it some credibility. It also means that there is going to be give and take, and usually public policy ends up in a compromise where you don't have, you are not going to the left, you are not going to the right, but you are some place in the middle. Usually that's where you want to be, and it's pretty good public policy. You've taken into consideration everybody's arguments and everybody's biases, and then you come up with something that might be good for the people actually. But there are good people on that health care commission. The staff is excellent. Dr. Ward Hurlburt is the chairman of the commission, very much an activist physician, constantly looking at what's being done throughout the world.

Deb Erickson is the executive director of the health care commission -- one of our sharpest employees that we have in state government, so we've got good people there. It's just a matter of whether they can go from studying the issues, making recommendations, to actually helping the Legislature and the governor see, "This is important, let's really work on this," and I think they are certainly leaning in that direction. Not there yet, but they are certainly pushing the agenda.

AHPR: I wonder if you could comment on the role of Commonwealth North. They periodically have a health policy working group that meets and is open to the public.

Luby: Commonwealth North is an interesting organization because it's primarily business leaders who are interested in public policy. Commonwealth North used to be sort of like the health care commission. They would study an issue, make recommendations, but really didn't work adamantly to try to follow up on those recommendations.

Now Commonwealth North actually will take a position on an individual bill or issue that they feel strongly about, and recommend that the Legislature pass something or oppose something. They are good folks. We have Dr. Tom Nighswander, the immediate past president of Commonwealth North, and he also chairs the Health Care Action Coalition, and I think the very title of that Health Action you know that was a big change for them to make. We are not just going to study, but we are going to try to take action to make sure that our recommendations are followed up on.

The beauty of Commonwealth North is that when they weigh in on something, the Legislature is going to pay attention. The legislature here, as in many states, pay attention to the business community. They know that's our life blood in terms of the economy, so when an organization like Commonwealth North steps forward, and steps up to the plate and says, "We think we ought to do this as a state" -- It's one thing for AARP or the American Red Cross, or the American Cancer Society, or the [Alaska] Primary Care Association to say we think we ought to do this. When the business community through Commonwealth North says we ought to do this, legislators look at it differently. Back to selected topics list

relocationRelocation not retirement

AHPR: I understand that your retirement is on the horizon, and I think you will be missed by so many people involved in public health and probably many other issues, but I know the public health community is really going to miss your sound analysis and your forgiving ways. What are your retirement plans? Because I think a lot of people are concerned about you and would like to know.

"AARP offers what we call 'phased retirement.' You can continue to work on a part-time basis, and get used to the idea of retirement, and you are still bringing in some income."

Luby: Well, actually my wife and I plan to leave Alaska, probably in the fall of 2012. Her mother is down in Texas, north of Dallas. She could use some assistance, so we are planning on either buying a house, or building a house in North Texas where she can move in with us. She is from Panama. She would never be able to move up here, and join us up here. We've already made the decision that we will go ahead, and move on down there. I don't know whether we are actually going to retire. We will relocate.

AHPR: I see.

Luby: AARP offers what we call "phased retirement." You can continue to work on a part-time basis, and get used to the idea of retirement, and you are still bringing in some income. You are also working for the organization, but then there are other organizations down there, just as we have here, that we may take a look at working.

I can't imagine not working. I can't imagine leaving Alaska, and all my friends up here, so that's going to be pretty tough. But you know family comes first, and we need to make sure that my mother-in-law is okay. Back to selected topics list

meanderingMeandering down memory lane

AHPR: I think this would be a great time for you to maybe indulge in a bit of retrospective, like what were some of the biggest political battles you recall in your time in Alaska, or some of the most notable battles, and some of the most challenging or memorable moments in your career here in the state?

Luby: Well, I came here from California, from our Sacramento office. When I came up here, it was the late fall of 2001 [and] we had just gone through 9/11. I came up here, and I was telling my colleagues in California, I said, "You know, I think we may have to work on an income tax in Alaska." Because in 2002, if you remember, we weren't doing real well from a financial standpoint as a state, and that's completely reversed itself, where Alaska and North Dakota are about the only states that are in really good financial shape right now.

And the legislators know it. The governor knows it. They are still trying to save money for that rainy day, which they should. But they are also willing to put money where they think it's necessary, and whether that's in health, or whether it's rebuilding highways. We are very, very fortunate to be in a situation that's completely different from 2001.

I can remember going to talk to Senator Gary Wilken from Fairbanks in 2002. And Senator Wilken is probably six foot six or so, and he stood up behind his desk when I came in, and he said, "I don't care what you say. We are not going to do an income tax." And we weren't even saying that we had to do an income tax.

Many older people were here when Alaska had an income tax, and when the income tax was eliminated, many of them said, "You know, that's probably not a good idea; that was a steady source of income for the state." It wasn't oil dependent, and it wasn't that bad. It wasn't that onerous from a financial standpoint. And it would have given us that extra blanket, the security blanket that we might have been able to use, but we are very fortunate and I think even with all the concern about the diminishing oil that's coming in from the North Slope, we still have people who are saying, "We've got oil over here. We've got gas over here. We are going to be looking at different sources of energy."

"Alaska and Florida have the highest percentage of baby boomers in the country, and Alaska's older population is growing at above five times the rate of the older population in the Lower 48."

Alaska is in a very unique situation where 90 percent of the income is coming in from one industry. And you know we don't pay an income tax and in our major cities we don't even pay a sales tax. There is no state sales tax. Many of our smaller municipalities do have sales tax ... I think in some cases even more than six percent, but it's a state that is changing. It is going to become older, which Alaskans aren't used to.

Alaska and Florida have the highest percentage of baby boomers in the country, and Alaska's older population is growing at above five times the rate of the older population in the Lower 48. Where we have been in the past a very young state, we are going to find ourselves much more similar to the Lower 48. We also have family members who are coming into Alaska to be near their kids and their grandkids -- more their grandkids than their kids, but that type of immigration from Outside into Alaska is something unusual.

We have excellent health care here to a great degree now. In the 1990s, if you look at the statistics, about 40 percent of older people would leave Alaska to go to Seattle or Oregon because there was good health care there. And now upon retirement, people are staying here. They like it here, their families are here. They may take off to go to Arizona for a month.

AHPR: In winter.

Luby: In the winter, but this is basically their home and it's going to remain their home. So that's a difference in Alaska, and I think Alaskans are going to have to get used to the fact that we are going to have an older population, and that has impact on the economy. It certainly has impact on the health care systems. If you witness what Providence did with their Senior Clinic, what Dr. Rhyneer did with his Medicare clinic, we seem to -- and the Legislature supports this -- we seem to be able to identify our problem, and then try to address it, and we are willing to put some money into it, and that speaks well for our state. Back to selected topics list

challengingChallenging ourselves to address the problems

AHPR: Is there anything I may have overlooked or anything you might like to emphasize or otherwise say to the readers of Alaska Health Policy Review?

