Legislature(2017 - 2018)BUTROVICH 205

03/15/2017 01:30 PM Senate HEALTH & SOCIAL SERVICES

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Audio Topic
05:30:33 PM Start
05:30:55 PM Confirmation Hearings
05:56:30 PM SB91
06:30:43 PM Adjourn
* first hearing in first committee of referral
+ teleconferenced
= bill was previously heard/scheduled
-- Meeting Postponed to 5:30 p.m. --
+ Consideration of Governor's Appointees: TELECONFERENCED
Mental Health Trust Authority Board of Trustees
- Christopher Cooke
-- Public Testimony --
+ Bills Previously Heard/Scheduled: TELECONFERENCED
Moved CSSB 91(HSS) Out of Committee
        SB 91-EXTEND DISASTER EMERGENCY: OPIOID EPIDEMIC                                                                    
5:56:30 PM                                                                                                                    
CHAIR WILSON  called the  committee back  to order.  He announced                                                               
the consideration  of SB 91. He  solicited a motion to  adopt the                                                               
proposed committee substitute (CS).                                                                                             
5:57:08 PM                                                                                                                    
SENATOR VON  IMHOF moved to  adopt the work  draft CS for  SB 91,                                                               
SENATOR GIESSEL objected for purposes of explanation of changes.                                                                
CHAIR  WILSON  reviewed the  sectional  analysis  for the  CS  as                                                               
Section 1                                                                                                                   
Authorizes the chief  medical officer to issue  a standing order,                                                               
including a statewide standing order,  for the prescription of an                                                               
opioid overdose drug.                                                                                                           
Section 2                                                                                                                   
Repeals section 1 on June 30, 2021.                                                                                             
Section 3                                                                                                                   
Extends to  February 14, 2018  the opioid epidemic  public health                                                               
disaster emergency  declared by  Governor Walker on  February 14,                                                               
2017.  This  section  also  limits the  sources  of  funding  the                                                               
governor  may  use  to  respond to  the  disaster  emergency  and                                                               
requires  the  Department  of  Health   and  Social  Services  to                                                               
complete a  report and submit  the report to the  legislature, on                                                               
or   before   October   1,  2018,   describing   activities   and                                                               
expenditures  related  to  substance   abuse  and  mental  health                                                               
services administration grants and the disaster emergency.                                                                      
Section 4                                                                                                                   
Makes the bill retroactive to March 15, 2017.                                                                                   
Section 5                                                                                                                   
Provides an immediate effective date for the bill.                                                                              
CHAIR WILSON  summarized that the  intent of  the CS was  to make                                                               
sure  that  funding  is  limited  to the  scope  of  the  federal                                                               
Substance  Abuse   and  Mental  Health   Services  Administration                                                               
(SAMHSA) grant  which the  state of  Alaska has  already received                                                               
with a declaration and the  distribution of naloxone. He said the                                                               
other part  of the CS would  allow the Legislature, if  deemed to                                                               
also  allow  additional  funds,  to  be  expended  if  additional                                                               
federal grants or  other funding sources were  allowed to respond                                                               
to the  disaster emergency.  He detailed that  the final  part of                                                               
the CS  was to make sure  that funding for current  projects will                                                               
not be affected by the actions of SB 91.                                                                                        
5:59:42 PM                                                                                                                    
SENATOR VON IMHOF thanked Chair Wilson  for working on the CS and                                                               
stated support for the changes that were made.                                                                                  
CHAIR  WILSON added  that the  CS also  allows the  state medical                                                               
director  to  have  a  five-year   coverage  to  extend  naloxone                                                               
SENATOR  BEGICH   thanked  Chair  Wilson  for   the  changes  and                                                               
acknowledged  that the  CS  is acceptable  to  the Department  of                                                               
Health and Social Services (DHSS) as well.                                                                                      
SENATOR MICCICHE asked  that confirmation from DHSS  be placed on                                                               
the record.                                                                                                                     
6:01:21 PM                                                                                                                    
DR. JAY BUTLER,  Chief Medical Officer and  Director, Division of                                                               
Public Health,  Alaska Department of Health  and Social Services,                                                               
Juneau, Alaska, stated that DHSS is in support of the CS.                                                                       
SENATOR MICCICHE  asked him to  clarify that the  emergency order                                                               
was extended to 2018.                                                                                                           
CHAIR WILSON answered yes.                                                                                                      
SENATOR  MICCICHE inquired  why immediate  authorization for  the                                                               
chief  medical  officer  to  issue  a  standing  order  was  also                                                               
included.  He said  he thought  the authorization  for the  chief                                                               
medical office  was the reason  for the declaration in  the first                                                               
SENATOR VON IMHOF replied that  she thought the authorization was                                                               
only good  for 30  days. She assumed  that the  authorization was                                                               
one-two type of step.                                                                                                           
6:03:09 PM                                                                                                                    
KATE  GLOVER, Attorney,  Legislative Legal  Services, Legislative                                                               
Affairs  Agency,   Alaska  State  Legislature,   Juneau,  Alaska,                                                               
