Alaska Legislature: House Health & Social Services, 4/7/26, 3:15pm

This meeting of the House Health and Social Services Committee will now come to order. It is 3:44 PM, Tuesday, April 7th, 2026, in Davis 106. Members present are Representatives Schwanke, Mears, Prox, Fields, and myself, Representative Mena. Chair, let the record reflect that we have a quorum to conduct business. Please take this time to silence your cell phones for the duration of the meeting. Staffing the committee today, we have Andrew Gianotti, our Health and Social Service recording Social Services recording secretary, Chloe Miller, our LAO moderator, and Katie Giorgio, my committee aide. If you need anything during the meeting, please don't hesitate to get her attention. First up today, we have House Bill 272 by Representative Andy Josephson on insurance coverage for prosthetics and orthotics. We also have available for questions Heather Carpenter, Director of the Division of Insurance. Do we have any additional questions or comments on House Bill 272? Representative Prox.

Well, I, I would just like to confirm that I understand correctly that the state of Alaska is going to end up picking up the tab.

So, Director Carpenter.

For the record, Heather Carpenter, Director of the Division of Insurance. I can only speak specifically to the Division of Insurance's fiscal note, but through the chair, Representative Prox, you are correct that the state— that is why we have a fiscal note that has a specific amount. We would need to defray the cost to the individual and small group markets, so you would be allocating us money so we can pay the insurers for these claims.

Follow-up for Medicaid? That's what was mostly unclear to me, was the Medicaid part of it.

Uh, through the chair, Representative, you will have to ask the Department of Health. They have an indeterminate fiscal note, and they will need to speak to that.

Any other questions or comments from the committee? Representative Schwanke.

Thank you, Madam Chair. Ms. Carpenter, I was just kind of curious on the last committee hearing. I think we heard that the estimated increase for insurance premiums would be a couple cents, and I was just kind of curious if you could expand on that a little bit more and who Who does that— who does that cover?

What insurance companies statewide, nationwide? Just kind of curious if you could expand on that a little.

Through the Chair, Representative. The insurers that are in our market that would be impacted by this bill are Premera, Moda, UnitedHealthcare, and Aetna, which is only in the large group. So they would have to— It's for any insurer under Title 21 regulated by the division. So as a reminder, that's about 15% of the healthcare marketplace in Alaska. In our fiscal note, we did estimate it that the premium dollar amount of premium cost for member would be 40 cents per member per month. We did our best estimates, multiplied that by 12 months and by the 47,000 individuals and small group market members in Alaska. That came up with our about $225,000 for the first year. Okay, thank you.

Representative Prox, and I, for the record, Representative Gray joined us at 3:45 PM. Representative Prox and then Fields.

Thank you, and through the chair, when you made your estimates, did you account for likely increase in demand based on the fact that the insurance is going to pay for it? Or how did you arrive at your estimated demand?

Through the chair, Representative, we tried to use our best estimate of what that demand uptake would be. We may be too low. I would remind you, the advocates last hearing said we were too high. So, you know, we tried to not overestimate that but be realistic about what that cost would be.

But just a quick follow-up, but you did take that into account that there's likely to be probably considerably more demand for these prosthetics?

Through the chair, we tried to use our best estimate without over-inflating it, and there may be some who don't want a second device. And again, you know, we may be, we may be too low. We tried, we built in what we felt like was a fair inflationary increase at that 5%, noting that that durable medical equipment is expensive. It usually jumps. So we tried to, again, keep that defensible and not overestimating those costs.

Okay, thank you.

Any other questions?

Representative Yeltsin?

Um, yeah, I asked the department if there were any technical changes they'd recommend to the bill, and the only one that Ms. Carpenter recommended was just to change the effective date in Section 1 to align with the start of a policy year. So maybe we could just do that through a conceptual amendment before we move the bill. What do you think? Assuming the bill sponsor doesn't object to just doing that.

What's your recommendation for the effective date?

January 1, 2027. Right, and just to line up with the policy year for insurance.

Which, uh, which page, which line?

Let's see.

Through the chair, if I, if I may, um, effective dates usually go at the end of the bill, so it would go

In on page 5 after line 16, but it would be specific to Section 1. So it would be a new section. Okay. Uh, and the— what would that effective date for Section 1 be? Excuse me.

