Legislature(2017 - 2018)CAPITOL 106

03/08/2018 03:00 PM HEALTH & SOCIAL SERVICES

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* first hearing in first committee of referral
+ teleconferenced
= bill was previously heard/scheduled
*+ HB 358 INSURANCE COVERAGE FOR TELEHEALTH TELECONFERENCED
Heard & Held
-- Testimony <Invitation Only> --
+= HB 351 JUVENILES: JUSTICE,FACILITES,TREATMENT TELECONFERENCED
Moved CSHB 351(HSS) Out of Committee
-- Public Testimony --
*+ HB 193 HEALTH CARE; BALANCE BILLING TELECONFERENCED
Heard & Held
-- Testimony <Invitation Only> --
+= HB 336 SUPPORTIVE DECISION-MAKING AGREEMENTS TELECONFERENCED
Moved CSHB 336(HSS) Out of Committee
+ Bills Previously Heard/Scheduled TELECONFERENCED
              HB 193-HEALTH CARE; BALANCE BILLING                                                                           
                                                                                                                                
3:56:15 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE  TARR announced  that the  next order  of business                                                               
would be HOUSE BILL NO. 193,  "An Act relating to insurance trade                                                               
practices  and frauds;  and relating  to  emergency services  and                                                               
balance billing."                                                                                                               
                                                                                                                                
3:56:39 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE   JASON    GRENN,   Alaska    State   Legislature,                                                               
paraphrased  from the  Sponsor  Statement  [included in  members'                                                               
packets], which read:                                                                                                           
                                                                                                                                
     House  Bill 193  is focused  on protecting  Alaskans in                                                                    
     emergency   situations   from  being   surprised   with                                                                    
     unexpected  medical bills.  The most  common occurrence                                                                    
     for  balance  billing  is during  emergency  situations                                                                    
     where  patients   are  left   without  the   option  or                                                                    
     wherewithal  to  ensure  they are  treated  by  an  in-                                                                    
     network provider. As a result,  they find themselves on                                                                    
     the  hook  for  hefty  medical  bills,  despite  having                                                                    
     proper  health insurance.  HB 193  would help  Alaskans                                                                    
     already  dealing   with  the   turmoil  of   a  medical                                                                    
     emergency  by removing  them from  the billing  side of                                                                    
     the  equation. When  a  patient is  already  in a  dire                                                                    
     situation,  they   should  not  be  punished   for  the                                                                    
     inability  of  an  in-network provider  to  respond  to                                                                    
     their crisis.                                                                                                              
                                                                                                                                
     HB  193 bans  the  practice of  medical providers  from                                                                    
     balance  billing in  emergency situations  and requires                                                                    
     insurance  providers to  hold  harmless their  clients.                                                                    
     This covers emergency situations  inside and outside of                                                                    
     hospitals. If a patient  was transported to a hospital,                                                                    
     or  an  emergency  arose  during  a  medical  procedure                                                                    
     requiring an out-of-network  provider, this legislation                                                                    
     mandates  the   insurance  and  medical   providers  to                                                                    
     develop  a   fair  and  equitable   payment  agreement.                                                                    
     Instead  of  being  left to  handle  the  labyrinth  of                                                                    
     medical billing on their own,  the patient will be held                                                                    
     harmless in these situations.                                                                                              
                                                                                                                                
     Medical costs are a major  concern in Alaska. HB 193 is                                                                    
     a  part of  a national  movement  to protect  consumers                                                                    
     from   unexpected  costs   in   an  already   difficult                                                                    
     situation. Twenty-one  states have  a ban of  some kind                                                                    
     on  balance billing  and more  states  are looking  are                                                                    
     into the issue. Unexpected  and excessive medical bills                                                                    
     from   out-of-network  providers   contribute  to   the                                                                    
     growing  problem   of  consumer  medical   debt,  which                                                                    
     continues  to  be  a   significant  cause  of  personal                                                                    
     bankruptcy. The goal  of this legislation is  to hold a                                                                    
     patient  harmless  while   the  medical  and  insurance                                                                    
     providers  come  to  an   agreement  for  the  services                                                                    
     rendered.                                                                                                                  
                                                                                                                                
3:58:50 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE EDGMON moved to adopt the proposed committee                                                                     
substitute (CS) for HB 193, labeled 30-LS0466\T, Wallace,                                                                       
3/6/18, as the working draft.                                                                                                   
                                                                                                                                