replied to Senator Micciche's question as follows:                                                                              
     As  I understand  the purpose  of the  extension is  to                                                                    
     extend  the  declaration   of  the  disaster  emergency                                                                    
     because the  governor only has  authority to  declare a                                                                    
     disaster  emergency for  30 days.  So  this bill  would                                                                    
     extend that  for an additional year.  The first section                                                                    
     of the  bill also authorizes the  chief medical officer                                                                    
     to issue  a standing  order and  that can  be effective                                                                    
     through June 30, 2021; but,  I think the purpose of the                                                                    
     retroactivity provision  through March  15 is  so there                                                                    
     is  no gap  between  the expiration  of the  governor's                                                                    
     disaster declaration and the extension.                                                                                    
SENATOR MICCICHE  stated that  there is  a "disconnect"  with his                                                               
question. He restated his inquiry as follows:                                                                                   
     The reason for  the declaration was to not  have a need                                                                    
     for  the  standing  order,  yet   we  are  providing  a                                                                    
     standing  order and  no longer  have a  reason for  the                                                                    
     emergency   declaration  and   we  are   extending  the                                                                    
     emergency  declaration  although  we  are  providing  a                                                                    
     standing order  that begins  on March  15, 2017  and it                                                                    
     goes to 2021.                                                                                                              
MS. GLOVER replied to Senator Micciche statement as follows:                                                                    
     The  March 15,  2017 applies  to the  entire bill,  not                                                                    
     just  to  the  standing   order.  As  to  the  specific                                                                    
     authorization  for the  standing  order,  that maybe  a                                                                    
     question   more    appropriately   directed    to   the                                                                    
CHAIR WILSON commented on the five-year grant as follows:                                                                       
     I  don't  want  to  speak for  the  department,  but  I                                                                    
     believe  that the  life  of the  grant  is a  five-year                                                                    
     grant  and so  by extending  the orders  for the  chief                                                                    
     medical officer,  it extends  for the lifetime  for the                                                                    
     project declared under the disaster.                                                                                       
6:06:14 PM                                                                                                                    
SENATOR MICCICHE addressed the need for an emergency declaration                                                                
as follows:                                                                                                                     
     Respectively,  that  is  quite  clear to  me.  I  don't                                                                    
     believe we  any longer have  a reason for  an emergency                                                                    
     declaration  which  is  my primary  question;  we  have                                                                    
     extended  that  a  year although  we  have  retroactive                                                                    
     coverage for  the standing order, which  was the reason                                                                    
     for the  emergency declaration. So  I don't  believe we                                                                    
     need both.                                                                                                                 
DR. BUTLER addressed Senator Micciche's question as follows:                                                                    
     Senator Micciche,  I think what  you are  describing is                                                                    
     correct,  the  disaster  declaration  was  intended  to                                                                    
     establish the  authority of  the chief  medical officer                                                                    
     to  do  the  prescription  and the  bill  now  actually                                                                    
     establishes that  authority and extends it  through the                                                                    
     life of the  funding cycle for the  program. So whether                                                                    
     or not  we need the  disaster declaration once  we have                                                                    
     that authority I think is a valid question.                                                                                
SENATOR GIESSEL asked him to verify that the emergency order                                                                    
also allowed federal receipts of funding.                                                                                       
DR.  BUTLER  answered  no.  He specified  that  the  funding  had                                                               
already  been acquired  through the  federal grant.  He specified                                                               
that the  disaster declaration  was the  most expeditious  way to                                                               
move forward with the program.                                                                                                  
6:08:31 PM                                                                                                                    
SENATOR GIESSEL asked him to  confirm that deleting the emergency                                                               
order's extension would not implicate or remove the funding.                                                                    
DR. BUTLER answered correct.                                                                                                    
SENATOR WILSON asked if DHSS  or the administration is looking to                                                               
acquire more federal funds  throughout different departments; for                                                               
example, corrections or public safety.                                                                                          
DR.  BUTLER  replied  that  DHSS is  looking  for  other  federal                                                               
sources of funds.                                                                                                               
CHAIR  WILSON  asked  if  another  declaration  is  required  for                                                               
additional funds.                                                                                                               
DR. BUTLER answered no.                                                                                                         
6:09:51 PM                                                                                                                    
At ease.                                                                                                                        
