Alaska Legislature: Senate Labor & Commerce, 4/10/26, 1:30pm

For the record,

this is Haley.

I'm a stroke survivor and OT patient in Savannah,

Alaska.

I was actually shocked to hear that rehabilitation was not a part of the language in the state statute.

My number one goal as a patient is getting back to my pre-stroke life and getting my independence back and that includes...

rehabilitation and not just coping and working around the problem it's tackling it head-on so in closing I support House Bill 110 thank you very much

Thank you for your testimony,

Ms.

Vest.

We'll go next to Steven Salinas.

Hello,

through the chair.

For the record,

my name is Stephen Salinas. I'm an occupational therapist who lives in Sodotna, Alaska working at Central Peninsula Hospital serving an area around Sodotna.

I'm calling in to show support for HB 110.

My peers in the field and previous patients who've came into the clinic have put it very well.

Just to reiterate,

this bill would be wonderful for making sure that all the patients in Central Alaska could access a standard of care that would be more in line with the federal standards.

Thank you for your time.

Thank you very much,

Mr.

Salinas. We'll go next to Brian Harder.

Through the chair, for the record, this is Brian Harder. I'm an occupational therapist who lives in Homer,

Alaska.

I provide occupational therapy services to Alaskans in several rural communities at South Peninsula Hospital Home Health from the Kiskee down to the head of the bay in the Kachemak Bay.

As previously said by Brittany Garner and my other colleagues, I agree with everything that they've addressed,

and I fully support House Bill 110.

Thank you for your time.

Thank you very much, Mr.

Harder.

Next we'll go to Margaret Rutkowski.

Please state your name and affiliation for the record and begin your testimony.

Through the chair, for the record,

this is Margaret Rutkowski.

I'm an occupational therapist who served on a travel contract in the Alaskan rural communities in Danilchik, Tustamina, Saldana, and the Kenai Peninsula.

As Brittany Gardner and my other colleagues have stated,

I'm fully in support of House Bill 110 and believe that it would be great for the state of Alaska and the patients in the communities we treat.

Thank you for your time.

Thank you for your testimony.

We appreciate your participation.

We'll go next to Karina Wade.

Please state your name and affiliation for the record and begin your testimony.

To care for the record,

this is Corinna Wade.

I am an occupational therapist in Palmer,

Alaska,

serving patients in the Mat-Su Valley area,

and I am in support of House Bill 110 to update the language to improve Alaskans' access to high-quality care after any of their events that revolt with them. I work at the hospital here,

and I'm very humbled to work with patients across the lifespan.

at using high quality evidence-based practice and I think that House Bill 110 would fully or would significantly improve their access to improved health care.

Thank you for your time.

Thank you very much Ms.

Wade.

Is there anyone else in the room or online who would like to testify to this item?

Please come forward.

Please state your name and affiliation for the record and begin your testimony.

Through the chair, thank you, chair and committee members,

for allowing me to speak today.

For the record,

my name is Tori Dottere and I am an occupational therapist.

I am available for technical questions today on behalf of the State Physical Therapy and Occupational Therapy Board,

as I am a member and secretary of this board.

This board is our state's licensing board for OTs and OTAs, as well as PTs and PTAs, and this board creates regulations based on statute to carry out the law.

the legislative intent.

Very good.

Very good. I have a question for you.

Yes.

Ms.

Doherty, thank you for being here today.

What is your opinion about this bill?

Through the chair,

Through the chair, for the record, this is Tori Daugherty.

I am only able to address technical questions today due to new guidance from the Governor's Legislative Office,

but I can defer to Director Sylvan-Robb if you have further questions along those lines.

I apologize.

That's okay,

That's okay, Ms.

Daugherty.

Let me try again.

Technically,

how would this bill affect the function of the PT and OT board?

Through the chair, for the record,

this is Tori Daughtery.

This bill defines the Occupational Therapy Scope of Practice.

So it breaks down areas within the scope of practice that are not currently addressed within Section 8.8.4.190 number three.

Back in 2023,

the licensing board had requested a law opinion in response to a scope of practice question.

And then that law opinion had highlighted there's a previously unrecognized limitation.