3:59:01 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE TARR objected for discussion.                                                                                    
                                                                                                                                
3:59:08 PM                                                                                                                    
                                                                                                                                
RYAN JOHNSTON, Staff, Representative Jason Grenn, Alaska State                                                                  
Legislature, paraphrased from the Sectional Analysis, which                                                                     
read:                                                                                                                           
                                                                                                                                
     Section 1:  Establishes a "Hold Harmless"  standard for                                                                  
     insurance providers  in the  situation where  a covered                                                                    
     person  receives medical  care  from an  out-of-network                                                                    
     medical   provider  in   an  emergency.   An  insurance                                                                    
     provider will hold a covered  person harmless to ensure                                                                    
     that the covered  person only pay what  would have been                                                                    
     paid  if   the  medical  provider  was   an  in-network                                                                    
     provider.                                                                                                                  
                                                                                                                                
     Outlines  the  standards  to establish  the  situations                                                                    
     where a medical provider  cannot balance bill a covered                                                                    
     person. An  insurance provider shall pay  a non-network                                                                    
     health  care  provider  if  the  health  care  provider                                                                    
     renders to a covered person;                                                                                               
                                                                                                                                
          emergency services or  treats an emergency medical                                                                    
     condition                                                                                                                  
          services at an in-network facility                                                                                    
          services for which a referral was made by an in-                                                                      
     network  health  care  provider to  an  out  of-network                                                                    
     health  care  provider  without  the  explicit  written                                                                    
     consent of the covered person.                                                                                             
                                                                                                                                
     The covered  person is  still required  to pay  the in-                                                                    
     network  rates  for  the  deductible,  coinsurance  and                                                                    
     copayment.  The amount  paid by  the covered  person is                                                                    
     required  to be  counted  towards  the covered  persons                                                                    
     deductible.                                                                                                                
                                                                                                                                
     The final  payment determined for the  medical provider                                                                    
     will subtract any amount paid by the covered person.                                                                       
                                                                                                                                
     The insurance provider  is to pay the  greater of three                                                                    
     possible amounts;                                                                                                          
                                                                                                                                
          the  median  negotiated  contract  rate  generated                                                                    
     using  the in-network  health  care  providers for  the                                                                    
     service provided;                                                                                                          
                                                                                                                                
          That is  equal to  the 80th percentile  of charges                                                                    
     for  the  services  calculated   using  a  method  that                                                                    
     establishes  a  statistically   credible  profile  that                                                                    
     reflects  the  general  cost  differences  between  the                                                                    
     geographical area  where the service was  preformed and                                                                    
     the  other  geographical  areas  when  performed  by  a                                                                    
     health care provider in the  same or similar specialty;                                                                    
     or                                                                                                                         
          That would be paid  under Medicare for the service                                                                    
     provided.                                                                                                                  
                                                                                                                                
     Medical  providers are  required to  send all  bills to                                                                    
     the  insurance  provider,  except for  the  deductible,                                                                    
     coinsurance and copayment.                                                                                                 
                                                                                                                                
     Contains a  clause that if  a covered  person knowingly                                                                    
     elects to  use an out-of-network medical  provider then                                                                    
     they can be balanced billed for the services.                                                                              
                                                                                                                                
4:01:41 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE  KITO   asked  for  clarification   regarding  the                                                               
determination of the calculations.                                                                                              
                                                                                                                                
MR.  JOHNSTON  explained  that  the  greater  of  three  possible                                                               
amounts model was  taken from an [PP]ACA  [Patient Protection and                                                               
Affordable Care Act]  regulation that was adopted at  the time of                                                               
its federal  adoption.  He  stated that the 80th  percentile, the                                                               
usual and  customary rate, had been  used as the standard  by the                                                               
State of Alaska, a precedent had already been set for its use.                                                                  
                                                                                                                                
4:02:41 PM                                                                                                                    
                                                                                                                                
MR.  JOHNSTON   continued  to   paraphrase  from   the  Sectional                                                               
Analysis, which read:                                                                                                           
                                                                                                                                
     Section 2:  Health care insurance plans  obtained under                                                                  
     AS  39.30.090 or  provided under  AS 39.30.091  will be                                                                    
     subject  to the  requirements  of  secs. 21.36.512  and                                                                    
     21.36.513.                                                                                                                 
                                                                                                                                