Luby: I think it may be that we all need to keep challenging ourselves if we see problems, especially in the health care area. We need to figure out "How do you bring those problems to the attention of people who might be able to help get them resolved?" I think we have a very sophisticated health care system in terms of hospitals who are figuring out what can Providence and Regional do in Anchorage, but also what can the Valdez Hospital do?

It's expensive here, but that's one of our problems. We have not addressed the cost of health care. Premera [Blue Cross Blue Shield of Alaska], because they do business in both Washington and Alaska, is very much aware of the differences that they have to pay for physician care, for example. For the same treatment it's going to cost more than 100 percent up here. Fewer than 50 percent of our physicians will even sign up with Premera because they want to be able to charge more than Premera will allow, so our overall health care costs are about 55 percent more than they are in Washington state.

"... if you are in a nursing home in Nome, it is going to be about $800 a day. You can stay in the Four Seasons Hotel in New York City for less money."

That's not because it costs more to ship stuff here. That's because we've never had any managed care. We've never had any HMOs. We've never had any incentive to try to bring those health care costs down. We need to do something. The whole country needs to bend the health care cost curve, but Alaska is right up there in the front.

If you look at long-term care, Medicare doesn't pay for long-term care. Medicaid ends up paying for long-term care. Our assisted living facilities charge more than any place else in the country. Our nursing homes, if you are in a nursing home in Nome, it is going to be about $800 a day. You know in other places in the state it's $400, $450 a day. You can stay in the Four Seasons Hotel in New York City for less money.

We have to figure out, and I don't know if we can, because in many cases those nursing home beds are in hospitals -- in what we call swing beds -- and you can't keep some of the small rural hospitals open unless they also operate as a nursing home, and Medicaid ends up subsidizing the entire hospital.

But I don't think there is any easy answer for our small health care facilities. I think we have an excellent primary care network. The community health centers, the Tribal organizations have really worked to figure out how to deliver good health care in our state. The Tribal system, I think, it just gets more and more sophisticated all the time.

One thing that I think is really a benefit to Alaska is the fact that we are small, and we know each other, and we work together. You know the Tribal system will talk to the military system. TRICARE is an important payer for many different facilities. The private health care system will talk to the military and to the VA and to the Tribal system. They all collaborate whether it's in ASHNHA or whether it's in the Alaska eHealth Network, making sure that we have good electronic health care exchanges for everybody. You don't see that in all states. In many cases, health care systems are siloed based on the payer. We don't have that here. We are really trying to integrate it. We know each other. We are willing to talk to each other, and we've got some very good health care leaders here.

AHPR: Well, that's a wonderful note to end this interview on, and I just want to say on behalf of all my colleagues in public health, thank you so much for all the work you've done in the years you've been in Alaska. We are really, really going to miss your sound judgment and kind demeanor. Back to selected topics list

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Alaska Health Policy Calendar

This calendar of health policy and related meetings is current as of May 18, 2012.

Commonwealth North Health Care Action Coalition
When: Thursday, May 31, 2012 from 7:00 AM to 9:00 AM     
Where: Alaska Mental Health Trust Authority at 3745 Community Park Loop Suite 200 in Anchorage
Other information: Email or call Joshua Wilson, program manager Commonwealth North at 907-258-9522

Alaska Federal Health Care Partnership's Federal Education Sharing Group (FESG) presents The Right Way: Finding the Ethical Path in a Time of Uncertainty

Presented by Emily Friedman
When: Anchorage on Tuesday, June 5, 2012, from 8:00 AM to 4:00 PM and Fort Wainwright (Fairbanks) on Thursday, June 7, 2012, from 8:00 AM to 4:00 PM
Where: Crowne Plaza Anchorage, 109 West International Airport Road and Last Frontier Community Activity Center, 1044 Apple Street, Fort Wainwright (Fairbanks)
Other information: Emily Friedman is an independent health policy and ethics analyst and adjunct assistant professor in the Department of Health, Law, Bioethics and Human Rights at the Boston University School of Public Health. For the past two years, she was named one of the "Top Five" U.S. health care speakers by Speaking.com. Ms. Friedman will address current, emerging, and eternal health care ethics issues. Interactive discussions will include analysis of issues and possible solutions, and case studies that require both thought and creativity. The special situation of those working in health care in Alaska, and ethics practice in the real world (as opposed to academic theory) will be woven into the discussions. This is a historical period in health care, and that includes a shifting ethics landscape for the responsible professional. Come, learn, share and find solutions!
Cost and contact information: Members $75; Non Members $125; After May 25, 2012, please add a $25 late fee. To register and for more information email Eric Wallis or call 907-729-4485 at Alaska Federal Health Care Partnership.

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Health Policy-Related Bills Passed by the 27th Alaska Legislature

Following is a list of the health policy-related bills introduced in the 27th Alaska State Legislature that passed or have been signed by the governor. The list is current as of May 17, 2012, at 5:00 PM.

Committees and date of last action: SIGNED INTO LAW BY THE GOVERNOR, 06/23/11, EFFECTIVE DATE 7/1/11

HB 13 Worker's Compensation: Medical Fees
Committees and date of last action: SIGNED INTO LAW BY THE GOVERNOR, 09/28/11, EFFECTIVE DATE 9/29/11

HB 15 Student Athlete Traumatic Brain Injuries
Committees and date of last action: SIGNED INTO LAW BY THE GOVERNOR, 06/24/11, EFFECTIVE DATE 8/25/11

Committees and date of last action: SIGNED INTO LAW BY THE GOVERNOR, 05/02/12, EFFECTIVE DATE 7/31/11

Committees and date of last action: Enrolled HB 21 due back from governor, 05/25/12

HB 28 Occ. Licenses: Temporary/Fees/Pawnbrokers
Committees and date of last action: SIGNED INTO LAW BY THE GOVERNOR, EFFECTIVE DATE 06/27/11

Committees and date of last action: Enrolled HB 78 due back from governor, 06/08/12

Committees and date of last action: SIGNED INTO LAW BY THE GOVERNOR, 08/24/11, EFFECTIVE DATE 7/1/11

Committees and date of last action: SIGNED INTO LAW BY THE GOVERNOR, EFFECTIVE DATE  04/23/11

Committees and date of last action: SIGNED INTO LAW BY THE GOVERNOR, EFFECTIVE DATE 06/23/11

Committees and date of last action: SIGNED INTO LAW BY THE GOVERNOR, 06/23/11; EFFECTIVE DATE 06/24/11

HB 218 Prescription Drug Specialty Tiers 

Committees and date of last action: Enrolled HB 218 awaiting transmittal to governor, 04/15/12