6:16:29 PM                                                                                                                    
CHAIR WILSON called the committee back to order.                                                                                
6:16:38 PM                                                                                                                    
SENATOR GIESSEL removed her objection to the CS.                                                                                
CHAIR WILSON asked if there were any other amendments.                                                                          
6:16:45 PM                                                                                                                    
SENATOR GIESSEL said  she'd like to offer  a conceptual amendment                                                               
and  ask Ms.  Glover if  it works.  She explained  her conceptual                                                               
amendment as follows:                                                                                                           
     There are  two facets  to my conceptual  amendment. The                                                                    
     first one  is on line  5, letter (d), starts  out, "The                                                                    
     chief medical officer  may issue." So there's  a lot of                                                                    
     chief medical  officers out there,  Mr. Chairman,  so I                                                                    
     believe this  specification should be made,  "The chief                                                                    
     medical officer of the Department  of Health and Social                                                                    
     Services  may  issue a  standing  order."  That is  the                                                                    
     first part of conceptual amendment.                                                                                        
     The second part  relates to section 3,  letter (a), and                                                                    
     that appears on line 11,  on page 1. We have identified                                                                    
     that (a)  is not needed,  that is to say  the extension                                                                    
     of the  disaster emergency  because we  are authorizing                                                                    
     on line 5,  the chief medical officer of  DHSS to issue                                                                    
     the standing  order; that authorization is  being taken                                                                    
     care of in  line 5, we don't need  a disaster extension                                                                    
     to do  that. So  we believe  that removing  section (a)                                                                    
     and then going on to  page 2 and removing references to                                                                    
     that extension on  lines 3, 5, and 14  would retain the                                                                    
     restrictions on  the money aspect  of all of  this, but                                                                    
     remove that  reference to  the extension.  There's also                                                                    
     the word  "extending" in line  1, page 1 in  the title,                                                                    
     but that's a drafter's expertise there.                                                                                    
SENATOR GIESSEL summarized that her conceptual amendment is the                                                                 
addition of DHSS to the chief medical officer's specification                                                                   
and the removal of the extension of the disaster emergency.                                                                     
CHAIR WILSON asked Ms. Glover if she had any concerns.                                                                          
6:19:01 PM                                                                                                                    
MS. GLOVER addressed Senator Giessel's conceptual amendment as                                                                  
     With respect to the  first part adding, "The Department                                                                    
     of  Health and  Social  Services"  after chief  medical                                                                    
     officer,  I  think  that  would  be  fine.  I  believe,                                                                    
     although  I can't  give  you a  citation  right now,  I                                                                    
     believe  we do  use  the term  "chief medical  officer"                                                                    
     elsewhere  in  the  statutes  to  refer  to  the  chief                                                                    
     medical officer of the Department  of Health and Social                                                                    
     Services without  specifying that, but I  don't believe                                                                    
     it would hurt to clarify that here.                                                                                        
     With respect to  the second part, if we  were to remove                                                                    
     (a), I don't  believe that we would need  (b). The only                                                                    
     reason that the governor  has the authority to transfer                                                                    
     funds  from other  sources to  use the  disaster relief                                                                    
     fund is  because he's declared a  disaster emergency. I                                                                    
     believe that  the disaster emergency ends  today, today                                                                    
     is  the  15th  and  so  once  that  disaster  emergency                                                                    
     expires  then  there is  no  longer  a need  for  those                                                                    
     specific funding  restrictions under  (b); if  it still                                                                    
     must report  than (c) is  helpful, but I  don't believe                                                                    
     that (b) would be necessary  anymore either if the only                                                                    
     incentive of  extending the disaster  was to  allow for                                                                    
     standing orders then all that  needs to happen to allow                                                                    
     standing orders.  The authority  to spend  funding that                                                                    
     is  not appropriated  for this  purpose goes  away when                                                                    
     the disaster declaration ends.                                                                                             
SENATOR MICCICHE noted that the  committee planned to support the                                                               
opioid  epidemic activities  by  having the  bill  on the  Senate                                                               
floor  the next  day.  He  asked Ms.  Glover  if  she might  have                                                               
trouble completing the changes in time for the floor session.                                                                   
MS. GLOVER replied that her office will try its best.                                                                           
6:21:23 PM                                                                                                                    
At ease.                                                                                                                        
6:23:31 PM                                                                                                                    
CHAIR WILSON called the committee back to order.                                                                                
SENATOR  GIESSEL   summarized  the  changes  to   the  conceptual                                                               
