Bill Summary – FastDemocracy

State of Alaska
                                                            Fiscal Note
                                                                                             Bill Version:                  CSHB 215(FIN)
 2018 Legislative Session
                                                                                             Fiscal Note Number:            2
                                                                                             (H) Publish Date:              2/7/2018
 Identifier:       HB215CS(HSS)-DHSS-PHAS-1-26-18                              Department:       Department of Health and Social Services
 Title:            DHSS: PUBLIC HEALTH FEES                                    Appropriation: Public Health
 Sponsor:          FINANCE                                                     Allocation:       Public Health Administrative Services
 Requester: House HSS                                                          OMB Component Number:              292
 Expenditures/Revenues
 Note: Amounts do not include inflation unless otherwise noted below.                                                             (Thousands of Dollars)
                                                 Included in
                                    FY2019       Governor's
                                Appropriation      FY2019                                           Out-Year Cost Estimates
                                  Requested       Request
 OPERATING EXPENDITURES               FY 2019        FY 2019       FY 2020                     FY 2021           FY 2022          FY 2023       FY 2024
 Personal Services                                                    400.0                      400.0             400.0            400.0         400.0
 Travel
 Services
 Commodities
 Capital Outlay
 Grants & Benefits
 Miscellaneous
 Total Operating                            0.0           0.0         400.0                       400.0             400.0           400.0             400.0
 Fund Source (Operating Only)
 1004 Gen Fund (UGF)                                                           (200.0)          (200.0)           (200.0)          (200.0)        (200.0)
 1005 GF/Prgm (DGF)                                                              600.0            600.0             600.0            600.0          600.0
 Total                                           0.0              0.0            400.0            400.0             400.0            400.0          400.0
 Positions
 Full-time
 Part-time
 Temporary
 Change in Revenues
 1005 GF/Prgm (DGF)                                                             600.0             600.0             600.0           600.0             600.0
 Total                                           0.0              0.0           600.0             600.0             600.0           600.0             600.0
 Estimated SUPPLEMENTAL (FY2018) cost:            0.0                    (separate supplemental appropriation required)
 (discuss reasons and fund source(s) in analysis section)
 Estimated CAPITAL (FY2019) cost:                 0.0                    (separate capital appropriation required)
 (discuss reasons and fund source(s) in analysis section)
 ASSOCIATED REGULATIONS
 Does the bill direct, or will the bill result in, regulation changes adopted by your agency?                yes
 If yes, by what date are the regulations to be adopted, amended or repealed?                                07/01/19
 Why this fiscal note differs from previous version/comments:
 Not applicable; initial version.
 Prepared By:            Jay C. Butler, MD, Chief Medical Officer/Director                                         Phone:       (907)269-6680
 Division:               Public Health                                                                             Date:        04/13/2017 03:00 PM
 Approved By:            Shawnda O'Brien, Asst. Commissioner                                                       Date:
                                                                                                                           OUT OF
                                                                                                                                04/14/17
 Agency:                 Health and Social Services                                                              REPORTED
Printed 2/7/2018                                                        Page 1 of 2                               HFC 02/07/2 018
                                                                                                                           Control Code: PJNeO
                                                                                                          CSHB 215(FIN) - Fiscal Note 2
                                                 FISCAL NOTE ANALYSIS
STATE OF ALASKA                                                                   BILL NO. CSHB215(HSS)
2018 LEGISLATIVE SESSION
Analysis
   HB 215 grants the Department of Health and Social Services the authority to collect fees to support the administration of
   public health programs. The bill would also add public health fees to the list of designated general fund program receipts,
   making clear that the program receipts collected would be used to support public health operations. The division is
   currently limited under AS 44.29.022(a), Fees for department services, to charge fees only for certain clinical services for
   maternal and child health, preventive medical services, public health nursing, nutrition, health education, and
   laboratories.
   The House and Senate both included legislative intent language in the FY2016 and FY2017 budgets that the Division of
   Public Health charge for services.
   Examples of public health services and functions provide by the department that currently lack fee authority include data
   extraction and analysis, training, expert consultation, inspections and certifications, enforcement activities, administrative
   functions, and professional services. The fees below would be the priority to establish. Additional fees may be added in
   the future.
    * Registration, certification, and inspection of radiological device fees are needed to support a second radiological health
   physicist for magnetic resonance imaging (MRI), computed tomography (CT), mammography, and ultraviolet devices.
   Currently only fees for X-ray devices are authorized and only X-ray devices are registered, certified and inspected. No new
   position are needed; the division will utilize an existing vacant position. ($100.0 DGF)
    * An administration fee for the healthcare practitioner loan repayment program, Supporting Healthcare Access through
   Loan Repayment Program (SHARP), would cover the cost of operating the program, which is currently supported with
   unrestricted general funds. Similar loan repayment programs charge an administrative fee. ($200.0 DGF/-200.0 UGF)
    * Allowing a reasonable fee for custom statistical and epidemiological analyses on public health data sets would greatly
   enhance the usefulness of the datasets. The division is frequently asked for ad hoc analyses; however, our resources are
   consumed in collecting the data, leaving little capacity for analysis. Other states charge annual or per-hour fees for
   analytical work. ($175.0 DGF)
     * The division has turned away requests to assist with community health assessments and community action plan
   development. The division lost the capacity for this service when the position funded with unrestricted general funds was
   eliminated in recent budget cuts. The ability to charge fees would enable us to once again support local efforts for
   healthier communities. No new positions are needed; the division will utilize existing positions. ($125.0 DGF)
   The fiscal note reflects our best estimates of the revenue we could collect, which would be applied toward salaries and
   benefits. In most cases, additional fee revenue may not be sufficient to fully offset costs; however, increasing fees will
   reduce dependence on other funds. The division would charge additional fees only when it is in the public interest and
   economical, and, most significantly, does not undermine the divisions public health mission. Services would not be denied
   because of an inability to pay.
   Regulations would be adopted for each new fee, after public comment was received and considered. To allow adequate
   time for that input process, the department estimates that implementation of new fees would begin in FY2020.
(Revised 9/26/17 OMB/LFD)                                                                                           Page 2 of 2
HB215CS(HSS)-DHSS-PHAS-1-26-18                                  Page 2 of 2                                              Control Code: PJNeO
Statutes affected: 
HB0215A, AM HB 215, introduced 04/07/2017: 37.05.146, 18.05.010, 44.29.022
HB0215B, AM CSHB 215(HSS), introduced 05/10/2017: 37.05.146, 47.05.080, 47.14.100, 44.29.022, 18.08.080, 25.27.120, 25.27.130, 47.27.040
HB0215C, AM CSHB 215(FIN), introduced 02/07/2018, passed House 02/16/2018, passed Senate 05/12/2018: 37.05.146, 47.05.080, 47.14.100, 44.29.022, 18.08.080, 25.27.120, 25.27.130, 47.27.040, 44.29.020, 47.30.655, 47.30.910, 47.80.100, 47.80.170
HB0215Z, AM Enrolled HB 215, introduced 05/12/2018: 37.05.146, 47.05.080, 47.14.100, 44.29.022, 18.08.080, 25.27.120, 25.27.130, 47.27.040, 44.29.020, 47.30.655, 47.30.910, 47.80.100, 47.80.170