Stakeholders urge Legislature to update emergency declaration
Alaska State Hospital and Nursing Home Association CEO Jared Kosin wrote to the Journal via email that the organization recieved a letter from federal Centers for Medicare and Medicaid Services officials that addresses many of the concerns ASHNHA member organizations had about pandemic response operations without a formal state emergency declaration. However, the health care group still "wholeheartedly" supports the Legislature's passage of House Bill 76, the public health emergency legislation lawmakers are debating to mitigate the regualtory amibuity and unintended consequences caused by the current situation, according to Kosin.
Alaska business, health care and local government leaders are urging lawmakers to renew the state’s COVID-19 disaster declaration to support social and economic recovery from the pandemic as much as public health needs.
Anchorage Economic Development Corp. CEO Bill Popp told members of the House Finance Committee March 15 that safely and effectively welcoming back the tourists the Alaska’s economy desperately needs will require further support from the state.
The state’s largest city — and likely its top visitor hub this year — needs to be able to offer tourists an environment in which they can feel safe and have minimal odds of contracting COVID-19 or being caught in another lockdown because of an outbreak of the virus, Popp said.
He stressed that state-sponsored programs enabled by a declaration, such as COVID-19 testing for arriving travelers at the state’s major airports, are crucial to a prolonged economic rebound statewide.
Mandatory COVID-19 testing for incoming travelers who did not have proof of a test within the past 72 hours ended with the Feb. 14 expiration of Gov. Mike Dunleavy’s most recent 30-day COVID-19 public health emergency declaration. The airport testing program detected 2,514 positive cases of COVID-19 since being stood up early last June, according to Department of Health and Social Services records.
“We need these tools in the toolbox to facilitate proper health care, proper food services and to give assurances to our businesses and our out-of-state visitors that Anchorage and Alaska are a safe place to visit and enjoy a great vacation,” Popp said.
Alaska Municipal League Executive Director Nils Andreassen said since the declaration expired that local governments have been struggling to fill gaps in management of the pandemic and many have had to rework local declarations that also expired because they were tied to the state’s.
The situation has also led to questions about how resources such as vaccine allotments and COVID-19 testing supplies will continue to be distributed, according to Andreassen.
“Ultimately, it’s this uncertainty that ends up being the most challenging,” he said.
Dunleavy asked the Legislature to pass a bill extending the declaration through September when the legislative session began in mid-January but it did not pass because of roughly a month of disorganization in the House and members of the Senate Republican majority who questioned the need for continuing the state of emergency.
Dunleavy declined to unilaterally extend the declaration despite a nonbinding resolution from the Senate and letters signed by the vast majority of House members asking him to do so. Attorneys for the Legislature said the governor likely cannot extend the emergency declaration on his own, even though he did so in the past while the Legislature wasn’t in session to maintain emergency health orders and regulatory changes.
DHSS Commissioner Adam Crum acknowledged during the House Finance hearing that the lack of a formal emergency declaration has left the department in a “precarious position” as DHSS officials try to navigate the complex realm of federal funding and regulatory flexibilities tied to the state declaration.
Crum noted that he believes Anchorage, for example, could require testing at the state-owned airport without an emergency declaration but other issues are more challenging.
State health department officials have attempted to continue operating with suspended statutes and regulations as if there has been a valid declaration in place since mid-February, a position that Senate President Peter Micciche said in a prior interview would normally raise significant concerns about DHSS overstepping its authority; however, the need to continue an effective, coordinated response to the pandemic trumps those issues for now, according to Micciche.
Senate leaders have said for several weeks they are working on a bill to give DHSS and other state agencies the authorities needed to be flexible with policy mandates and accept federal COVID-19 aid, such as $8 million per month in boosted food stamp assistance, without the politically sensitive formal disaster declaration. It’s unclear exactly when the Senate legislation will be submitted.
Instead, the House is gradually moving House Bill 76, the governor’s bill to renew the declaration, ahead of an April 1 deadline for the state to have an emergency declaration or other statutory mechanism that meets the U.S. Department of Agriculture’s requirements to get the extra $8 million per month from the Supplemental Nutrition Assistance Program known as SNAP.
Cara Durr, engagement director for the Food Bank of Alaska, testified that the charity saw a 43 percent increase in demand during the last half of 2020 compared to 2019 and the record need has continued into this year. The $8 million per month provides about 2.2 million meals, while the Food Bank currently has the capacity to distribute about 750,000 meals per month she said.
“With the current high level of need that we’re seeing, we’re deeply concerned about the loss of the SNAP emergency allotments could mean for food insecurity in Alaska and for the additional burden their loss will place on the charitable food network,” Durr said.
Rep. Dan Ortiz, I-Ketchikan, relayed concerns from a constituent who he said could not continue to receive telehealth care from an Outside provider because regulatory exemptions tied to the emergency declaration had also expired.
“Removing ambiguity” from declaration-related telehealth mandates is one of the main immediate priorities for DHSS, Crum said.
Alaska normally requires a provider to conduct an in-person visit before future telehealth appointments. Out-of-state providers also usually need a valid Alaska medical license to conduct telehealth appointments with Alaskans — another requirement the declaration lifted.
Alaska State Nursing Home and Hospital Association CEO Jared Kosin testified that the group “strongly supports” HB 76.
“There is no harm or unintended consequences to passing (HB 76). In fact, there are only unintended consequences and harm if this legislation is not passed,” said Kosin, who also emphasized that broad COVID-19 testing at airports is still very important.
Testimony from the general public was mixed on HB 76, with several individuals stressing a need for Alaska to move past emergency declarations to help the economy recover.
Kosin wrote via email that ASHNHA requested a formal letter roughly a month ago from Centers for Medicare and Medicaid Services officials clarifying hospitals and providers can still operate under a host of waivers once effective in the state because of the declaration, including one allowing health care organizations to have off-site facilities, such as COVID-19 testing sites.
The group is still waiting for a response from CMS, according to Kosin.
“A disaster declaration is a legal mechanism,” Kosin said. “Alaskans may not see it or experience it in everyday life but Alaska’s health care providers do.”
The House Finance Committee tabled HB 76 at the end of its March 15 meeting and another hearing on the bill had not been scheduled as of this writing.
Elwood Brehmer can be reached at [email protected].