Committees and date of last action: Enrolled HB 224 awaiting transmittal to governor, 04/14/12

Committees and date of last action: SIGNED INTO LAW BY THE GOVERNOR, 05/10/12; EFFECTIVE DATE 05/11/12

Committees and date of last action: Enrolled HB 279 due back from governor, 06/04/12

Committees and date of last action: SIGNED INTO LAW BY THE GOVERNOR, 05/14/12; EFFECTIVE DATE 07/01/12

Committees and date of last action: Enrolled HB 310 due back from governor, 06/02/12

Committees and date of last action: LEGISLATIVE RESOLVE 9 PERMANENTLY FILED, 08/24/11

Committees and date of last action: SIGNED BY THE GOVERNOR, LEGISLATIVE RESOLVE 14, EFFECTIVE DATE 7/19/11

Committees and date of last action: LEGISLATIVE RESOLVE 16 PERMANENTLY FILED, 08/24/11

Committees and date of last action: LEGISLATIVE RESOLVE 7 PERMANENTLY FILED, 08/24/11

Committee and date of last action: Enrolled HCR 20 awaiting transmittal to governor, 04/12/12

Committees and date of last action: LEGISLATIVE RESOLVE 17 PERMANENTLY FILED, 08/24/11

Committees and date of last action: Enrolled SB 74 awaiting transmittal to governor, 04/15/12; engrossed and returned to Senate, 04/18/12

Committees and date of last action: Enrolled SB 86 awaiting transmittal to governor, 03/28/12

Committees and date of last action: Enrolled SB 92 awaiting transmittal to governor, 04/14/12

Committees and date of last action: Enrolled SB 119 due back from governor, 06/08/12

Committees and date of last action: SIGNED INTO LAW 04/24/12; EFFECTIVE DATE 07/23/12

Committees and date of last action: Enrolled SB 137 due back from governor, 06/08/12

SB 140 Cathinone Bath Salts 

Committees and date of last action: Enrolled SB 140 awaiting transmittal to governor, 04/18/12

Committees and date of last action: Enrolled SB 151 awaiting transmittal to governor, 04/18/12

Committees and date of last action: LEGISLATIVE RESOLVE 11 PERMANENTLY FILED, 08/24/11

SCR 16 Celiac Disease Awareness Month
Committees and date of last action: LEGISLATIVE RESOLVE 34, PERMANENTLY FILED, 04/24/12

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Results of Other Health Policy-Related Legislative Bills

Other health policy-related bills did not pass the legislative process. Following is a final rundown of those bills and their status when the Legislature adjourned. The information is current as of Wednesday, May 16, 2012, at 9:00 PM.

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Bill Watch: Drugs

   

HB 42 Prescription Drug Discounts
Committees and date of last action: Referred to (H) HSS, 01/18/11
Sponsor: Rep. GUTTENBERG
Description: This bill directs the Department of Health and Social Services to conduct a study of the feasibility of providing discounted prescription drug pricing to every person in the state who is not otherwise covered by a prescription drug plan. The Department of Health and Social Services shall, after conducting the study, prepare a report summarizing the study and submit the report to the Legislature on or before January 1, 2012.     

 

HB 43 Prescriptions and Generic Drugs
Committees and date of last action: Referred to (H) HSS, 01/18/11
Sponsor: Rep. GUTTENBERG
Description: This bill amends state statute that directs pharmacists to substitute generic drugs for brand name drugs except under specific circumstances, and directs the Department of Health and Social Services to approve and maintain a publicly available list of therapeutically equivalent drugs. 

     

HB 44 Prescription Drug Program
Committees and date of last action: Referred to (H) HSS, 01/18/11
Sponsor: Rep. GUTTENBERG
Description: This bill adds a new section to the uncodified law of the State of Alaska that expands the state's role as a participant in the prescription drug marketplace, negotiating voluntary rebates from drug companies, and subject to appropriation, using the rebates to make prescription drugs more affordable to the medical assistance program and to state residents.     

 

HB 45 Drug Marketing Costs
Committees and date of last action: Referred to (H) HSS, 01/18/11
Sponsor: Rep. GUTTENBERG
Description: This bill adds a new section to the uncodified law of the State of Alaska that requires manufacturers or labelers of prescription drugs dispensed in this state, with some exceptions, to report marketing costs to the Department of Health and Social Services, and directs the Department to provide a written report every two years to the attorney general and to the Legislature, that analyzes the information submitted to the Department during the two previous fiscal years.    

 

HB 47 Clinical Trials of Drugs/Biol. Products
Committees and date of last action: Referred to (H) HSS, 01/18/11
Sponsor: Rep. GUTTENBERG
Description: The Department of Health and Social Services commissioner is directed to establish and maintain a comprehensive repository of information regarding all clinical trials conducted in the state, with some exemptions, including information about the results of clinical trials, regardless of outcome, for access by the public, based on standards established by regulation and information available from the National Institutes of Health, United States Department of Health and Human Services, and from all other credible sources.  

 

HB 50 Access to Licensed Premises 

Committees and date of last action: (S) L&C moved HB 50 out of committee, 04/10/12
Sponsor: Reps. SADDLER, Hawker, and Thompson
Description: This bill amends Alaska statute in regards to access by persons under 21 years of age to a club's licensed premises when alcoholic beverages are present.       

HB 153 Controlled Substances
Committees and date of last action: Heard in (H) JUD, 03/07/11
Sponsors: Reps. JOHANSEN and Lynn
Description: This bill would add Salvia divinorum and Salvinorin A (Divinorin A) to the list of Schedule IIA controlled substances.      

 

HB 167 Controlled Substances/Dextromethorphan
Committees and date of last action: Referred to (H) JUD and FIN, 02/23/11
Sponsor: Rep. JOHANSEN by request
Description: This bill restricts the sale of products in Alaska that contain dextromethorphan and makes violations a class B misdemeanor.     

 

HB 253 Cathinone Bath Salts    

Committees and date of last action: Scheduled but not heard in (H) FIN, 02/22/12

SponsorsReps. STOLTZE, THOMPSON, MILLETT, PRUITT, TUCK, Lynn, Costello, Keller, Gara, and Holmes
Description: HB 253 is an Act classifying certain substances as schedule IIA controlled substances.

 

HB 259 Pharmacy Audits 

Committees and date of last action: Heard and held in (H) L&C, 04/11/12  

Sponsors: Sponsors: Reps. MUNOZ , P. WILSON, and Olson

Description: This bill establishes procedures and guidelines for auditing pharmacy records.

 

SB 17 Classifying MDPV & Others as Sched. IA
Committees and date of last action: Heard in and held in (H) JUD, 02/25/11
Sponsor: Sens. MEYER, Dyson, and Giessel
Description: AS 11.71.150(b) is amended to include 10 synthetic cannabinoids as schedule IIA controlled substances.    


