Legislature(2017 - 2018)BELTZ 105 (TSBldg)

04/14/2017 05:15 PM Senate HEALTH & SOCIAL SERVICES

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* first hearing in first committee of referral
+ teleconferenced
= bill was previously heard/scheduled
-- Location Change --
-- Time Change --
<Bill Hearing Canceled>
+ Bills Previously Heard/Scheduled: TELECONFERENCED
Moved HJR 14 Out of Committee
-- Public Testimony --
Heard & Held
         HJR 14-FCC: INCREASE RURAL HEALTH CARE BUDGET                                                                      
5:20:50 PM                                                                                                                    
CHAIR  WILSON announced  the consideration  of HJR  14. He  noted                                                               
that the  legislation is time  sensitive and his intention  is to                                                               
hear  the bill,  take public  testimony, and  hopefully move  the                                                               
resolution out of committee.                                                                                                    
5:21:15 PM                                                                                                                    
TIMOTHY CLARK, Staff, Representative Bryce Edgmon, Alaska State                                                                 
Legislature, Juneau, Alaska, sponsor of the resolution, provided                                                                
the following overview of HJR 14:                                                                                               
     HJR  14  has  to   do  with  a  Federal  Communications                                                                    
     Commission (FCC)  funded broadband support  program for                                                                    
     rural centers  in Alaska and across  the country. Rural                                                                    
     Alaska has  made great strides  in recent years  in the                                                                    
     long  distance  delivery  of   health  care  via  tele-                                                                    
     medicine;  these  broadband   services  expand  locally                                                                    
     available  treatment options  for an  increasing number                                                                    
     of  maladies including  treatment for  substance abuse,                                                                    
     they  accelerate  diagnosis  and  treatment,  and  help                                                                    
     Alaskans avoid  expensive travel for care,  but despite                                                                    
     these advances, we are about to hit a roadblock.                                                                           
     The  existence  of such  services  depends  on the  FCC                                                                    
     Rural  Health Care  Universal Service  Support Program.                                                                    
     The budget for the program  has been capped at the same                                                                    
     level since  it was established in  1997, 20-years ago.                                                                    
     The  program   is  funded  through   Universal  Service                                                                    
     charges,  there  is  no state-funding  obligation.  For                                                                    
     most  of  the  program's existence,  the  $400  million                                                                    
     budget has been  enough to meet demand, but  as you can                                                                    
     imagine  after  decades   of  advances  in  technology,                                                                    
     increases in  demand, and the effect  of inflation, the                                                                    
     FCC expects  the demand exceed  the budget cap  for the                                                                    
     first time in 2017.                                                                                                        
     HJR 14 urges the FCC  to increase the Rural Health Care                                                                    
     Universal  Support budget  sufficiently  to adjust  for                                                                    
     inflation, to  keep up with advances  in technology and                                                                    
     services available  to increase broadband, and  to meet                                                                    
     the   increased   demand  for   these   broadband-based                                                                    
     services; additionally,  the resolution  encourages the                                                                    
     FCC to  index the program  budget for inflation  and to                                                                    
     allow any unused funds to  be carried forward to future                                                                    
     funding  years, this  will allow  health-care providers                                                                    
     to continue  improving access to  health care  in rural                                                                    
5:24:24 PM                                                                                                                    
SENATOR MICCICHE said he respects the noted names and                                                                           
organizations that support HJR 14. He asked Mr. Clark if he was                                                                 
aware of any opposition to HJR 14.                                                                                              
MR. CLARK answered none that he  was aware of. He noted that when                                                               
the  resolution  crossed  the  floor of  the  House  concern  was                                                               
expressed regarding  the way programs from  the Universal Service                                                               
charges are  funded. He opined  that the objection may  have been                                                               
related to  the potential  for increased  costs to  consumers. He                                                               
pointed  out that  a $200  million increase  to the  budget would                                                               
equate  to pennies  on consumers'  bills  because the  fund is  a                                                               
nationwide program.                                                                                                             
CHAIR WILSON asked Mr. Zasada if he had any comments to add.                                                                    
5:26:50 PM                                                                                                                    
JON  ZASADA, Policy  Integration  Director,  Alaska Primary  Care                                                               
