State Policy and Issues

2017 State Legislative Resolutions

These 2017 Legislative Priorities reflect our goals of supporting full implementation of Medicaid reform, supporting efforts to reform insurance and care for privately insured Alaskans, and ensuring that the primary health care system is adequately staffed now and into the future.  Finally, we lend our voice to efforts seeking to stabilize budgets to ensure funding for safety net health programs and sustainable healthy communities continues. 
 
1. Healthcare Workforce
2. Cost of Care and Coverage
3. Integration of Care
4. 2018 Budget

Priority - Healthcare Workforce
Patient experience, quality care, and efficiency all rely on training, recruiting, and retaining the right work force working at the peak of their qualifications

Summary
Attracting, training, and retaining the full range of clinical providers and support staff necessary to operate a Community Health Center is a top priority. Community Health Centers collaborate closely on activities including recruitment, apprenticeship development, professional development programs, and innovative tools to retain staff.  In Alaska, Community Health Centers could serve an additional 12,000 patients if all of their current provider vacancies were filled.

2017 Regulatory and Legislative Goals

Support Reimbursement To New Provider Types To Expand Cost Effective Access To Care 

  • Support Medicaid and private insurance reimbursement for behavioral health provider types such as LPCs, LMFTs, and others commensurate with LCSW reimbursement.

  • Support Medicaid and private insurance reimbursement for Behavioral Health, Dental Health, and Community Health Aide programs.

Develop Low-Cost Healthcare Apprenticeship Programs To Increase Primary Care Sustainability 

  • Educate legislators on the opportunity to lower the cost of care coordination and improve health outcomes through support of funded Health Worker Apprentice program.

Train Alaska’s Next Generation Of Healthcare Providers

  • Maintain University of Alaska funding to support health careers programs that provide graduates for Alaska’s Community Health Centers.  Key programs include WWAMI Physician Program, MEDEX Physician Assistant Program, and other University of Alaska College of Health professional programs. 

Support Critical Providers In Hard To Hire Professions and Isolated Areas

  • Support of SHARP program and other state opportunities to reduce student loan debts of hard to place providers in communities throughout the state.

  • Support AHFC Provider Housing Development program in rural Alaska.

Continue To Expand Telehealth To Support Access To Behavioral Health Care

  • Support reimbursement, regulatory, and technology solutions to expand access to telehealth in Alaska Health Centers. 

 

 

PRIORITY – COST OF CARE AND COVERAGE
Initiatives that immediately slow the inflation rate of insurance coverage and care while addressing structural changes to Alaska’s healthcare system to become more transparent, affordable, and accessible

Summary
Analyzing information gained in the Alaska Health Authority feasibility report to begin discussion on combining the benefit plans for various groups of employees and beneficiaries touched by the State of Alaska to reduce cost and increase access to affordable care for those in the individual and small group markets.  This is also an important opportunity to address the cost of care, transparency, and introducing quality reforms that were included in Medicaid redesign last session. 


2017 Regulatory and Legislative Goals

Support Opportunities To Lower Cost, Expand Competition, and Retain Continuity Of Coverage

  • Support submission of CMS 1332 waiver seeking use of federal funds to shift cost of reinsurance program

  • Support initiatives to continue State stop-loss program in individual insurance market.

  • Support initiatives to introduce competition into the Alaska Individual Marketplace.

  • Facilitate communication between the Federally Facilitated Marketplace and State of Alaska.

Analyze Findings And Support Reforms Identified Alaska Healthcare Authority Study Phase 1

  • Support inclusion of Alaska Medicaid program for consideration.
  • Support inclusion of Federally Facilitated Marketplace individual insurance for consideration.

  • Support achievable steps to begin reducing silos in purchasing.

  • Support key role for primary care as gateway to comprehensive, quality, efficient care.

PRIORITY - INTEGRATION OF CARE
The movement toward whole person care relies on the continued integration of medical, behavioral and oral health care and supporting programs to achieve cost savings, and continued improvements in health outcomes and patient experience. 