SB 221 Alcohol Bev. Tax/Prevention Fund

Committees and date of last action: Scheduled to be heard in (S) FIN but removed from agenda, 04/02/12 

Sponsor: Senate Finance Committee  

Description: SB 221 allocates the disposition of proceeds from the alcoholic beverage tax and to the alcohol and other drug abuse treatment and prevention fund. 

Bill Watch: Health Professional Workforce and Education

 

HB 38 University Institutes of Law and Medicine
Committees and date of last action: Heard and held in (H) EDC, 04/01/11
Sponsor: Rep. KAWASAKI
Description: Alaska statute is amended to allow the University of Alaska to establish institutes of medicine and law.     

 

HB 122 Naturopaths  

Committees and date of last action: Scheduled but not heard in (H) L&C, 03/23/11 

Sponsors: Reps. MUNOZ and Kerttula

Description: Establishes an Alaska Naturopathic Medical Board; authorizes medical assistance program coverage of naturopathic services, and amends the definition of "practice of medicine."    

 

HB 266 Practice of Naturopathy  

Committees and date of last action: Heard and held in (H) L&C, 04/12/12

SponsorsReps. Munoz, Tuck, Thompson, Kerttula, Keller, Miller, and Kawasaki

Description: The Alaska Division of Occupational Licensing, which oversees the naturopathic profession in Alaska, adopted regulations in 1994 that "prescription drugs" do not include a "device or herbal or homeopathic remedy or dietetic substances in a form that is not a controlled substance" with further clarification that "herbal remedies" include the extract of a plant, tree, root, moss, fungus or other natural substance. The Alaska DOL asked medical suppliers in Alaska and the Lower 48 not to sell anything that is restricted by the prescription (Rx) legend to naturopathic doctors in Alaska. HB 266 codifies the status quo.     

 

SB 175 Practice of Naturopathy 

Committee and date of last action: CSSB 175(L&C) referred to (H) L&C, 04/13/12

Sponsors: Sens. MCGUIRE, Ellis, Davis, Giessel, Dyson, Huggins, Thomas, Wagoner, Stevens, Miller, and Cissna

Cross Sponsors: Reps. Holmes, Tuck, Kerttula, Kawasaki, Thompson, and Keller 

Description: The Alaska Division of Occupational Licensing, which oversees the naturopathic profession in Alaska, adopted regulations in 1994 that "prescription drugs" do not include a "device or herbal or homeopathic remedy or dietetic substances in a form that is not a controlled substance" with further clarification that "herbal remedies" include the extract of a plant, tree, root, moss, fungus or other natural substance. The Alaska DOL asked medical suppliers in Alaska and the Lower 48 not to sell anything that is restricted by the prescription (Rx) legend to Naturopathic Doctors in Alaska. SB 175 codifies the status quo.   

 


Bill Watch: Medical Assistance and Health Insurance

 

HB 1 Policy for Securing Health Care Services
Committees and date of last action: Referred to (S) HSS, 04/12/11
Sponsors: Reps. GATTO, LYNN, P. Wilson, Johnson, and Dick
Description: Alaska statute is amended to add a new section that it is the policy of the State of Alaska that a person has the right to choose or decline any mode of obtaining health care services without penalty or threat of penalty. CSHB 1(HSS) adds language to the final sentence: however, liability for the cost of health care services is not a penalty.

HB 11 Colonoscopy: Pub. Employee Retirees
Committees and date of last action: Heard and held in (H) L&C, 03/18/11
Sponsors: Reps. GARA, Gruenberg, Tuck, Holmes, Thompson, Kerttula, and Lynn
Description: Alaska statute is amended to include colonoscopy coverage for retired public employees and other who receive benefits under AS 14.25.110, AS 22.25, AS 39.35, or former AS 39.37.

HB 29 Public Retiree Medical Benefits Coverage
Committees and date of last action: Referred to (H) L&C, 01/18/11
Sponsors: Reps. MILLET, Gruenberg, and Lynn
Description: Alaska statute is amended by adding a new paragraph that reads, "Preventive health services benefits provided to a person receiving retiree medical benefits under AS 14.25, AS 22.25, or AS 39.35 may not be less than the preventive health services medical benefits provided to the active members of the respective system."

HB 79 Ins. Coverage: Autism Spectrum Disorder 

Committees and date of last action:Referred to (H) HSS, 01/18/11
Sponsors: Reps. PETERSEN, KAWASAKI, Gruenberg, Gara, Kertulla, Johansen, Munoz, Millett, Tuck, Guttenberg, Cissna, Olson, Gardner, Foster, Costello, Herron, Lynn, and Feige
Description: HB 79 requires insurance coverage for autism spectrum disorders, describes the method for establishing a covered treatment plan, and defines the covered treatment for those disorders.

HB 152 Grants for Seniors' Medical Care
Committees and date of last action:Referred to (H) HSS, 02/11/11
Sponsors: Reps. GARA and Kawasaki
Description: HB 152 establishes a grant fund for health care providers serving seniors 65 years of age or over. The grants would provide payments to those providers that see seniors in a cost effective manner and expand access to health care for this underserved population.


HB 209 Insurance Coverage for Tobacco Cessation
Committees and dates of last action: Heard and held in (H) HSS, 02/14/12
Sponsors: Reps. HERRON, Kerttula, and Holmes
Description: A health care insurer that offers, issues for delivery, delivers, or renews a health care insurance plan in the state shall provide coverage for a minimum of two courses of tobacco cessation treatment during each plan year.

HB 211 Eye Drop Prescription Refills
Committees and date of last action: Referred to (H) HSS and L&C, 03/29/11
Sponsors: Rep. P. WILSON
Description: From the sponsor statement: HB 211 would require insurance coverage for prescription eye drops by authorizing a refill or renewal even when it is requested prior to the expiration of the intended period of use, limited to the amount of the remaining dosage initially prescribed.

HB 227 Drug Pricing: Medical Assist. Recipients
Committees and date of last action: Heard and held in (H) HSS, 04/05/12
Sponsor: Rep. HERRON
Description: "An Act relating to generic drug pricing for medical assistance recipients; and providing for an effective date."

HB 275 Retiree Benefits: Colorectal/Drug Benefits 

Committees and date of last action:  Heard and held (H) L&C, 03/28/12  
Sponsors:
 
Reps. LYNN, Gara, Miller, P. Wilson, Munoz, Thompson, and Kertula
Description: This bill requires that a policy of group health insurance offered by the state and certain local governments include coverage for colorectal screening, allow retirees to choose between brand-name and generic drug products, and limit certain prescription drug benefit payments to an amount based on the cost of the generic drug product.