     Section 3: Bans the practice  of "Balance Billing" by a                                                                  
     medical  provider under  the criteria  of section  1 of                                                                    
     the  bill. Stipulates  that  the  medical provider  can                                                                    
     still   bill  for   the  deductible,   coinsurance  and                                                                    
     copayment.                                                                                                                 
                                                                                                                                
     States that  a medical provider will  be paid according                                                                    
     to section 1 of the bill.                                                                                                  
                                                                                                                                
       Section 4: Establishes the punishment for medical                                                                      
         providers under the Unfair Trade Practices and                                                                         
     Consumer Protection.                                                                                                       
                                                                                                                                
4:03:36 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE TARR  mused that  Version T  of the  proposed bill                                                               
did not have an effective date.                                                                                                 
                                                                                                                                
REPRESENTATIVE KITO  asked whether  the consumer  was responsible                                                               
for the balance billing.                                                                                                        
                                                                                                                                
MR. JOHNSTON  replied that the  patient would not  be responsible                                                               
for balance billing, and that  the patient would only be required                                                               
to  pay the  co-insurance co-payment  and deductible  at the  in-                                                               
network  rates.   The  insurance  provider,  after providing  the                                                               
three possible amounts, would choose  the greater, which would be                                                               
the reimbursement amount for the medical provider.                                                                              
                                                                                                                                
REPRESENTATIVE  SULLIVAN-LEONARD  offered  her  belief  that  the                                                               
insurance through  the State of  Alaska already  covered patients                                                               
for emergency  room treatment.   She asked  if the care  for many                                                               
patients was not being covered in the emergency room.                                                                           
                                                                                                                                
4:05:10 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE  GRENN  explained   that  initially  the  proposed                                                               
legislation  had been  suggested by  a constituent  who had  this                                                               
experience with  another insurance provider  in Alaska.   He said                                                               
that  insurance for  State of  Alaska employees  was still  under                                                               
investigation,  although   statements  from  the   Department  of                                                               
Administration indicated that  the state did not  balance bill in                                                               
emergency situations as those focused on by the proposed bill.                                                                  
                                                                                                                                
4:06:01 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE SULLIVAN-LEONARD asked  for additional information                                                               
to those  statistics for non-coverage of  emergency situations by                                                               
insurance companies in Alaska as well as other states.                                                                          
                                                                                                                                
4:06:27 PM                                                                                                                    
                                                                                                                                
MR. JOHNSTON said that he would provide that information.                                                                       
                                                                                                                                
4:06:36 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE JOHNSTON asked, as  there were insurance companies                                                               
which did  cover balance billing,  whether this would  "level the                                                               
field for everybody."                                                                                                           
                                                                                                                                
4:07:10 PM                                                                                                                    
                                                                                                                                
MR. JOHNSTON replied that the  proposed bill only covered private                                                               
insurers  and would  "not catch  all the  plans like  self-funded                                                               
plans."   He stated that  this would be  the standard for  out of                                                               
network plans with billings for emergency situations.                                                                           
                                                                                                                                
REPRESENTATIVE JOHNSTON  suggested to  expand the breadth  of the                                                               
proposed  bill.   She mused  that,  as 21  states were  currently                                                               
offering this,  it would  be good to  have those  benchmarks, how                                                               
long they had  been offering this program, and if  there had been                                                               
any  cause  and  effect.    She asked  about  the  proposed  80th                                                               
percentile,  which  she  deemed  was  "very  different  than  the                                                               
current  80th   percentile,  cause  you're  using   a  geographic                                                               
region."    She offered  her  belief  that  this was  a  business                                                               
geographic region, and asked how  this would change if there were                                                               
certain  fees.   She shared  that  past problems  with this  80th                                                               
percentile had  arisen as,  although the  policy and  the purpose                                                               
was  very   good,  it  had  caused   a  "hockey  stick"     in  a                                                               
representative chart  of medical  costs.   She suggested  to take                                                               
some emergency fees and see what would happen.                                                                                  
                                                                                                                                
4:09:49 PM                                                                                                                    
                                                                                                                                
MR.  JOHNSTON   replied  that  he  had   been  reviewing  various                                                               
databases  and  that  his experimentation  for  the  geographical                                                               
area,  using  FAIR Health,  had  revealed  a  similar rate.    He                                                               
acknowledged that "the geographical  area has been an interesting                                                               
part of this conversation."                                                                                                     
                                                                                                                                