January 1st, 2027.

Okay.

And we don't have to, but I figure if we can do that now, why not?

Okay. At ease. Back on the record. Representative Fields.

I move conceptual amendment number 1. Conceptual amendment number 1. On line 17 of page 5, at Section 8, it adds an effective date referring to Section 1 of the bill, and it says Section 1 of the bill's effective date is January 1st, 2027.

Is there any objection? Seeing no objection, Conceptual Amendment 1 has been adopted. Is there any further discussion from the committee on House Bill 272? Seeing none, I would now entertain a motion to move the bill from committee.

Chair Mina, I move House Bill 272, Work Order 34-LS1296/N, as in November, from committee with individual recommendations and attached fiscal notes.

Amended.

Oh, as amended.

Is there any objection? Seeing none, House Bill 272 as amended passes from committee. We'll take a brief recess to sign the committee report. Back on the record. Our next item on our agenda is the, uh, additional hearing on House Bill 157 on adoption decree on siblings by Representative Gray. Uh, and we have available for questions Kim Swisher, Deputy Director of the Office of Children's Services, as well as Carla Erickson, Chief Assistant Attorney General. With the Child Protection Division. Do we have any questions or additional discussion from the committee on House Bill 157? Representative Prox?

Yes, thank you. Through the chair, I don't recall hearing from a foster parent's perspective. If Ms. Swisher might give us some insight on that, that would be appreciated.

Uh, Deputy Director Swisher, could you perhaps provide some insight on foster parents as they relate to Hospice 157?

Uh, this is Deputy Director Kim Swisher for the record. Um, to Representative Prax through the chair, I am not sure that I know of any feedback from, uh, licensed foster parents regarding this particular piece of legislation. But I, I will say that, as we've mentioned in other hearings, the definition as it holds would create a new category of adult family member. And so that could change the status of a nonrelative foster parent in these situations. So I hope that that helps answer your question.

No, but I'm not sure we can sort that out at this point.

And it looks like Representative Gray also has a comment.

Thank you. Through the chair to Representative Prox and to Deputy Director Swisher, something that since the last hearing that my staff and I have discussed is The— what, what Miss Erickson had said at the last hearing was talking about this— a foster parent, a non-relative foster, a non-relative adoptive parent becoming a preferred placement for a sibling. And there were a couple of things that weren't said then, but I think it might inform Representative Prox's question. And one was, well, they would be treated like a grandparent placement. But of course, when that initial foster child was adopted, the grandparent at that time would have been considered, and for whatever reason, the grandparent wasn't, or the grandparent declined. So I think that there's some logic in that adoptive non-relative placement being considered on par, because you'd want— siblings to be together. And I know that when we adopted our son, uh, we were asked, if another child that is his sibling comes into the world, would you be willing to consider having that child placed with you? And, and, and we said yes. That never happened, but, but I mean, so that is part of the conversation. And I don't know if, um, Deputy Director Swisher has any comment on that, of anything that I said, but, but I just think that's something that we've been thinking about and talking about since the last hearing, that there's some logic in that non-relative adoptive parent being considered as a preferred placement for any siblings in the future, since the whole process would have gone through with that initial placement. Follow-up.

Follow-up.

So to Rep. Gray, you have experience, I don't, except tangential. But just thinking back, friends, and this— I can see the logic in this. It would be important to the siblings. My concern would be, would it be more complicated for the potential foster parents, and would it discourage foster parents from becoming involved in becoming a foster parent?

Thank you. Through the chair, this is about adoption, right? And so it's a little bit different. And when— and again, I don't want to speak for Deputy Swisher, Deputy Director Swisher, so I, I mean, she can answer or I can correct, but, or she could correct me. But the bottom line is, is that when you become a foster parent, it's, uh, you, you're agreeing to a certain number of children. And most of the time, the reason why siblings are separated is because

The group of siblings is too large for one foster family. So, that's why you end up with two kids with one foster parent and two kids with another foster parent and one kid by themselves. And so, I don't— and then, and that's when you lead to, you know, two of the kids being adopted, but not their three siblings, because that foster family had agreed to take two children, not five. And so, I don't think this would discourage or change anything from a foster parent's perspective, but Deputy— I would ask that Deputy Director Swisher comment.