Committees and date of last actionReferred to (H) FIN, 02/22/12
Sponsor: Rep. KELLER
Description: "An Act prohibiting denial or withholding of medical assistance eligibility or coverage for a prisoner."

 

HB 326 Child-Only Health Care Coverage

Committees and date of last action: Heard and held in (H) L&C, 04/09/12

Sponsor: Rep. GUTTENBERG

Description: HB 326 requires health care insurers to offer a child-only policy. Its purpose is to fill in the health insurance coverage gaps for certain children. From the sponsor: Children fall into this insurability gap for a number of reasons: children for whom coverage has lapsed due to parents' or guardians' loss of employer-sponsored health insurance; families who employer stopped covering dependents; families insured exclusively though ACHIA; loss of coverage through state or federal plans; children raised by grandparents covered by Medicare; children who lose insurance due to a death or separation of a family member.


Committees and date of last action: Referred to (H) HSS, 01/18/11
Sponsor: Rep. KELLER and P. Wilson
Description: This resolution proposes amendment to the Constitution of the State of Alaska prohibiting passage of laws that interfere with direct payments for health care services and the right to purchase health care insurance from a privately owned company, and that compel a person to participate in a health care system.

Committees and date of last action: CSSB 5(HSS) referred to (S) RLS, 03/23/12
Sponsors: Sens. DAVIS, ELLIS, FRENCH, WIELECHOWSKI, and Thomas
Description: This bill amends Alaska statute to include specific optional groups of persons for whom the state may claim federal financial participation for medical assistance, and the state may require premiums or cost-sharing contributions from recipients eligible for benefits and whose household income is between 150 and 200 percent of the federal poverty line.

Committees and date of last action: CSSB70(FIN) out of committee, 02/03/12
Sponsors: Sens. FRENCH, Ellis, and Davis
Description: This bill would establish the Alaska Health Benefit Exchange, along with an effective
date. This act is designed:
(1) to facilitate the purchase and sale of qualified health plans in the individual market in this state;
(2) to establish a small business health options program exchange to assist qualified small employers in the state in enrolling employees in qualified health plans offered in the small group market;
(3) to provide consumer education and assist individuals with access to programs, credits, and cost-sharing reductions;  
(4) to reduce the number of uninsured Alaskans by creating an organized, transparent, and easy-to-navigate health insurance marketplace that offers a choice of high value health plans with low administrative costs for individuals and employers; and

(5) that the Alaska Health Benefit Exchange Board recommend to the legislature and the Office of the Governor methods to keep premium costs low and risk pools strong in the health insurance market place.  
 

Committees and date of last action: Heard in (S) L&C, passed out of committee, and referred to (S) FIN, 03/16/11
Sponsors: Sens. DAVIS and Ellis
Description: This bill establishes a requirement that group life and health insurance benefits, in regard to dependents, may not be less than those benefits provided to active members.

Committees and date of last action: Passed in the Senate and transmitted to the House, 4/7/11; referred to (H) L&C, 4/8/11
Sponsors: Sens. FRENCH, Ellis, Davis, Wielechowski, Wagoner, Kookesh, McGuire, Paskvan, Egan, Menard, Stedman, Thomas, Meyer, and Stevens
Cross Sponsors: Reps. Kawasaki and Tuck
Description: SB 87 establishes a grant fund for health care providers serving seniors 65 years of age or over. The grants would provide payments to those providers that see seniors in a cost effective manner and expand access to health care for this underserved population. Companion bill to HB 152. 

SB 118 Medicaid Reimbursement for Family Therapy
Committees and date of last action: Referred to (S) FIN, 03/23/12
Sponsor: Sen. DAVIS
Description: "An Act providing medical assistance reimbursement for the services of licensed marital and family therapists."

 


Bill Watch: Mental Health Issues
 
Committees and date of last action: Scheduled but not heard in (S) FIN, 04/18/11; Meeting canceled
Sponsor: RULES by request of the governor
Description: This Act appropriates funds to the state's integrated mental health programs for operating and capital expenses.

Committees and date of last action: Heard and held in (S) HSS, 02/28/11
Sponsor: Sen. DAVIS
Description: This bill requires parity between health care coverage for mental health, alcoholism, and substance abuse benefits and other medical care benefits.

Committees and date of last action: CSSB 55(HSS) referred to (S) FIN, 03/23/12
Sponsor: Sens. DAVIS, Wielechowski, and Ellis  
Description: This bill would add the right of mental health patients to file a grievance under AS 47.30.855, and the right to a designated representative to assist in filing the grievance under AS 47.30.847.

Committees and date of last action: Heard and held in (S) FIN, 02/16/2012 
Sponsor: RULES by the request of the governor
Description: SB 162 makes appropriations for the operating and capital expenses of the state's integrated comprehensive mental health program.

SB 186 Sentencing/Probation/Mentally Ill 

Committee and date of last action: Scheduled to be heard in (S) JUD, 03/16/12 at 1:30 PM in Beltz 105 (TS Building) 

Sponsor: Judiciary

Description: SB 186 is an Act relating to persons found guilty but mentally ill; relating to sentencing procedures for factors that may increase the presumptive range or affect mandatory parole eligibility; relating to the granting of probation; relating to procedures for finding aggravating factors at sentencing; and amending Rule 32.1, Alaska Rules of Criminal Procedure.

 


Bill Watch: State Boards and Issues

HB 46 Alaska Prescription Drug Task Force
Committees and date of last action: Referred to (H) HSS and FIN, 01/18/11
Sponsor: Rep. GUTTENBERG
Description: This bill adds a new section to the uncodified law of the State of Alaska that establishes the Alaska Prescription Drug Task Force in the Department of Health and Social Services.    

 

HB 126 Board Extensions: Nurse/Dentist/Barbers
Committees and date of last action: VETOED BY THE GOVERNOR, 6/27/11
Sponsor: RULES by request of Legislative Budget and Audit
Description: Extends termination dates of certain boards, including the Board of Nursing and the Board of Dental Examiners, to June 30, 2019. CSHB 126(FIN) eliminated the Regulatory Commission of Alaska and the Alcoholic Beverage Control Board from the language in the bill.  

 

HB 206 Extend Alcoholic Beverage Control Board
Committees and date of last action: Referred to (S) FIN, 04/11/11
Sponsor: LABOR & COMMERCE
Description: HB 206 extends the life of the Alcoholic Beverage Control Board until June 30, 2015; CSHB 206(FIN) changes the termination date to June 30, 2012.     

 

HB 257 Crime Victims Compensation
Committees and date of last action: Referred to (H) STA and FIN, 01/17/12
Sponsor: Rep. KERTTULA
Description: "An Act relating to time limitations on applications for compensation to victims of crime by the Violent Crimes Compensation Board."