In Section 884-190-3,

it identified that the scope of practice does not recognize OT's role in improving,

enhancing,

or recovering a patient's function.

So if a therapist were to be a very black and right,

straightforward,

follow the letter of the law provider.

Then the letter of the law does not define that a therapist should be helping the patient to get better.

They should only be helping them to cope with the deficits that they currently have.

And that is different than just basic national standard of care.

So when this bill outlines the different areas of a therapist's scope of practice,

it allows opportunity for the licensing board to create regulations accordingly.

And then it opens up scope of practice to include the concept of improving, enhancing or recovering a patient's function.

Thank you.

Thank you. That was helpful.

Thanks.

Any further questions?

Thank you very much.

Thank you.

Is there anyone else in the room or online who wishes to testify to this item?

Seeing and hearing none, at this time we will close public testimony on House Bill 110.

At this time we will set House Bill 110 aside for further consideration at a future meeting,

and we will take a brief at ease while we set up for our next bill on our agenda.

Back on the record, it's 2.20 now in Senate Labor and Commerce. Up next we have Senate Bill 272, sponsored by the Honourable Senator Forrest Dunbar. It's their first hearing on the bill. To present the bill we have the bill sponsor, the Honourable Senator Forrest Dunbar and his staff,

Halen Banken. Welcome back to Senate Labor and Commerce. Please place yourselves on the record and begin your presentation.

Thank you, Mr.

Chair.

This is Forrest Dunbar, State Senator from District J.

Halen Benkin stopped Senator Dunbar.

Thank you, Mr. Chair, for hearing this bill,

members of the committee.

This is a health and services committee bill that is primarily a cleanup related to rapidly changing and improving the rapidly changing and improving world of health information exchanges and electronic health records.

The Health Information Technology for Economic and Clinical Health High-Tech Act of 2009 mandated the adoption of electronic health records across states by linking federal funding to rigorous technical standards.

High-Tech removed the fragmented state-by-state approach to medical record-keeping and replaced it with a unified national vision.

In response,

the 26th Legislature passed SB133, providing the framework to establish a statewide health information exchange.

Exchange and improve the safety,

cost-effectiveness,

and quality of health care in Alaska.

Since 2009,

both EHRs and HIEs have matured and evolved,

necessitating updates to Alaska's HIE law.

SB 272 before you today improves the holistic approach to Alaska's HIE while continuing to uphold the strict privacy and security standards required by law.

Key changes in SB 272 include providing clarity in the division of responsibilities between the Alaska Department of Health and a designee administering the HIE system,

ensuring that an individual who is the subject of individually identifiable information can authorize disclosure of their information for purposes they choose.

clarifying the scope of data by providing specific detail on allowable uses for limited health care operations and codifying public health as a primary allowable use and adding a representative to the governing body representing behavioral health providers.

SB 272 does not change the core allowable uses of the health information exchange but provides updated and clear language ensuring that Alaska's HIE effectively functions as core health care.

care infrastructure.

And I would say for technical questions on this bill,

I will defer to our invited testifier, Ms.

Kendra Sticka.

Mr.

Chair, we also have Halen. Mr.

Benken has also prepared to provide a sectional for the committee.

Excellent. Thank you, Senator Dunbar. Are there any questions before we have Mr.

Benken run us briefly through a sectional analysis?

Hearing and seeing none, Mr.

Benkin.

Thank you, Mr. Chair.

Section one of the bill amends A.S. eighteen point two three point three hundred A_ to refine the department's mandate uh for the statewide H_I_E_ emphasising the interoperability and compliance with state and federal protocols for data exchange.

Section 2 repeals and reenacts AS 18.23.300b, requiring the commissioner to designate one or more qualified entities to perform specific tasks overseen by a body of health system stakeholders.

It outlines their responsibilities and requires them to submit an annual budget, comply with non-discrimination and privacy laws,

and provide cost-saving data to the department.

Section 3 amends AS 18.23.300c.

to seek both directing the department and its designee to seek both public and private funds and equipment and clarifies the department's authority.

Section 4 amends AS 18.23.300 regarding the designee's governance and composition,

specifically allowing for the designee to be a private for-profit or non-profit entity under state contract.

It also increases the number of representative individuals on the governing body from eight to nine by adding a representative from behavioral health providers.