Deputy Director Swisher?

And I'm using— I'm sorry, using the wrong term— adoption, adoptive parents.

Oh, very good clarification. So Deputy Director Swisher, can you comment with adoptive parents specifically?

Um, this is Deputy Director Swisher for the record, uh, to Representative Prox and, um, Gray through the chair. I, I don't actually know that I have anything else to add. I think they're— it's very speculative, and I don't have any evidence to indicate one way or the other, um, how that would influence a person's choice in this situation. I think we'd need to hear from adoptives or licensed foster parents to get their opinion.

Okay, thank you.

Representative Schwanke. Thank you, Madam Chair. Deputy Director Swisher, I was curious if you had any comments on the creation here of a new definition of sibling with that second part at the end of the bill, because I, I'm a little concerned about that. I I don't completely understand where it was coming from when it was drafted, but there are a lot of children that grow up with a lot of different people during a lot of different periods of their life. So is that going to be a concern, do you think, in implementation? Deputy Director Swisher.

Kim Swisher for the record. And I apologize, the phone cut out, but I believe that was Representative Schwonke to the Chair. Yes. Or yes, okay, thank you. I think we've outlined it in our response to the bill that there would be some increased administrative burden possibly. And I think in terms of like the legal repercussions, I'd like to defer that to Carla Erickson for further discussion. But we have, you know, outlined that there's potentially, as written, this law could include increased costs or administrative burden for notifications. And so, that could be additional work for our agency. But, you know, we support this type of legislation in general. Like, we want siblings to be together. And we want siblings to remain in contact. I think just as it's currently in this current form, we do have some questions.

Okay. Chief Assistant Attorney General Erickson, did you want to add any additional comment?

Thank you. For the record, Carla Erickson, Department of Welfare Protection Section. Through the Chair, it does raise— that section raises some questions. That definition doesn't appear in the child need of aid statutes, and so it's a different definition. As I mentioned at the last couple hearings, there are several definitions. Throughout the Child Need of Aid statute depending on what section you're talking about and for what purpose, like for information exchange in 4710.093. Also, there's another definition in 4714.100(r), which is a section that already emphasizes placement with siblings if they had been living together at the time of their removal. But then this definition is a little different than that, and as the representative noted, there are timeframes that aren't— defined, and when things are not defined, it can lend themselves to litigation. That section feeds into Section 2 that requires the court to determine— shall determine whether post-adoption visitation with the siblings is in the best interest of the minor. Again, this is taking place under the adoption statutes, which is a probate matter, and those parties are are similar, lots of similar parties, but not the same as what's happening in China cases. To the extent this was meant to have some sort of evidentiary hearing, like what does constitute the best interest of a minor in any particular situation, that could create some implementation, putting into operation how that's supposed to work between both, both matters. In theory, The adoption judge is supposed to be the same judge that heard the child need of aid matter, and that's very often the case, but sometimes not. So those are some outstanding questions with that definition. It's hard to say, though, how much litigation there will be, but probably some, just given the lack of clear definitions or boundaries.

Thank you. Representative Gray.

Thank you. Through the chair to Representative Schwanke. We have met with lawyers, and when we get to judiciary, we have basically two choices before us. So I'm going to just basically speak very briefly about what will happen in the next committee, if that's okay, Madam Chair. Go ahead. So this very broad definition of siblings I think that very broad definition of siblings makes sense to the original intent of the bill, that a judge would tell the new adoptive family that this child that you're adopting has existing relationships with, you know, even a kid that's not related by birth but has spent every moment with them since birth, and we think that they should continue that relationship. That can stand alone. The problem is if we're doing this legal definition in the middle. So if we strike the legal definition, then I think we can leave this broad definition of siblings in, since really it would just be almost like intent language to the judge to, you know, that you should remark upon this at the adoption. However, if we decide that we are going to keep Section 3 then we would need to strike Section 2 of Section 4. Mainly, in other words, we would need to go to a more narrow definition of what a sibling is that would match the existing statutes. And that is, I think, something that is legal questions that can be dealt with in judiciary about which the best path forward is.