 

HB 338 Licensing Radiologic Technologists

Committees and date of last action: Read and referred to (H) L&C, then (H) FIN, 02/22/12

Sponsor: Rep. TUCK

Description: HB 338 requires licensure of occupations relating to radiologic technology, radiation therapy, and nuclear medicine technology.
 

SB 12 Extend Board of Nursing
Committees and date of last action: Referred to (S) FIN, 02/04/11
Sponsor: Sen. DAVIS
Description: The bill amends Alaska statute to extend the Board of Nursing until June 30, 2019.     

 

SB 59 Extend Board of Dental Examiners
Committees and date of last action: Referred to (S) FIN on 02/02/11
Sponsor: (S) L&C
Description: The bill extends the termination date of the Board of Dental Examiners.  

 

SB 155 Extending Certain Boards & Commissions
Committees and date of last action: Heard in (S) L&C, 01/31/12 and referred to (S) FIN, 02/01/12
Sponsor: RULES by request of Leg Budget & Audit
Description: "An Act extending the termination dates of the Board of Nursing, the Board of Dental Examiners, the Board of Barbers and Hairdressers, the Big Game Commercial Services Board, the Alcoholic Beverage Control Board, and the Alaska Seismic Hazards Safety Commission."

 

SB 166 Laboratory Science Professional Licensing

Committees and date of last action: Scheduled to be heard in (S) L&C, 04/12/12; meeting canceled, 04/12/12  

Sponsor: Sen. DAVIS
Description: "An Act relating to the licensing of medical laboratory science professionals; and providing for an effective date."     

 


Bill Watch: Family Health Issues

HB 63 Flame Retardants and Toxic Chemicals
Committees and date of last action: Scheduled to be heard in (H) L&C on 04/6/11, meeting canceled
Sponsors: Reps. HOLMES, Kawasaki, Kerttula, and Foster
Description: HB 63 will end the use of polybrominated fire retardants (PBDEs) in mattresses, upholstered furniture and the plastic housing of electronics in Alaska. In addition, it will give the Department of Environmental Conservation the authority to prohibit the use of other toxic flame retardants when safer alternatives exist. It will also allow the Department to participate with other states in learning about and sharing information on toxins.

HB 94 Student Athlete Traumatic Brain Injuries
Committees and date of last action: Referred to (H) EDC and HSS, 01/31/11
Sponsors: Reps. JOHNSON, Doogan, Millet, Munoz, and Kerttula
Description: Uncodified law of the State of Alaska is amended to add a new section that directs the governing body of a school district to consult with the Alaska School Activities Association to develop and publish guidelines and other information to educate coaches, student athletes, and parents of student athletes regarding the nature and risks of concussions and other traumatic brain injuries.

 

Committees and date of last action: Referred to (H) HSS and L&C, 02/25/11
Sponsors: Reps. KERTTULA and Kawasaki
Description: This bill prohibits the manufacture, sale, offer to sell, or otherwise commercially distribute goods and foods for children that contain bisphenol-A, and it sets a effective date of January 1, 2012.

 

Committees and date of last action: Version CSHB 224(FIN) am moved out of (S) JUD, 04/11/12
Sponsor: Rep. SEATON
Description: Adds language throughout Section 1 AS 11.76.100(a) that prohibits selling or giving a product containing nicotine to a person under 19 years of age unless prescribed by a physician.

 

HB 363 No Public Health Funds/Facilities for Abortions 

Committees and date of last action: Heard and held in (H) HSS, 03/22/12

Sponsor: House Health & Social Services Committee

Description: HB 363, also known as the Abortion Subsidy Prohibition Act, would prohibit any public health funds or facilities from providing for abortions.

 

HB 367 Fetal Alcohol Spec. Disorder as Mitigator 

Committees and date of last action: Scheduled but not heard in (H) JUD on 04/06/12

Sponsor: House Health & Social Services Committee

Description: Factors related to fetal alcohol spectrum disorder shall be considered by the sentencing court and may allow imposition of a sentence below the presumptive range set out in AS 12.55.125.

 

HCR 26 Reproductive Rights Awareness Week

Committees and date of last action: Read and referred to (H) HSS, then (H) FIN, 02/22/12

Sponsors: Reps. KERTTULA and Miller

Description: HCR 26 designates January 21 - 25, 2013, as Reproductive Rights Awareness Week.

Committees and date of last action: Referred to (S) FIN, 03/07/11
Sponsors: Sens.
WIELCHOWSKI, ELLIS, DAVIS, EGAN, FRENCH, KOOKESH, MCGUIRE, MENARD, PASKVAN AND THOMAS 
Cross sponsors: Reps. Kawasaki, Petersen, Kerttula, Munoz, Seaton, and Miller
Description: This bill amends Alaska statute to add a new section that directs state funding to supplement the cost of lunch and breakfast provided to each student eligible for a free or reduced-price lunch under 42 U.S.C. 1771 - 1784.

Committees and date of last action: Moved out of (H) EDC, 03/21/12
Sponsor: 
Sen. DAVIS   

Cross Sponsor: Rep. P. Wilson

Description: The purpose of this bill is to increase participation in the national biennial Youth Risk Behavior Survey (YRBS) in order to meet the minimum 60 percent participation required by the Centers for Disease Control (CDC) for the survey to be validated for assessment, recording and reporting of reliable results.

SB 22 Student Athlete Traumatic Brain Injuries 
 

Committees and date of last action: CSSB 22(HSS) referred to (S) FIN, 04/01/11 

Sponsor: Sen. MCGUIRE

Description: Uncodified law of the State of Alaska is amended to add a new section that directs the governing body of a school district to consult with the Alaska School Activities Association to develop and publish guidelines and other information to educate coaches, student athletes, and parents of student athletes regarding the nature and risks of concussions and other traumatic brain injuries. CSSB 22 (HSS) changes the full title to "An Act relating to prevention and evaluation of and liability for concussions in student athletes," and adds a new section requiring schools to provide written information annually to parents or guardians about the nature and risks of concussion, and prohibiting student participation in school athletic activities without a signed verification of receipt of that information by the parent or guardian.  

 

SB 179 Missing Vulnerable Adult Response Plan 

Committees and date of last action: (H) JUD moved version HCS SB 179(STA) out of committee, 4/14/12

Sponsor: Sen. DAVIS, Wielechowski, Dyson, Kookesh, Ellis, Meyer, Menard, Paskvan, Stedman, Thomas, Olson, Wagoner, and Stevens

Cross Sponsors: Reps. Petersen, Gruenberg, and Tuck  

Description: SB 179 creates a statewide alert system to help find vulnerable missing adults. 

