Members of the Alaska House of Representatives worked on several health care initiatives during the 2022 legislative session. In this conversation, Rep. Mike Prax (R-North Pole) and Rep. Zack Fields (D -Anchorage) are discussing their health policy priorities with State of Reform.
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Governor Mike Dunleavy issued an executive order to restructure the Department of Health and Social Services into two departments at the start of the 2022 legislative session. The executive order divides the department into the Department of Health and the Department of Family and Community Services. Prax said the split should lead to opportunities that will make Alaskans happy.
“We’re probably going to be able to reduce healthcare spending,” Prax said. “It’s such a big department now that we’re adding more money for administration. Right now, the whole department is so busy that they don’t have time to focus on asking the big questions and seeing how one department affects another. Are there any duplicates? »
Fields said the department split was perhaps the most controversial part of the legislative session of the House.
“I don’t think the idea of splitting it up was controversial; just the pace and nature of stakeholder engagement,” Fields said. “I would have put it off for another year of stakeholder engagement.”
Fields said the goal will be to implement the division of the department without disruption of services or financial hitches.
“Hopefully it’s a smooth process where you have multiple streams of federal funding, making sure it’s not disrupted,” Fields said. “I hope the team will manage to find their way there.”
Fields and Prax also discussed Shortage of healthcare workers in Alaska. There aren’t enough healthcare workers to meet the demand for services in Alaska, and vacancies in the industry are growing. The industry had a projected job growth rate of 7.6% over the next 10 years, with 5,000 new jobs expected, which was more than any other sector. Employers often have to recruit workers from other states to fill positions, and nonresidents hold 11.3% of state healthcare jobs. Twenty-one percent of key positions in state hospitals and nursing homes are vacant.
Prax said Fairbanks Memorial Hospital is struggling to recruit workers, but a new apprenticeship program there that trains people for licensed practical nurse, certified practical nurse and other certifications could help with that.
“There aren’t enough successful people in nursing school, so they’re trying to start their own training program,” Prax said. “If someone wants to get involved in the healthcare industry, there will be something close to an apprenticeship program for them.”
Fields said there’s no question the state needs more resources in the nursing industry.
“We’re going to need more programs like this apprenticeship program,” Fields said. “I think we should move towards employee-focused programs where people get a living wage with training. We also need to align this with college credit. [The Alaska Primary Care Association] (APCA) is a model in how to do this. We must support the APCA, and [the Alaska State Hospital and Nursing Home Association] as long-term workforce solutions.
One of the main objectives of legislators, specifically related to mental health care, has been to establish Crisis now, a health crisis mitigation program that connects people to resources at the onset of a crisis, to recovery and to follow-up care, Prax said. The program can serve as an alternative to sending people to jail or detention centers at the onset of a mental health crisis.
“They’re trying to set up a program where people can get less intensive care,” Prax said. “It will be about longer term care to help people stabilize their situation in an environment that is less formal and expensive than a hospital, and more appropriate than a prison. This should work better than what we currently have. The government has, through the regulatory process, provided an emergency permit or a short-term permit to [Crisis Now] can go to work while their status application is being processed. I think it will help, in particular, with mental health.
Prax also expects to see more patients using telehealth services in the future.
“Telehealth will become more permanent,” Prax said. “I think it will reduce the cost of health care a little bit.”
The legislative process has also given lawmakers a chance to focus on fixing certain tax practices, Fields said.
“When you live through years of austerity, the cuts add up over time,” Fields said. “We rolled back some of those cuts and went back to core funding. We funded our Medicaid benefits. In previous years, we acted like it was unnecessary.