Okay.

Could you restate that last part for me? So if we keep Section 3, we still need the definition?

I think if we If we keep Section 3, from my brief conversations with lawyers, we would need to adhere to a more narrow definition of a sibling. If you're going to change what is a legal sibling, then we should use the definition of sibling as it appears in other parts of China law.

I just wanted to add on this as well. Looking back onto what I believe Attorney General Eric— Chief Assistant Attorney General Ericsson said on— I think it might be in the China statutes or excuse me, this is in placement. So, I'm looking at 47-1400-R and I believe that was also included in the bill packet. So, they define sibling as sibling means 2 or more persons who are related by blood, adoption, or marriage as a child or one or both parents. So, are you looking at in the next committee narrowing that definition, narrowing the definition to the bill to what's in Title 47?

Thank you, um, Representative Mena. I'm not prepared to answer. What the lawyer said is that if we're going to keep the legal— if we're going to do the legal change, we need to make sure that the definition of sibling is a bit narrower than how broad it is in this bill.

Okay. One other area that I know less about, but I also think could— I don't know if it should be considered— is tribal adoption. And I don't know who to ask this question to. Maybe I'll start with Deputy Director Swisher. In the current definition for this bill, ought we consider to incorporate tribal adoption as part of the definition for sibling?

Boy, I'm sorry. This is Deputy Director Swisher for the record. Chair Mina, I— that is a tough question for me to answer. I feel like that requires a legal mind, and I apologize for not being able to answer that more clearly.

Well, I might pivot to— that's okay, Deputy Director Swisher. I'll pivot to Chief Assistant Attorney General Erickson. Do you have any perspective on incorporating tribal adoption in the sibling definition?

For the record, Carla Erickson, Department of Law Child Protection Section, Chair Mina. I think what you're asking is if you're expanding the definitions to mean a sibling is through biological or through adoption, including a tribal adoption. Is that correct? Is that the question?

Yes.

Yes, it is. I want to like caveat, I want to think about that more, but I think the answer is going to be yes,

Course, the state does recognize tribal adoptions, either done cultural adoption through a kind of a regulatory mechanism as well as tribal adoption through their tribal courts that are then— the state is made aware of. So I will say yes, but I also reserve the right to like see what that looks like if the language is changed at a future iteration.

All right, and it looks like Representative Schwanke has another question.

Yeah, thank you, Madam Chair. I just wanted to kind of follow up on that.

We—

I didn't have it in front of me, I meant to bring it, but I believe the ICWA definition of siblings and family members are actually significantly more broad than our state definitions, and so wouldn't that trump any of the state-defined terms that we put in statute when it comes to tribal adoption?

Chief Assistant Attorney General Erickson.

Yes, for the record, Carla Erickson, Department of Law. Through the Chair, that's true. The definition of extended family member under ICWA is much broader than the adult family member definition under 47.14-100, which is kind of what we're talking about right now, and it does include that definition through adoption as well. I was limiting my remarks to the legal effect of a tribal adoption on state actions. And to that end, we do— the state does routinely recognize the validity of tribal adoptions. And so if a child is adopted through a tribal adoption to a family, we would consider them— that would get that full faith and credit normally. I wouldn't expect it to be different here, but again, I definitely want to see how it's written if the language does change.

Thank you. I have another question. I think it might be toward the bill sponsor. So I was looking at another area of statute and listening to the testimony and the bill presentation. I know that the heart of this bill is when you're separating two siblings, there's no mechanism to have that contact, and they don't know where the other sibling has even gone to when they're adopted. And so I believe it's AS 2523-150 subsection C. It's not in the bill, but it's in statute, and it's related to the confidentiality of the adoption decree. I believe the adoption information is only available to the parents who adopt the child, but not to the sibling. And so This bill doesn't include that. Is there interest in also looking at that statute and broadening the confidentiality of that adoption decree so that a sibling does know where their other brother or sister or sibling has been adopted into?

Thank you for the question, Chair Mena. I would need to think on it and discuss it with lawyers. Since I'm not an attorney, but yes, I'm open to discussing ways of siblings finding each other or having a mechanism of finding each other.

