5 Things Alaska: End of session, Q&A w/ Lindsey Kato, Rural hospitals


Eli Kirshbaum


Yesterday marked the final day of the 2022 legislative session following days of budget negotiations and policy conversations. With that in mind, this edition of “5 Things We’re Watching” includes a look at some of the last minute bill movement that took place at the capitol in the final days. We also highlight new supportive housing grants and feature a Q&A with HMA’s Lindsey Kato on substance use in Alaska.

Thanks for reading!

Emily Boerger
State of Reform


1. Health policy movement in final days of session

Lawmakers passed a series of health-related bills in the lead-up to the end of session. Recently passed legislation includes a bill that would allow physicians licensed in other states to provide follow up telehealth care in Alaska after an initial visit. Another bill that passed both chambers, referred to as “The Pharmacist Mobilization Act,” would increase access to health care through pharmacists and ensure they are reimbursed for providing services.

This week legislators also passed a bill that would raise the minimum age to purchase tobacco products to 21, and another that would create an evidence-based, statewide dementia awareness campaign. They also passed HB 363, which will establish the Office of Broadband to expand broadband access and digital equity across the state.


2. Q&A: Lindsey Kato, HMA

Lindsey Kato is a Senior Consultant at Health Management Associates with experience in the substance abuse and suicide prevention fields. Most recently, she helped lead efforts to establish the Overdose Response Strategy—a program funded by the CDC and the Office of National Drug Control Policy. In this conversation, Kato discusses Alaska’s addiction issues and effective treatment/prevention tactics.

Kato says individualized treatments, strengthening communities, and listening to individuals currently impacted by substance use are all important factors in addressing SUD in the state. “I think we can do more aligned and coordinated efforts across the state. That will help both in funding and resources,” she says. “I hope we’re headed toward a shared risk and protective factor approach [because] everyone has a stake in it.”


3. Trust Authority awards $1.55 million for housing projects

The Alaska Mental Health Trust Authority recently announced it had awarded $1.55 million in grant funding for supportive housing projects across the state. Funding includes $375,000 for the Nome Community Center to build 15 units of supportive housing with wraparound services, and $375,000 for Bethel Community Services Foundation to build a 20-unit permanent supportive housing complex.

Other funding will go to complete Juneau’s Teal Street Center ($300,000) and to Catholic Social Services to operate a Complex Care Center in Anchorage ($500,000). “We know that housing is a critical component to the continuum of care,” said Trust CEO Steve Williams. “Many of our beneficiaries experiencing chronic homelessness must have the safety and security of a place to live before they can commit to consistent treatment of health and behavioral health conditions, reducing or eliminating substance use, and obtaining employment or meeting other goals.”


4. Standardized plan requirements for ACA coverage in 2023

At the end of April, CMS announced its final ACA rule adjustments for 2023, which include a requirement that plan sponsors participating in the federally run exchange offer standardized plans in addition to their other products. In his latest column, Jim Capretta offers details on the rule change and a description of the new policy.

“The CMS rule creates eight standardized plans that all insurers participating in healthcare.gov must offer when selling policies on the relevant tiers,” writes Capretta. The goal of the new rule is to make it easier for consumers to compare insurance options and to increase plan competition. “If the new rules are found to lower premiums for consumers … they are likely to become a permanent feature of the market. Conversely, if consumers are left with inadequate options because many insurers withdraw from the market, pressure could build on CMS to revisit the requirements.”


5. Rural hospitals at risk of closing

Over 600 rural hospitals—about 30% of the nation’s total—are at risk of closing in the next 6 years due to financial challenges, according to the Center for Healthcare Quality and Payment Reform. CHQPR’s data suggests that 5 rural hospitals (38%) in Alaska are at risk of closure, with 2 hospitals at an “immediate risk of closure” within 2-3 years.

The challenges are most significant for small rural hospitals, which experienced significant hits to their margins on patient services during the pandemic but were kept afloat by federal financial aid. CHQPR’s report says the most critical way to support rural hospitals is through adequate reimbursement for services provided. “It will cost about $3 billion per year to prevent closures of the at-risk hospitals and preserve access to rural healthcare services. This represents an increase of only 1/10 of 1% in total national healthcare spending,” reads the report.