4:10:44 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE  JOHNSTON acknowledged  that the  database he  had                                                               
used, FAIR  Health, was an  excellent source, except that  it was                                                               
voluntary.   She  stated that  an  advantage for  only using  the                                                               
Municipality  of Anchorage  was  that a  local ordinance  allowed                                                               
someone  to ask  a medical  facility about  a procedure  and then                                                               
"get the rack rate."                                                                                                            
                                                                                                                                
4:11:12 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE CLAMAN  asked about the  lack of a  definition for                                                               
balance billing in  the proposed bill, as it  was not necessarily                                                               
a term that was easily understood.                                                                                              
                                                                                                                                
MR.  JOHNSTON  offered his  belief  that,  as the  proposed  bill                                                               
focused  on the  emergency situations,  balance billing  was what                                                               
was stipulated in the bill, and  the bill itself was "kind of the                                                               
definition."   He acknowledged  that balance  billing was  a much                                                               
broader term.                                                                                                                   
                                                                                                                                
4:12:16 PM                                                                                                                    
                                                                                                                                
MEGAN WALLACE,  Attorney, Legislative Legal  Counsel, Legislative                                                               
Legal Services,  reiterated that the bill  described the instance                                                               
of balance billing, and she opined:                                                                                             
                                                                                                                                
     because the explanation  in Section 3 of  the bill that                                                                    
     talks, that  uses the  term balance  bill, specifically                                                                    
     states that  the balance bill cannot  result in charges                                                                    
     that are  more than those  out of pocket  expenses that                                                                    
     the  covered  person  would   incur  in  an  in-network                                                                    
     facility or being treated by  an in-network health care                                                                    
     provider.    That the  bill  is  sufficiently clear  to                                                                    
     articulate what the balance bill would be for.                                                                             
                                                                                                                                
4:13:15 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE  TARR   mused  that,  as  some   insurers  covered                                                               
Providence  [Alaska  Medical  Center]  and  some  covered  Alaska                                                               
Regional  [Hospital], a  person  would be  taken  to the  closest                                                               
hospital in an emergency.   The proposed bill would eliminate the                                                               
possibility that  a person  would pay  extra charges  even though                                                               
they  had  not  been  taken  to the  hospital  covered  by  their                                                               
insurance.                                                                                                                      
                                                                                                                                
4:14:17 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE   GRENN   expressed   his   agreement   with   her                                                               
explanation for  the intent  of the  proposed bill,  pointing out                                                               
that this was only for emergency  situations as it was not always                                                               
possible to indicate which hospital.                                                                                            
                                                                                                                                
4:14:55 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE  TARR  removed  her  objection.   There  being  no                                                               
further objection, Version T was adopted.                                                                                       
                                                                                                                                
4:16:34 PM                                                                                                                    
                                                                                                                                
NATHAN PAIMANN,  MD, Bartlett Regional  Hospital, in  response to                                                               
Representative Tarr,  explained that some physicians  staffing at                                                               
hospitals  were independent,  and had  to independently  contract                                                               
with  the  network to  be  in-network  providers.   Although  the                                                               
hospital could  be in-network,  the providers may  not be  an in-                                                               
network  provider.   He  stated  that  the proposed  bill  "would                                                               
change  this  so  you  had no  surprise  insurance  gap  billing,                                                               
outside of what your usual and customary charges would be."                                                                     
                                                                                                                                
4:18:17 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE KITO shared some  anecdotes of hospital situations                                                               
for  physicians   not  in-network  which  resulted   in  surprise                                                               
billings for the patients.                                                                                                      
                                                                                                                                