And I appreciate that. And knowing that this bill, the next committee is Judiciary, and I am also on that committee, we can discuss this a little bit more. I'm wondering, Chief Assistant Attorney General Erickson, if you have any perspective on opening up the confidentiality of those adoption decrees to siblings in that narrow way.

Thank you. For the record, Carla Erickson, Department of Law. Jeremina, I also would want to think about that. That is a— I'm not sure what those ramifications would be, and I'd want to see what that looks like. A proposed bill before I kind of shoot from the hip on that.

Thank you. One last question that I have also for Chief Assistant Attorney General Erickson: What are the legal rights of siblings, and how does that compare to the legal rights of parents?

Carla Erickson, Department of Law and Child Protection. I'm not sure I understand— I'm not sure I understand the full context of your question. Can you ask it another way?

Yes, I can. I know that last week— and we've talked about this a little bit before, but when we were talking about what does this materially change in terms of a sibling's ability to contact their other sibling, etc. I mean, one of the examples offered was inheritances, and so I'm wondering if you could talk about other legal aspects or where in statute are those legal rights as it pertains to siblings.

Thank you. For the record, Carla Erickson. I can only speak to kind of what my area of expertise would be is child need of aid and rights of siblings within the context of child child need of aid or permanency. And as I mentioned, I think the first hearing, you know, if siblings are still siblings after the adoption, then certainly inheritance would be impacted as that's listed in the section, 2523(a)(1). I can't really speak outside of China to the full extent of sibling rights that would be impacted in other areas of law that I'm not familiar with. And not even much more than inheritance other than seeing it written right there. I'm sorry, I can't be more responsive to that.

Oh, that's okay. I think my interest— I know we've passed the amendment deadline for House Bill 157, and I definitely support the spirit of the bill. I am interested in trying to explore these other parts of statute that we haven't discussed thoroughly in the Health and Social Services Committee, but seeing that this is as much of a child welfare bill as it is a very legal bill. I think we can have and continue those discussions in the Judiciary Committee. So that's my interest there. And I'm also interested in just trying to figure out what, what would the difference in impact be, good or not, to create new additional legal rights for these siblings and how that impacts parents. And so I just know about the inheritance examples, and I think if we could follow up with the Department of Law and just know about what what else would happen.

Thank you, Representative Mena. I look forward to exploring those questions myself.

Wonderful. Representative Prox.

And, and I, as I recall hearing, there's two very competent people, members of this committee, that will be on the Judiciary Committee.

Oh, I hope so. I think I'd be happy to leave it up to them. Wonderful. Yeah, and definitely I'm interested in helping clean up the sibling definition, whether it's narrowing it or removing it, and just teasing out these— those different examples. Any other questions or comments from the committee? Seeing none, I would now entertain a motion to move the bill from committee.

Chair Mina, I move House Bill 157, work order 34-LS0458/i, as in India, from committee with individual recommendations and attached fiscal notes.

Is there any objection? Seeing none, House Bill 157 passes from committee, and we'll take a brief at ease to sign the committee report.

Back on the record.

Our last item on the agenda today is House Bill 376 by the House Education Committee on expanding early intervention services for children. And available for questions, we have Niamh Dardis, Director of the REACH Infant Learning Program. Amy Simpson, Executive Director of the Programs for Infants and Children. Susan Kessler, Early Intervention Unity Manager at the Division of Senior and Disability Services. Tony Newman, Director of Senior and Disability Services. Richard Saville, Program Coordinator II on the Governor's Council on Disabilities and Special Education. And Nicole Wary, Administrative Operations Manager with the Division of Senior and Disability Services. Full crowd. Public testimony on House Bill 376 is now open. First off, is there anyone in the room who wishes to testify? Seeing none, is there anyone online who wishes to testify? And it looks like we have Heidi Haas, Executive Director with the Alaska Center for Children and Adults, calling from Fairbanks. Ms. Haas, please put yourself on the record and begin your testimony.

Good afternoon, Chair Mena. Can you hear me?

Yes, we can.