Section five amends A_S_ eighteen point two three point three O_ five regarding department duties by mandating consultation with the designee on system development.

facilitating applications for available funding and providing for self-sustaining requiring the system to become self-sustaining through user fees and other funding sources.

Section six amends A_S_ eighteen point two three point three one zero uh require regarding confidentiality and security of information, adding privacy and disclosure standards for individually identifiable inform individually identifiable information.

limiting the release of that information and establishing patient opt-out procedures and notification protocols in the event of confidentiality violations.

Section 7 provides a definition of system under AS18.23.325.3 and Section 8 adds a definition of designee.

as the entity or entities designated under Subsection B.

Finally, Section nine provides for an immediate defect effective date of this bill.

Thank you, Mr. Chair.

Thank you, Mr. Bencken. Are there any questions from committee members?

Hearing and seeing none, we'll go now to invited testimony.

First up, we have Kendra Sticca.

Ms. Sticca, welcome to Senate Labor and Commerce.

Please put yourself on the record and begin your presentation.

Thank you, chair.

For the record,

Kendra Sticca, executive director of Healthy Connect Alaska,

the state designated HIE.

In terms of this bill, I think Senator Dunbar outlined it very well.

It really is an effort to modernize the bill to be in alignment with what's current standards in electronic medical records as well as health information exchange.

It positions the state to do well to align with federal standards and federal initiatives around health information exchange while we retain the state level governance of health systems, health information systems while still being able to align with federal initiatives.

A key piece, as Senator Dunbar pointed out, is looking at our governing board and ensuring that there's behavioral health representation as we really think about health care as being much more holistic.

ensuring that that representation is there.

Clarity in language sometimes seems small but is really critical as we think about exchanging health information that some of the most private personal information that people have it's really important that the language is clear so it's very everyone understands how the health information exchange can and cannot be used what types of these cases so a huge part of the clarifying language is to ensure that everybody is clear and the language is very clear on that ensuring also the clarity and what is the responsibility of the

of the Department of Health and what's the responsibility of the designee that's actually administering the Health Information Exchange

and then the element of allowing

about the person who is the information is about to direct their information to be used in ways they would like is really critical to maintain that personal choice over information exchange and allow efficiency and how individuals can access and get their records to where they would like it to be happy to answer questions as it's helpful

Thank you very much, Ms.

Sticca.

Are there any questions from committee members?

Mr.

Gowee, appreciate you being available today.

I have just a kind of an informational educational question.

I really know nothing about this topic, so I'm hoping that you can maybe break it down from two perspectives.

How would a patient interface,

how would they use or interact with the state's health information exchange?

Thank you for the question,

Chair.

At this point, the data comes in from electronic medical records at the provider level,

so the patient doesn't directly interface with it, but when a health organization,

whether it's a private physician or a hospital, whatever that healthcare system is,

connects to the health information exchange,

when they document in their electronic medical record,

it comes into the health information exchange repository that then other participating...

members of the health information exchange,

those providers who have a relationship with that patient,

so it's all based on HIPAA protected patient relationships,

they would be able to see the patient's record.

So while the patient doesn't interface with the health information exchange directly,

it means if they are seeing,

for example, at a private practice clinic in one place and then they end up in the emergency room somewhere else,

the records would be immediately available.

available for their care.

Excellent. Thank you. So do I understand the answer to your question then to mean that that type of information availability is not currently available to providers?

It is available to providers it's not available directly to the patient so the patient wouldn't look there but the provider would look there for the patient's information.

If I'm— I apologize

Okay.

for not asking

That's okay.

questions correctly.

I'm just trying to track what it is that the bill does.

So can you please describe how providers and patients interact with this type of information under current law and how things would change if this bill were to be passed for providers and patients?

Absolutely.

So in current state, and largely things would stay the same, so I'll highlight a couple changes,

but largely it would stay the same that just clarifies how it works.

So current state,

healthcare organizations who sign a participation agreement with us so that we cover the legal protection so that we fall under all of the privacy standards around health information,

we would connect to their electronic medical records. So we will use an example of

We would collect—

Epic is a large medical record provider so that's just one example but there's lots so if I am a health care organization who uses Epic and I want to connect to the health information exchange basically we would set up a pipe that connects from that health organization's Epic system to the health information exchange then anytime certain

Things happen. Data is entered into that Epiq system.