   

SB 191 Ultrasound Before Abortion

Committees and date of last action: Introduced and referred to (S) HSS, then (S) JUD, 02/08/12 

Sponsor: Sens. COGHILL, Huggins, Davis, Giessel, and Olson

Description: SB 191 would require that certain licensed health professionals conduct an ultrasound before an abortion; it allows for a woman to decline viewing and hearing the explanation of the ultrasound.

 

Bill Watch: Workers' Compensation

HB 12 Workers' Compensation Advisory Council
Committees and date of last action: Scheduled to be heard in (H) L&C, 03/16/11; hearing canceled

Sponsor: Rep. OLSON
Description: This bill establishes a Workers' Compensation Advisory Council, describes the membership, and other particulars.
 
HB 232 Workers' Compensation for Firefighters
Committees and date of last action: Referred to the (H) L&C, 04/7/11

Sponsors: Reps. STOLTZE, Millett, and Lynn
Description: "An Act amending the medical examination requirements for firefighters entitled to a presumption of compensability for a disability resulting from certain diseases."

SB 103 Workers' Compensation for Firefighters
Committees and date of last action: CSSB 103 read and referred to (H) L&C and (H) FIN, 02/03/12
Sponsor: JUDICIARY
Description: SB 103 is, "An Act amending the medical examination requirements for firefighters entitled to a presumption of compensability for a disability resulting from certain diseases."

SB 116 Workers' Comp.: Coll Bargaining/Mediation
Committees and date of last action:Delayed to call of the Chair in (S) L&C, 4/12/12 
Sponsor: LABOR & COMMERCE
Description: "An Act offering mediation of disputed workers' compensation claims by a hearing officer or other classified employee of the division of workers' compensation and allowing collective bargaining agreements to supersede certain provisions of the Alaska Workers' Compensation Act; and providing for an effective date."

 


Bill Watch: Public Safety

HB 22 No Cell Phone Use When Driving
Committees and date of last action: CSHB 22(TRA) failed to move out of (H) JUD, 04/15/11
Sponsors: Reps. MUNOZ, HERRON, and Gruenberg
Description: HB 22 amends state statute that prohibits the use of cellular telephones while driving except in hands-free mode and in emergencies, to take effect July 1, 2011. CSHB 22 amends HB 22 by defining "hands-free mode" and limiting the use of hands-free mode to drivers over 18 years of age.

     

HB 35 Ban Cell Phone Use When Driving
Committees and date of last action: Scheduled but not heard in (H) TRA, 03/01/11
Sponsor: Rep. DOOGAN
Description: This bill amends Alaska statute to prohibit cellular phone use while driving, with exceptions for emergencies, to take effect July 1, 2011.    

 

HB 57 Bicycle Program
Committees and date of last action: Referred to (H) FIN, 03/30/11
Sponsors: Reps. SEATON and Gruenberg
Description: This bills amends Alaska statute to authorize municipalities and nonprofit groups in Alaska to apply for grant money for programs that promote safe ridership and directs the Department of Transportation to establish grant programs.    

 

HB 68 Ban Cell Phone Use When Driving
Committees and date of last action: Scheduled but not heard in (H) TRA, 03/01/11
Sponsor: Rep. GRUENBERG
Description: This bill amends Alaska statute to prohibit cellular phone use while driving, with exceptions for hands-free configuration and emergencies, to take effect July 1, 2011. It adds that a peace officer may not stop or detain a motor vehicle to determine compliance with section, or issue a citation for a violation of of this section, unless the peace officer has probable cause to stop or detain the motor vehicle other than for a violation of this section.   
 

 

HB 95 Seat Belt Violation Secondary Offense
Committees and date of last action: Heard and held in (H) TRA, 03/17/11
Sponsors: Reps. T. WILSON, GARDNER, and Stoltze
Description: Amends Section 1. AS 28.05.095(e) to read, "(e) Notwithstanding any other provision of law, a peace officer may not stop or detain a motor vehicle to determine compliance with (a) of this section issue a citation for a violation of (a) of this section, unless the peace officer has probable cause to stop or detain the motor vehicle other than for a violation of (a) of this section," and repeals Sec. 2. AS 28.05.095(f).    

 

HB 128 Ban Cell Phone Use By Minors When Driving 

Committees and date of last action: CSHB 128(TRA) was heard in (H) JUD and referred to (H) RLS, 03/15/12  
Sponsor: Rep. GARDNER and Gruenberg
Description: Amends AS 28.35 by adding a new section that prohibits drivers under 18 years of age from using a cell phone while driving a motor vehicle. A peace officer is not authorized to stop or detain a motor vehicle to determine compliance with this provision unless the officer has probable cause to stop or detain the vehicle for reasons other than violation of provision. Effective date is July 1, 2011.

HB 149 Driver's Licensing; Medical Conditions
Committees and date of last action: Heard and held in (H) STA, 04/14/11
Sponsor: Reps. FAIRCLOUGH and Olson
Description: Section 2 AS 28.15 is amended by adding a new section that reads: Sec. 28.15.156 Duty to disclose certain medical conditions; reports to department by physicians and other persons regarding persons with certain medical conditions.    

 

HB 150 Protection of Vulnerable Adults/Minors
Committees and date of last action: Heard and held in (H) FIN, 03/30/11
Sponsor: RULES by request of the governor
Description: From Governor Parnell's letter, "Financial exploitation of the elderly and other vulnerable adults is a growing problem. Victims of financial exploitation may not need a guardian, but may need assistance stopping immediate misuse or theft of their money. ... With a temporary conservator, the vulnerable victim retains autonomy while receiving assistance. The ex parte relief from fraud procedure is similar to the existing domestic violence protection law, providing a means for vulnerable adults to independently obtain straightforward, expedited relief from immediate financial exploitation." 

 

HB 191 Department of Agriculture and Food 

Committees and date of last action: Heard and held in (H) RES, 03/26/12 
Sponsors:
Reps. THOMPSON by request, Kerttula, Tuck, Lynn, Dick, Miller, Munoz, and T. Wilson

Description: HB 191 was introduced at the request of the state-wide Alaska Farm Bureau. HB 191 establishes a new state Department of Agriculture and Food with the intent of using the current Division of Agriculture's budget. Currently, statutes and regulations that govern food, food products, land sales, loans, land development, and animals are spread between the Department of Natural Resources (DNR), and the Department of Environmental Conservation (DEC). HB 191 is an effort to stream-line government by bringing agriculture and agricultural foods products under the purview of one department.    

 

HB 195 Pesticides and Broadcast Chemicals
Committees and date of last action: Scheduled in (H) RES, 04/16/11; hearing canceled, 04/06/11
Sponsor: Rep. FEIGE
Description: From the sponsor statement: This bill repeals the authority of the Department of Environmental Conservation to regulate application on public lands or with public funds pesticides and broadcast chemicals in a manner different than it requires of commercial applicators working on private property. It will not change the safety or licensing requirements for the application of pesticides or broadcast chemicals.