Excellent, thank you so much. Um, good afternoon, Chair Mena and members of the committee. For the record, my name is Heidi Haas and I am the executive director of ACCA, which has an infant learning program. While our office is in Fairbanks, we travel our great state to serve the Fairbanks North Star Borough, Delta Junction, Fort Greely, the the Copper Center region and the North Slope. Our IOP service region is over 120,000 square miles. And I did listen in on the testimony or on the presentation last week and appreciated the questions from representatives. So those that HCCA represents your constituents, I'd be happy to meet with you individually as well, should that be necessary. Today I call in support of HB 376 and aligning eligibility in IEP with school-based special education services, which will improve outcomes for Alaskan students. Greater access to early intervention services will also decrease the number of children who require special education services long-term. The savings to the state in future years after initial investment is a demonstration of how good investments pay off. In light of the tight fiscal constraints our state faces each year, taking the steps to invest now to save later is an approach I support as a program director and as a citizen of our state. ILP services are not mandated services. These are services parents request. The investment in these services not only fosters individual growth but also yields long-term benefits for the community and the state. Therefore, supporting HB 376 and the changes to the early intervention services in Alaska is crucial to ensure more families can access these life-changing resources, ultimately leading to better outcomes for children with developmental disabilities. Please support the expansion of Infant Learning Program and the contribution to long-term savings for the state. The investment will not only enhance the quality of life for those directly affected but also positively influence the future of Alaska as a whole and reduce the need for more costly services. Thank you for your time and especially for your interest in supporting a more comprehensive early intervention service in Alaska.

Thank you very much for your testimony. Next up, we've got Brittany Taylor, the Director of Infant Learning Program from Soldotna.

Good afternoon. My name is Brittany Taylor, and I'm the Infant Learning Program Coordinator calling in from Soldotna, Alaska, and serving the communities of Kenai, Soldotna, McKinsey, Sterling, Cooper Landing, and Pioneers. Thank you for the opportunity to provide testimony today. I am here in strong support of House Bill 376 and the expansion of Infant Learning Program services. This bill would allow us to serve infants and toddlers experiencing a 25% developmental delay rather than the current 50% threshold. This change is critical. Approximately 90% of brain development occurs within the first 3 years of life, making early intervention one of the most effective tools we have to support children in reaching developmental milestones before entering kindergarten. I also recognize that Alaska is facing a tight budget. This is exactly why the bill deserves serious consideration. Expanding early intervention is not only the right thing to do for children and families, it also happens to be a smart financial decision. Research shows that early intervention can yield up to a 400% return on investment. By supporting children earlier, we reduce the need for more intensive and costly services later. In fact, nearly half the children with delays between 25% and 50% who receive early intervention do not go on to require special education services in the K-12 system. For the Kenai Peninsula, the impact would be especially meaningful. Expansion would increase access to services in rural and underserved communities, strengthen family support through coaching and early skill building, improve workforce stability within our early intervention programs, and generate long-term cost savings by reducing the need for special education services. Ultimately, House Bill 376 ensures that children receive the right support at the right time when it matters most. Thank you for your time and consideration. I respect— respectfully urge you to advance House Bill 376 out of committee.

Thank you.

Thank you very much for your testimony. Seeing no more individuals in the room or online for testimony, I'm going to go ahead and close public testimony.

Madam Chair, could we ask the folks who are online to stay online? I've got a question, I don't know, for the bill sponsor or somebody. We have fiscal notes.

We've got the bill sponsor here, and that might be enough for committee discussion.

Okay.

Representative Story, can you please join us? Welcome.

Thank you, Madam Chair and members of the Health and Social Services Committee. It's good to be back today. For the record, I am Representative Andy Story, representing District 3, which is the North Mendenhall Valley here in Juneau, Fritz Cove, Oak Bay, Out the Road, Haines, Dagway, Klukwan, and Gustavus. I appreciate taking public testimony this morning. I don't think there's a reason to give a brief recap on the bill unless you would like me to do that. No?

Okay.

I see a unanimous nodding of the heads there. But I'm very pleased that we've got the Department of Health, many members on the line today, and we have other— our other testifiers from the first committee hearing. Online, so I am happy to take any questions and I'm happy to see who is best to respond. So thank you.

Thank you, Representative Brocks. You want to ask a specific question?