4:19:04 PM                                                                                                                    
                                                                                                                                
MS.  LATHAM,  in  response  to  Representative  Sullivan-Leonard,                                                               
stated that  there was an  80th percentile regulation  already in                                                               
effect,  which  had been  adopted  to  include the  treatment  of                                                               
emergency  services and  services  at an  in-network hospital  or                                                               
ambulatory surgical center,  as explained on page 2, lines  4 - 6                                                               
of the  proposed bill.   She added  that the proposed  bill "does                                                               
broaden the  scope of coverage  services to services for  which a                                                               
referral was  made by an  in-network health care provider  to the                                                               
non-network health care providers  without written consent of the                                                               
covered  person."     She  declared  that   this  did  strengthen                                                               
provisions  for consumers.   She  directed attention  to page  4,                                                               
line 27, which  created a violation of the  [Alaska] Unfair Trade                                                               
Practices  and Consumer  Protection Act.   She  expressed concern                                                               
that,  as the  Division of  Insurance had  never regulated  state                                                               
health plans,  Section 2 of  the proposed  bill [page 4,  line 5]                                                               
moved AS 39 under AS 21, which she deemed to be "unusual."                                                                      
                                                                                                                                
4:21:23 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE SULLIVAN-LEONARD  expressed that she  had concerns                                                               
with the  application and possible  outcome because of  Section 4                                                               
[page 4, lines 27 - 29].                                                                                                        
                                                                                                                                
MS. LATHAM replied  that, as this was enforced  by the Department                                                               
of Law, it offered "very, very strong consumer protections."                                                                    
                                                                                                                                
4:22:01 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE SULLIVAN-LEONARD  asked if the bill  sponsor could                                                               
review that section.                                                                                                            
                                                                                                                                
REPRESENTATIVE JOHNSTON asked if the  concern for Section 2 [page                                                               
4,   lines  6   -  11]   was   because  it   was  an   additional                                                               
responsibility,  and  whether  it  was  for  the  possibility  of                                                               
"opening up a door that might go beyond this."                                                                                  
                                                                                                                                
MS.  LATHAM said  that  this  was similar  to  House  Bill 25,  a                                                               
contraceptive  coverage bill,  as  this proposed  bill also  just                                                               
included the state self-insured,  non-federal health plans, which                                                               
had  never  been  under  the   jurisdiction  of  AS  21  and  was                                                               
unprecedented.                                                                                                                  
                                                                                                                                
4:23:05 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE  KITO  asked  if  she was  referencing  the  state                                                               
employee plans.                                                                                                                 
                                                                                                                                
MS. LATHAM said, "that's exactly what I'm referencing."                                                                         
                                                                                                                                