It automatically flows into the health information exchange repository.

So there's not a manual sending information,

faxing information,

calling a person. It automatically flows in.

So that's coming from all sorts of health organizations around the state and sitting in the health information exchange repository.

We have all this privacy and security standards around that health information.

So then when any of those participating health care.

care providers who are part of our network log on to either directly to our portal or some electronic health records can just allow it right through their electronic medical record system so epic for example they would be able to see all that information for the patients that have a known relationship with them so there's back-end stuff that makes sure it's just about their patients so then they would have access for example if I end up you know I'm up in Juno visiting you all but I have my health care in Anchorage

and I end up in the hospital in Juneau they would have the records from the providers that send information to the HIE so if they need to treat me there they wouldn't have to be calling to get faxed records that sort of thing so I'll pause there for a minute is that any other questions on kind of how it exists that sort of the basic functional level and

then I can talk about just

Nope, that was good.

Nope, that was good. Please continue.

So largely it would stay the same with this legislation. Right now, one piece that's different,

the piece that Senator Dunbar read about allowing an individual who is the subject of that information to be able to authorize disclosure somewhere else. Right now, everything falls under HIPAA standards, which means treatment,

operations and payment.

So those are the only things we can allow.

records to go out for.

Where this has come up, for example,

that we feel like there are some things that would be beneficial to Alaskans is if I, for example, am applying for something that requires me to document that I have a medical disability and I know there's records from 12 different places that show that and it's all in the HIE.

The way the existing statute is written,

I can't say please HIE allow my records to be used.

based on the HIE so one central place to show my disability determination I would have to whoever's doing that disability determination would have to go to each of those separate 12 providers so this piece of allowing an individual to say and again this is only if an individual says they want to use this way they could authorize that their data will be able to be used for this that things to create efficiencies and systems right now we don't that technology is not necessarily set there

up there because our statute hasn't allowed it anyway but it would give that type of provision so that's one piece of change the other pieces are largely again related to how we're structured in terms of our governing board the governing board as you see really represents a wide sector of health care you know sectors of health care but behavioral health has sort of often been left out of that historically so it's really to rectify that so we make sure as we're setting up systems that we have that perspective of behavioral health providers

And then some of the language was just kind of messy because when the original statute was set up, health information exchanges were really more of a vision than a reality.

So as they rolled out and the reality came to be, the language just wasn't clear. So it wasn't necessarily clear what's the department's responsibility,

what's the designee. So for example, Health and Connect.

responsibility so it's really sort of clarifying that language but largely the use cases allowed don't change with the bill in terms of data can't be used people's individual data can't be used in different ways than it was is under the current statute

Understood.

Okay.

Thank you for that. Any further questions?

Seeing hearing none on the phone from the Department of Health is Mr. Jason Ball.

He is the chief data officer.

Are there any questions for Mr.

Jason Ball?

Seeing hearing none,

Senator Dunbar, do you have any closing comments on this bill?

Thank you, Mr.

Chair. Just briefly,

I think your questions were the most important ones,

which is what does it do and how is it different?

And what's the difference experience for the patient?

By and large today and after this bill passes,

the patient experience should be largely the same. This is back office style infrastructure that most of us don't even realize is operating. But it's also crucial if we go to different providers, we want our health records to be available to those.

for those providers.

And as Ms. Sticca indicated,

there's some very specific instances where this bill would help those flow a little better.

And then,

of course, it does add that seat for behavioral health.

So thank you very much for hearing the bill.

And I'm sure if there are follow-up questions,

Ms. Sticca would be available to answer those as well.

Thank you, Mr.

Chair.

Excellent.

At this time, we will set Senate Bill 78 aside for further consideration at a future meeting.

The Senate Labor and Commerce Committee will meet again on Monday, April 13th and we will take up Senate Bill 111, Digital Product Repair and Senate Bill 121, Health Insurance Allowable Charges. As there is no further business to come before the Senate Labor and Commerce Committee today,

we are adjourned at 2:36 p.m.