Yes, through the Chair, we have fiscal notes, let's see, from the Department of Health Medicaid Services and Senior and Disability Services, and there is quite a bit of additional upfront expense. Anticipated. What we don't have, and it would be interesting to know if we could get a fiscal note from the Department of Education and maybe other— some other divisions on how much might be saved, because I'm thinking there is a fairly quick return on investment. Is that possible to do?

Representative Story.

Through the Chair, thank you, Rep. Prox, for that. I certainly can ask DEED what they would estimate. I do know that I think it's Neve— oh, I'm Neve, I'm sorry.

Darvis.

Darvis.

I think she has given us a number in her previous testimony about what they estimate that we save. So if I could go to Ms. Darvis, please.

Ms. Darvis, are you able to respond to Representative Prox? I'm seeing a graph in my head.

Yes, for the record, this is me, Darvis, to the chair for Representative Prax. We have some cost estimates that we had previously presented to committee, and I believe that right now the annual savings in special education costs is in the region of $34 million with that providing that earlier intervention.

Thank you, Ms. Dardis. Do you have a follow-up, Representative Prax? Representative Fields.

Yes, I think it would be good to have that in an official fiscal note because when this gets to the Finance Committee, this is going to be kind of a hard sell.

Representative Sorrell.

Yes, thank you. I think through the Chair, I think we are always looking. It is hard. To fund prevention, to fund upfront, because it takes a while to see what the returns are. I think one thing that's important to note in this bill is costs, because one of the things that this bill does that's very important, it amends Alaska's Medicaid statute to add early intervention services to the list of optimal services the Department of Health may provide, which positions the state to receive federal Medicaid reimbursement for services that are otherwise funded with state dollars. And I think we could ask the Department of Health online today how many— how long they think that is going to take to implement. So then the state— it's my understanding the federal government will be paying for many of the infant learning services.

Representative Story, would you suggest Ms. Kessler?

I'm not quite sure who would be the person to do that. I'm sorry. So sure, try, Ms. Kessler, through the chair.

Ms.

Kessler? For the record, this is Susan Kessler. I'm the unit and data manager for the Infant Learning Program. Through the chair, it was a little difficult to follow on the phone the question. Could you repeat the question?

Representative Prox.

Yes, thank you. Through the chair, Ms. Kessler, I'm wondering if we could get a fiscal note, I guess an official fiscal note, that will give the— well, nothing else— Finance Committee an idea of how much we anticipate saving because we're providing these services upfront. We have estimates within the documentation, but to have that official would make this a lot easier to sell in the Finance Committee.

Okay, yes, I understand. So, uh, I think that we would have to— this is through the chair, this is Susan Kessler again. I think that we would have to, um put that question to DEED and have that response come from, from DEED, because we don't— we can't really speak to their costs.

Thank you.

And we've got a couple folks from Department of Health online, but not, not DEED here today. Representative Stewart, did you want to add to that?

Thank you. Through the chair, I'm looking at the fiscal notes, and I see that we do have Director Newman online who prepared one of the fiscal notes. I'm looking at the one that the fiscal note that shows the proportion of what Medicaid will be paying and the 50% match, and that was done by Pam Halloran. And I— is Pam on the— is Ms. Halloran on the line today? Then maybe I would suggest Director Newman.

Thank you, Director Newman.

Taking the gavel back. Hello. I believe—

I'm sorry, hello.

Oh, Director Newman, Representative Prox had a question about fiscal notes. Representative Prox, you want to repeat your question and then Chair Mena will take things back over again. As she picks up where we are in the conversation.

Thank you. Through the Chair to Director Newman, the assertion of this bill, or one of the assertions, is that spending the money on upfront on early intervention is going to save the state a considerable amount of money in the long term, like 4-to-1 return, or I think I've seen almost 7 or 8-to-1. I forget the exact numbers, but I'm wondering if we can get the savings realized, estimated in fiscal notes, either through this department or education or somewhere else.