4:23:36 PM                                                                                                                    
                                                                                                                                

Document Name Date/Time Subjects
HB 193 Draft Proposed Blank CS ver T 03.08.2018.pdf HHSS 3/8/2018 3:00:00 PM
HHSS 3/29/2018 3:00:00 PM
HB 193
HB 193 Definitions 03.08.2018.pdf HHSS 3/8/2018 3:00:00 PM
HHSS 3/29/2018 3:00:00 PM
HB 193
HB 193 Sectional Analysis 03.08.2018.pdf HHSS 3/8/2018 3:00:00 PM
HHSS 3/29/2018 3:00:00 PM
HB 193
HB 193 Sponsor Statement 03.08.2018.pdf HHSS 3/8/2018 3:00:00 PM
HHSS 3/29/2018 3:00:00 PM
HB 193
HB193 Fiscal Note CED--IO 3.7.2018.pdf HHSS 3/8/2018 3:00:00 PM
HHSS 3/29/2018 3:00:00 PM
HB 193
HB358 Fiscal Note CED--IO 3.7.2018.pdf HHSS 3/8/2018 3:00:00 PM
HB 358
HB358 Sponsor Statement 03.07.18.pdf HHSS 3/8/2018 3:00:00 PM
HB 358
HB358 Sectional Analysis ver J 03.07.18.pdf HHSS 3/8/2018 3:00:00 PM
HHSS 3/29/2018 3:00:00 PM
HB 358
HB351 Additional Document -- DJJ responses to questions.pdf HHSS 3/8/2018 3:00:00 PM
HB 351
HB 351 Draft Proposed Amendment R.1 3.5.2018.pdf HHSS 3/6/2018 3:00:00 PM
HHSS 3/8/2018 3:00:00 PM
HB 351
HB351 Sectional Analysis 3.5.2018.pdf HHSS 3/6/2018 3:00:00 PM
HHSS 3/8/2018 3:00:00 PM
HB 351
HB351 Fiscal Note DHS--DJJ 3.5.2018.pdf HHSS 3/6/2018 3:00:00 PM
HHSS 3/8/2018 3:00:00 PM
HB 351
HB351 Sponsor Statement 3.5.2018.pdf HHSS 3/6/2018 3:00:00 PM
HHSS 3/8/2018 3:00:00 PM
HB 351
HB351 Supporting Document -- Letter from DJJ.pdf HHSS 3/6/2018 3:00:00 PM
HHSS 3/8/2018 3:00:00 PM
HB 351
HB 336 Fiscal Note DHS--SDS 2.28.2018.pdf HHSS 3/1/2018 3:00:00 PM
HHSS 3/8/2018 3:00:00 PM
HB 336
Draft CS for HB 336 Version J Explanation of Changes.pdf HHSS 3/1/2018 3:00:00 PM
HHSS 3/8/2018 3:00:00 PM
HB 336
Draft CS for House Bill 336 Version J Sectional Analysis.pdf HHSS 3/1/2018 3:00:00 PM
HHSS 3/8/2018 3:00:00 PM
HB 336
House Bill 336 Additional Documents Rule 402 2.9.2018.pdf HHSS 3/1/2018 3:00:00 PM
HHSS 3/8/2018 3:00:00 PM
HB 336
House Bill 336 Draft CS Version J.pdf HHSS 3/1/2018 3:00:00 PM
HHSS 3/8/2018 3:00:00 PM
HB 336
House Bill 336 Sponsor Statement 2.9.2018.pdf HHSS 3/1/2018 3:00:00 PM
HHSS 3/8/2018 3:00:00 PM
HB 336
House Bill 336 Supporting Documents - Govs Council on Disabilities 2.9.2018.pdf HHSS 3/1/2018 3:00:00 PM
HHSS 3/8/2018 3:00:00 PM
HB 336
House Bill 336 Supporting Documents - OPA & Guardianship 2.9.2018.pdf HHSS 3/1/2018 3:00:00 PM
HHSS 3/8/2018 3:00:00 PM
HB 336
House Bill 336 Supporting Documents - Paper on Guardianship Concerning NCI Adult Consumer Survey 2.9.2018.pdf HHSS 3/1/2018 3:00:00 PM
HHSS 3/8/2018 3:00:00 PM
HB 336
House Bill 336 Supporting Documents - SDMA Example from Autistic Self Advocary Network 2.9.2018.pdf HHSS 3/1/2018 3:00:00 PM
HHSS 3/8/2018 3:00:00 PM
HB 336
House Bill 336 Supporting Documents - SDMA Example from Texas 2.9.2018.pdf HHSS 3/1/2018 3:00:00 PM
HHSS 3/8/2018 3:00:00 PM
HB 336
House Bill 336 Supporting Documents - SDMA Law from Delaware 2.9.2018.pdf HHSS 3/1/2018 3:00:00 PM
HHSS 3/8/2018 3:00:00 PM
HB 336
House Bill 336 Supporting Documents - SDMA Texas 2.9.2018.pdf HHSS 3/1/2018 3:00:00 PM
HHSS 3/8/2018 3:00:00 PM
HB 336
House Bill 336 Supporting Documents Massachusetts SDMA Example 2.9.2018.pdf HHSS 3/1/2018 3:00:00 PM
HHSS 3/8/2018 3:00:00 PM
HB 336
House Bill 336 Supporting Documents National Core Indicators 2016 Survey 2.9.2018.pdf HHSS 3/1/2018 3:00:00 PM
HHSS 3/8/2018 3:00:00 PM
HB 336
House Bill 336 Supporting Documents SDMA - Agenda for Action 2.9.2018.pdf HHSS 3/1/2018 3:00:00 PM
HHSS 3/8/2018 3:00:00 PM
HB 336
House Bill 336 Supporting Documents SDMA Bill from Rhode Island 2.9.2018.pdf HHSS 3/1/2018 3:00:00 PM
HHSS 3/8/2018 3:00:00 PM
HB 336
House Bill 336 Supporting Documents SMDA Paper by Council on Quality and Leadership 2.9.2018.pdf HHSS 3/1/2018 3:00:00 PM
HHSS 3/8/2018 3:00:00 PM
HB 336
HB 336 Letter of Support AARP Alaska.pdf HHSS 3/1/2018 3:00:00 PM
HHSS 3/8/2018 3:00:00 PM
HB 336
HB 336 Letter of Support Delaune.pdf HHSS 3/1/2018 3:00:00 PM
HHSS 3/8/2018 3:00:00 PM
HB 336