Association, Anchorage,  Alaska, addressed  the need  to increase                                                               
the rural health-care budget as follows:                                                                                        
     This  issue  is  moving  quickly,  federally.  For  the                                                                    
     current  fiscal year  that we  are  in, some  community                                                                    
     health  centers  are  already  seeing  a  drop  in  the                                                                    
     subsidy  that they  are  receiving  through this  fund,                                                                    
     meaning  that some  providers'  monthly internet  bills                                                                    
     are  going up  from $500  a  month to  almost $4,000  a                                                                    
     month. The  cap-increase effort is very  timely, we are                                                                    
     working so  that it doesn't  occur for the  fiscal year                                                                    
     that starts July 1.                                                                                                        
     Additional ramifications  that I  wanted to  just share                                                                    
     with the  committee, certain SB 74  redesign components                                                                    
     could also be  endangered if the cap is  not raised and                                                                    
     these include: the ability of  rural providers to fully                                                                    
     use  tele-health, to  undertake  care coordination,  to                                                                    
     continue  to  support  mental-health  parity  in  rural                                                                    
     communities and in their efforts  to address the opioid                                                                    
     Basically,  rural  health  providers have  built  their                                                                    
     care   systems  around   dedicated  internet   that  is                                                                    
     subsidized  through   this  program  and  it   is  very                                                                    
     important. We  believe the state  of Alaska  showed its                                                                    
     full  support  to  the  federal  government  as  we  go                                                                    
     through the process of having the cap increased.                                                                           
5:28:44 PM                                                                                                                    
SENATOR MICCICHE asked if Mr.  Zasada believes that Alaska enjoys                                                               
more support  from the  program than what  the state  likely pays                                                               
into the program.                                                                                                               
MR. ZASADA replied that Senator  Micciche's query is probably the                                                               
case. He detailed that Alaska uses  about $100 million out of the                                                               
$400 million fund: $38 million  for community health, $27 million                                                               
for rural hospitals, and other care entities take up the rest.                                                                  
SENATOR  MICCICHE  explained that  his  question  related to  the                                                               
concern  about  increased costs  and  pointed  out that  Alaskans                                                               
enjoy much more benefit on a dollar value than what is paid in.                                                                 
MR. CLARK  stated that  his assumption is  that Alaskans  enjoy a                                                               
considerable  benefit from  the  program, far  short  of what  is                                                               
being contributed to the program.                                                                                               
5:30:44 PM                                                                                                                    
SENATOR BEGICH  commended Senator Micciche for  his question that                                                               
underscored the state receiving 25  percent of the fund. He asked                                                               
Mr. Zasada  to verify that the  state receives 25 percent  of the                                                               
MR. ZASADA answered correct.                                                                                                    
SENATOR BEGICH agreed  that the state really  is benefitting from                                                               
the fund to a great degree.                                                                                                     
CHAIR WILSON disclosed  that during his time  at Eastern Aleutian                                                               
Tribes he  was able to  see some of the  tele-health technologies                                                               
and its capabilities. He said he  could only imagine what some of                                                               
the  health-care centers  are  doing  now in  some  of the  rural                                                               
entities to try to hopefully lower health-care costs.                                                                           
5:32:09 PM                                                                                                                    
CHAIR WILSON opened public testimony on HJR 14.                                                                                 
5:32:24 PM                                                                                                                    
CHAIR WILSON closed public testimony on HJR 14.                                                                                 
5:32:39 PM                                                                                                                    
SENATOR  MICCICHE  moved  to  report  HJR  14,  version  J,  [30-                                                               
LS0422\J],  from committee  with  individual recommendations  and                                                               
attached zero-fiscal note.                                                                                                      
5:32:49 PM                                                                                                                    
CHAIR  WILSON announced  that being  no objection,  HJR 14  moved                                                               
from the Senate Health and Social Services Standing Committee.