Thank you. Thank you, Madam Chair. This is Tony Newman. I'm the director of the Division of Senior and Disability Services. And through the chair representative Prax, as Ms. Kessler noted, that would be a— to understand what savings might be realized down the road from expansion of the instant learning program in terms of dollars saved later in the special education services provided around the state. Would at best be an estimate that the Department of Education and Early Development would have to provide. I think it would be a real challenge for them to be able to do that. But as Ms. Dardis and others have pointed out through the course of this bill's hearings, there's a pretty good national track record that does demonstrate that there is savings to be had, not only in education, but I think in things like juvenile justice, criminal justice, health services that are needed down the road, but I'm unaware that we've been able to really dive into that at the Alaska state level.

Representative Fields.

Thank you.

Representative Prock started to answer my question, and actually with what Director Newman just said, I was going to ask Director Newman if he might be willing to coordinate with those other agencies because ILP is a really interesting program that has I mean, it seems like easily quantifiable savings in terms of special ed expenses through the state and education. Maybe the savings in juvenile justice are a little hard to quantify, but I wanted to ask Director Newman if he might be willing to try coordinating with those agencies to provide sort of an estimate on a reasonable range of savings that might be projected. And one interesting time period would be the sort of the the life of an adolescent. So a child who receives ILP services at age 3, or a representative sample of children, what are the savings by the time they turn 18, for example? I know that we don't typically— we have a myopic budget process that only looks at one side of the ledger, which is why we spend over $500 million a year on corrections. But maybe this is an opportunity to be a little smarter in terms of how we budget. Director Newman, is that something you might be willing to take a crack at.

Director Newman.

Through the Chair, Representative Fields, absolutely. Always happy to meet with people to see if we can get more information than we've been able to provide so far. So I will follow up with our legislative liaison to see if we can connect with the Department of Education to examine that question.

Follow-up?

I just want to say thank you for taking that on. I think it's a tremendously important subject, so I really appreciate the time that you're willing to invest in it.

Representative Gray.

Thank you. My question through the chair could be for the sponsor or perhaps for an expert online. I support the idea of expanding ILP eligibility and getting more kids who need it involved, but I'm curious just about the way it works in terms of parental involvement and How does the ILP program work if parents aren't enthusiastic about it or not, not trying to participate? I just imagine that as we expand the eligibility, there may be kids that would really benefit from this, but their parents may not understand it and may not want to participate, and that would be a huge detriment to the child.

Through the chair, thank you, Rep. Gray, for that very important question. I think Aniv Darvis online with the REACH program might be able to best handle that. Ms. Dardis?

Yes, for the record, this is me, Dardis, to the CARE representative, Gray. Yes, we've been very consistent that our program is

is absolutely optional and based on parent consent. What we do through our activities, from through Child Find through all our public awareness, we're heavily engaged within all of our respective communities with other resources that parents may access. I think that all of our programs put an incredible amount of effort into being a non-judgmental place for families, being a welcoming presence, really spending time trying to identify a family's unique challenges We want to hear from their perspective what they feel their barriers to entering services might look like. And so I think we just, we really meet each family as we find them and work expertly to build trust, to help them understand what healthy development should look like, to kind of see where their child falls on that spectrum, and really just be open to hearing their concerns and work at a pace that works for them in order to build that trusting relationship. Inevitably, you know, Parents do, you know, ultimately elect to not engage with the program, but that is entirely their choice, and ILP programs are very respectful of that. We just, you know, often we will tell families that our door is often open, and if they feel more comfortable in the future or have additional concerns, that we are here and waiting to support them.

Thank you.

Any other questions or comments from the committee?

Rep. Mena, if I might. Yes, go ahead. Thank you very much. It's Chair Mena, I think. I did want to point out one of the graphs in the PowerPoint that we were given from Rich Savell about savings to Alaska. It's on page 8, and I see Rep. Prox nodding his head, so he's aware of that. But basically they're saying in this— I wanted to point out it says for each child that doesn't need special education due to infant learning programs services, the state could save up to $229,000. And then it says it's budget neutral at 4 years, overall cost neutral at 6.5 years. So just wanted to note that for the record.

Wonderful. Any other questions from the committee? Seeing none, I am setting an amendment deadline for House Bill 376 for Monday, April 13th at 12:00 PM. The next meeting hearing of the House Health and Social Services Committee is scheduled to be Thursday, April 9th at 3:15 PM here in Davis 106. The time is 4:43 PM, and this hearing of the House Health and Social Services Committee is now adjourned.