amendment as follows:                                                                                                           
     We  took  under  consideration your  recommendation  to                                                                    
     remove  section (b)  on page  2 and  saw the  wisdom of                                                                    
     that, (c) now becomes the  only piece of section 3, but                                                                    
     we  would  like to  make  sure  that those  are  annual                                                                    
     reports. So, what  is (c), line 12, on  page 2, deletes                                                                    
     "On or  before October  1, 2018;" the  sentence begins,                                                                    
     "The  Department of  Health and  Social Services  shall                                                                    
     'annually'," the word "annually"  is added, "Complete a                                                                    
     report describing activities and expenditures, etc."                                                                       
MS. GLOVER  replied that the  changes made sound fine.  She asked                                                               
if  the annual  reports would  be through  June 30,  2021 because                                                               
that is the date section 1 is repealed.                                                                                         
SENATOR GIESSEL  explained that the thought  of committee members                                                               
was  that it  is  possible that  the governor  may,  or DHSS  may                                                               
secure an  additional grant that  even goes beyond 2021  in which                                                               
case  the Legislature  would want  to  continue receiving  annual                                                               
MS.  GLOVER replied  that  Senator  Giessel's explanation  sounds                                                               
fine.  She  summarized  that   the  reporting  requirement  would                                                               
continue  in effect  indefinitely.  She added  that the  standing                                                               
order would be repealed on June  30, 2021 and what remains of the                                                               
act would take effect immediately.                                                                                              
SENATOR  GIESSEL  concurred with  Ms.  Glover's  synopsis of  the                                                               
conceptual amendment.                                                                                                           
MS. GLOVER  suggested that some changes  be made to the  title as                                                               
SENATOR  GIESSEL  replied  yes.  She  noted  that  the  committee                                                               
anticipated a title change.                                                                                                     
CHAIR WILSON asked that Senator  Giessel reiterate her conceptual                                                               
6:25:39 PM                                                                                                                    
SENATOR GIESSEL stated the following:                                                                                           
     I move  conceptual amendment 1,  that being on  page 1,                                                                    
     line 5,  after the  words, "The chief  medical officer"                                                                    
     would be  added to this  phrase, "Of the  Department of                                                                    
     Health and Social Services."                                                                                               
     Then  going  down  to  Section  3,  line  11,  removing                                                                    
     subsection  (a) and  continuing on  page 2,  removal of                                                                    
     subsection (b).                                                                                                            
     Then  under subsection  (c),  line 12  on  page 2,  the                                                                    
     sentence would delete, "On or  before October 1, 2018,"                                                                    
     and would  begin, "The Department of  Health and Social                                                                    
     Services shall  'annually' [the word annually  would be                                                                    
     added there] complete a report."                                                                                           
     Then in  section (c) there  is a  phrase on line  14 at                                                                    
     the end  of the  line that  says, "Extended  under this                                                                    
     section  that  is  no longer  relevant  and  should  be                                                                    
6:27:04 PM                                                                                                                    
CHAIR  WILSON   asked  if  there  was   objection  to  conceptual                                                               
amendment 1.                                                                                                                    
SENATOR  BEGICH  said he  had  no  objection,  but asked  that  a                                                               
conforming title be added.                                                                                                      
SENATOR GIESSEL agreed to a conforming title change.                                                                            
CHAIR  WILSON  asked  Ms.  Glover if  the  committee  could  also                                                               
request an  explanation of the  changes that accompany the  CS as                                                               
MS. GLOVER answered yes.                                                                                                        
6:27:47 PM                                                                                                                    
CHAIR  WILSON announced  that  hearing  no objection,  conceptual                                                               
amendment 1 is adopted.                                                                                                         
6:28:04 PM                                                                                                                    
At ease.                                                                                                                        
6:28:20 PM                                                                                                                    
CHAIR  WILSON called  the  committee back  to  order. Finding  no                                                               
further objection, he solicited a motion.                                                                                       
6:28:46 PM                                                                                                                    
SENATOR  VON  IMHOF moved  to  report  SB  91, as  amended,  with                                                               
forthcoming updated fiscal note(s).                                                                                             
CHAIR  WILSON  announced  that there  being  no  objection,  CSSB
91(HSS)  moved  from  the  Senate   Health  and  Social  Services                                                               
Standing Committee.                                                                                                             

Document Name Date/Time Subjects
Leg Legal Memo SB 91.pdf SHSS 3/15/2017 1:30:00 PM
SB 91
CSSB 91(HSS) v D.pdf SHSS 3/15/2017 1:30:00 PM
SB 91
CSSB 91(HSS) v D sectional.pdf SHSS 3/15/2017 1:30:00 PM
SB 91
CSSB 91(HSS) v J.pdf SHSS 3/15/2017 1:30:00 PM
SB 91
CSSB 91(HSS) v J changes.pdf SHSS 3/15/2017 1:30:00 PM
SB 91
CSSB 91(HSS) v D FN2.pdf SHSS 3/15/2017 1:30:00 PM
SB 91
Alaska Mental Health Board Support SB 91.pdf SHSS 3/15/2017 1:30:00 PM
SB 91