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Governor Dunleavy Introduces Postpartum Medicaid Expansion, Adult Home Care Bills

Feb 3, 2023

Today, Governor Mike Dunleavy introduced three bills which are components of Alaska’s Healthy Families Initiative. HB 59 would allow the extension of postpartum Medicaid coverage from the required 60 days to 12 months. HB 58 would establish an adult home care service. The third bill introduced is related to the implementation of EO 121 which separated the Department of Health and Social Services into the Department of Health (DOH) and the Department of Family and Community Services (DFCS).

“As I said my State of the State address, my vision is for Alaska to be the best place in the country for families,” said Governor Mike Dunleavy. “These bills aren’t conceptual. They will tangibly improve quality of life for thousands of Alaskans and help make sure that bureaucratic barriers don’t get in the way of Alaskan families.”

HB 59 authorizes the Department of Health to implement section 9812 of the American Rescue Plan Act, which allows but does not require the extension of postpartum coverage from the required 60 days to 12 months for eligible beneficiaries. Extending postpartum Medicaid to 12 months is one evidence-based action the department can take to support growing families in Alaska.

Maternal mental health is one of Alaska’s most significant contributing factors to pregnancy-associated deaths. Many women who experience postpartum depression don’t have an onset of symptoms until after that initial screening, which is too late to seek treatment with Medicaid coverage. Nearly 16 percent of women in Alaska who experienced perinatal depression or anxiety between 2015 and 2020 indicated that they could not access needed treatments or support due to challenges with insurance or cost. Expanding postpartum Medicaid coverage will ensure that mothers are able to receive the physical and mental health care needed support a strong start to their child’s life.

In addition to mental health, other areas of impact include improved access to care in the following critical areas: substance use, family planning, and prevention and screening of chronic diseases. By extending postpartum coverage through the critical year post-delivery, this bill reduces gaps in care. Gaps in care are associated with increased use of the emergency room and poorer health outcomes. With extended postpartum coverage, women are much more likely to have access to continuous, regular primary care that is less costly than emergency services.

HB 59 establishes a new alternative for children with disabilities in foster care when they age out of the foster care system. The legislation establishes adult home care as new service type and adult care home as a new residential license type. This legislation provides a solution to a regulatory gap that existed between the licensing requirements and restrictions for foster care and assisted living homes. This bill also provides incentives for caregivers to continue to offer support for individuals in foster care with severe disabilities who are moving into adulthood and would like to continue to reside in their familiar home setting. The new service would be reimbursed through a 50/50 federal Medicaid match.

“Our goal at the Alaska Department of Health is to serve Alaskans based on their actual needs,” said Department of Health Commissioner Heidi Hedberg. “This legislation does that by providing a new option for home care for seniors and people with disabilities, with fewer administrative burdens than existing options. This legislation will keep families together, provide critical in-home support to Alaskans who need it and simplify the state bureaucracy that helps support all Alaskans through every stage of their life.”

The third bill introduced, HB 60, addresses issues related to Executive Order 121 which separated the Department of Health and Social Services into the Department of Health (DOH) and the Department of Family and Community Services (DFCS). This bill will facilitate administration of both departments by enacting a statute to allow the departments to share identifiable health information necessary for the operation of state programs for Alaskans who are engaged with both departments. It would correct an error wherein licensing authority for runaway shelters was assigned to DFCS. The bill would also add the Commissioner of DFCS as a board advisor to the Alaska Mental Health Trust Authority. In addition to these substantive changes, the bill contains clarifying amendments to properly identify or assist with identification of the new departments in statute.

Governor Dunleavy launched the Healthy Families Initiative as part of his FY2024 budget. The Healthy Families Initiative has three pillars: Healthy Beginnings, Improving Access to Healthcare and Healthy Communities.