 

HB 202 Sales of Food by Producers to Consumers

Committees and date of last action: Heard and held (H) L&C, 04/09/12

Sponsors: Reps. DICK and T. Wilson 
Description: "An Act relating to the sale of food products by the producer to the consumer."    

 

HB 238 Chemicals in Children's Products
Committees and date of last action: Referred to (H) L&C and JUD, 04/14/11
Sponsors: Reps. KAWASAKI, Petersen, and Kerttula
Description: Full title: "An Act relating to chemicals in children's products; and adding an unlawful act to the Alaska Unfair Trade Practices and Consumer Protection Act."   

 
HB 262 Passenger Security: Transport. Facility

Committees and date of last action: Heard and held in (H) JUD, 02/22/12
Sponsor: Rep. CISSNA
Description: "An Act relating to the offense of interference with access to public buildings or transportation facilities, when a person conditions access to a public building or transportation facility on consent to certain physical contact or to an electronic process that produces a picture of the private exposure of the person."    

 

HB 270 Warning of Airport Pat Downs/Scans
Committees and date of last action: Heard and held in (H) TRA, 02/21/12 

Sponsors: Reps. CISSNA, GRUENBERG, and TUCK

Description: "An Act requiring the Department of Transportation and Public Facilities to require airports to post warning signs outside of security screening areas warning passengers that they are subject to searches of their bodies by physical touching and by electronic devices that emit radiation."  

 

HB 319 Study Health Effects of Airport Screening

Committees and date of last action: Heard and held in (H) HSS, 03/29/12

Sponsors: Reps. CISSNA, Doogan, Tuck, and Kerttula

Description: DHSS will conduct a study by January 1, 2014 of the mental and physical health effects of airport security screening and report the findings to the legislative committees having jurisdiction over health matters.

 

HB 321 State/Muni. Airport Security Screening

Committees and date of last action: Heard and held in (H) TRA, 03/29/12

Sponsor: Rep. CISSNA

Description: This bill would require certain airports in the state to apply for the federal security screening opt-out program and to provide reimbursement to a municipality that applies for the federal security screening opt-out program.    

      

SB 96 Application of Village Safe Water Act
Committees and date of last action: Scheduled but not heard in (S) FIN, 04/08/11
Sponsor: Sen. KOOKESH
Description:
This bill would add home rule language to AS 46.07.080 that would allow home rule cities with a population between 25 and 600 residents to be eligible for grants under the Village Safe Water Act. CSSB 96(CRA) changes language to be more inclusive of eligible places of residence.  

 

SB 147 Water and Sewer Task Force
Committees and date of last action: Moved out of (S) CRA, 02/28/12; referred to (S) FIN, 02/29/12 

Sponsor: Sen. KOOKESH
Description: This bill creates a Water and Sewer Task Force within the Alaska legislative branch.

   


Bill Watch: General Health Policy

HB 61 Advance Health Care Directives Registry
Committees and date of last action:
Heard and held in (H) HSS, 04/07/11
Sponsors: Reps. HOLMES, KAWASAKI, OLSON, GARDNER, Kerttula and Millet
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, the bill 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 233 Biometric Information for ID
Committees and date of last action: Referred to (H) HSS and JUD, 04/08/11
Sponsors: Reps. GARDNER, Neuman, Tuck, Dick, Kerttula, Keller, Gara, Millett, Kawasaki, Petersen, and Cissna
Description: "An Act relating to biometric information."   

 

HB 309 Care Directives/Do Not Resuscitate Orders

Committees and date of last action: Introduced and referred to (H) HSS, 02/01/12

Sponsors: Rep. LYNN

Description: "An Act relating to health care decisions, including do not resuscitate orders" adds protections for health care providers and facilities by clarifying the conditions under which a provider or facility may or may not comply with care directives or do not resuscitate orders.

 

SB 14 Protect Health Care Provider Conscience 

Committees and date of last action: Heard and held in (S) HSS, 03/07/11
Sponsors: Sens. DYSON AND COGHILL
Description: This bill amends Alaska statute to include accommodation and protection for health care providers' expressions of conscience pertaining to the delivery of a health care service.


SB 27 Flame Retardants and Toxic Chemicals
Committees and date of last action: Heard and held in H (L&C), 4/12/12 

Sponsor: Sen. WIELECHOWSKI
Description: Amends Alaska statute to prohibit the manufacture, sale, or distribution of products containing certain toxic chemicals in Alaska.

 

SB 98 Biometric Information for ID 

Committees and date of last action: Heard and held in (H) JUD, 04/14/12  
Sponsors: Sens. WIELECHOWSKI, Coghill, Ellis, Menard, McGuire, Giessel, Egan, Paskvan, Dyson, Wagoner, and Thomas
Cross Sponsors: 
Sens. Tuck, Petersen, and Kawasaki
Description: SB 98 updates Alaska statutes to protect not only Alaskans' DNA, but all similar forms of biometric information. The term "biometric information" refers to any information about an individual based on their unique behavioral or physiological characteristics. The most commonly known forms of biometric information are a person's fingerprints and their DNA, but also includes such information as iris and retinal patterns, hand geometry, voice patterns, and facial characteristics.  

Committees and date of last action: CSSB 144(FIN) was heard in and moved out of (S) FIN, 02/29/12
Sponsors: Sens. GIESSEL, OLSON, Davis, Dyson, and Thomas  
Description: SB 144 temporarily reinstates the child and adult immunization program in the Department of Health and Social Service.

 

SB 172 Care Directives/Do Not Resuscitate Orders

Committees and date of last action: Heard and held in (S) JUD, 03/19/12
Sponsors: Sens. DYSON, Davis, Coghill, McGuire, Olson, and Giessel
Description: This bill amends current statutes.  

 

SCR 1 Lupus Awareness Month 

Committees and date of last action: Referred to (H) RLS, 02/22/12
Sponsor: Sen. DAVIS
Description: Proclaims May 2011 as Lupus Awareness Month. 
 

Bill Watch: Bill Tracking Methodology

Bills listed here were selected based on a series of subjective criteria to determine whether they were "health-policy related." All bills currently sitting in the Senate and House Health 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.
 
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
(H) CRA: House Community and Regional Affairs Committee
(S) CRA: Senate Community and Regional Affairs Committee
(H) TRA: House Transportation Committee
(S) TRA: Senate Transportation Committee
(H) RES: House Resources Committee
(S) RES: Senate Resources Committee

AHPR Staff and Contributors
 
Kelby Murphy,
MPH, Contributor, Transcriptionist, Proofreader

Lawrence D. Weiss, PhD, MS, Former Editor
Jacqui Yeagle, MPA, Managing Editor


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