Summary
Alaska’s healthcare system is slowly evolving from a system that treats patients for their symptoms and pays by the visit to one that strives to build patient health and compensates providers based on the quality of patient outcomes.  In 2017, attention will turn from Medicaid redesign to addressing affordability and reform of the private health care system.  The APCA supports action that addresses the cost of care and coverage, price transparency, and improving both the patient experience and quality of care. 

2017 Regulatory and Legislative Goals

Support Continued Progress On Medicaid Redesign Implementation

  • Section 1945/2703 health home demonstration project and waiver application.

  • Coordinated care demonstration projects.

  • Emergency care coordination.

  • Behavioral health integration.

 Comprehensive Behavioral Health Integration Will Lower Costs & Improve Health Outcomes 

  • Support 1115 waiver supporting expanded behavioral health integration with eventual Medicaid savings

  • Address gaps in behavioral health integration to increase access to substance abuse and opioid treatment services in primary care settings.

  • Build understanding amongst legislators and policy leaders on best practice models of integration.

  • Support regulatory or legislative action to add same day Medicaid behavioral health billing

 Build Recognition Of The Importance Of Oral Health Integration:

  •  Advocate for completion of updated Alaska Oral Health Plan and inclusion of robust oral health quality measures in Healthy Alaskans 2020 and dashboards of the health of Alaskans. 

  • Support full appropriation and utilization of funding for Adult Oral Health and expanded Medicaid Oral Health benefits. 

 Care Coordination:

  •  Seek interim opportunities for compensation of care coordination for immediate future while demonstration projects operate.

  • Continue to foster understanding of best practices in clinical case management and care coordination. 

 

PRIORITY – 2018 BUDGET  
Alaska’s Community Health Centers need healthy Alaskan communities in which to operate – communities that are fiscally sound and stable.  In order for Alaska’s safety net to provide efficient, quality care and contribute to fiscal savings, Medicaid and other related programs must have adequate resources.

Summary
Alaska’s Community Health Centers are economic engines that are vital to the communities in which they operate, AND they require almost no ongoing investment from the State of Alaska beyond their ability to bill Medicaid and other private insurance programs for the care they provide to patients.  Community Health Centers in Alaska operate at over 170 sites, employ over 1,750 providers and support personnel, and have a total economic impact of 269 million. 

APCA will be analyzing the 2018 budget proposals and advocating for smart investments that move Alaska forward toward a future in which providers are compensated based on objective quality outcomes and patient experience in integrated health environments.  Successful primary care also relies upon adequately funded community providers of other services who play an important role in the health of patients.   The APCA and its members will also analyze potential cuts to other programs that affect the operations and sustainability of Alaska Community Health Centers including: Community Development Block Grants, Municipal Revenue Sharing, Power Cost Equalization, and the Community Transportation program. 

2017 Regulatory and Legislative Goals

2018 Budget:

  • Pass a revenue bills that balances the budget with new revenue streams.

  • Statement regarding cuts.

Alaska Medicaid

  • Include rate increase in 2018 budget to catch up for previous two years without an increase.

  • Advocate for maintenance of specific Medicaid optional services.

Funding Alaska’s Response To The Opioid Epidemic 

  • Seek exclusion in Federal Law to allow residential treatment facilities with more than 16 beds to bill Medicaid for reimbursement to expand access to substance and Opioid treatment services.

Department of Health and Social Services funding levels: 

  • Support continued funding for Public Health Nursing functions.

  • Support funding for DHSS health planning functions.

OTHER 2017 PRIORITIES
Community Health Centers have identified additional priorities beyond those in the four broad categories above.  They are important enough to warrant targeted support and advocacy in 2017. 

Supporting Smoke-Free Workplace Legislation
 

  • The APCA and numerous Community Health Centers will once again be supporters of comprehensive legislation to establish smoke-free workplaces throughout Alaska.

 

Weekly Bill and Hearing Updates

The Alaska Primary Care Association Advocacy Team publishes a weekly Bill and Hearing Update during each State Legislative Session. For the most recent edition, please contact Jon Zasada at 907-929-8102.

Additional Resources:

www.akleg.gov
www.akhealthreform.org