The disaster declaration Alaska has operated under since March is scheduled to expire in mid-November. It gives the state special powers to protect public health, using mandates. With case counts rising significantly in the state, hospitals are concerned about what comes next.
Gov. Mike Dunleavy declared a public health disaster emergency on March 11, before Alaska’s first case of COVID-19 was detected. The declaration began a period in which Dunleavy’s administration issued 18 different mandates that affected how people could travel in to and out of the state, or even whether they could be within 6 feet of others outside their households.
All but five of those mandates have expired or been rescinded.
The most noteworthy mandate still in place requires those coming from elsewhere to have a negative coronavirus test within 72 hours of departure. Without that mandate, Alaska could lose the advantage it’s had of being geographically separated.
Alaska’s hospitals and nursing homes are among those trying to understand what would happen if the disaster declaration expires next month, said Jared Kosin, president and CEO of the Alaska State Hospital and Nursing Home Association.
“This is the issue that is now popping up as now top of mind, and understanding the impacts,” he said.
He said that the federal government has waived some regulations that have allowed providers to be more flexible in offering telehealth and ordering coronavirus testing and licensing out-of-state nurses and other providers.
These waivers depend on the state response to the pandemic being consistent with the federal response. And it’s not clear to hospitals and nursing homes if that will be the case if the disaster declaration expires.
“We’re still seeing really high case counts,” Kosin said. “Thankfully, we’re all still managing it. But we’re also entering in with a lot of unknowns. And I think we’re just concerned that a lot of the tools we all have been using could go away. And I don’t think anyone has ill intent. I think we just don’t truly understand what the impact would be.”
Kosin said providers also are concerned that the federal government may not consider Alaska to be eligible for federal relief payments if the disaster declaration expires.
Kosin said he and hospital leaders are looking for clarity and will be talking more with Dunleavy’s administration about it.
State Health and Social Services Commissioner Adam Crum has laid out some of the administration’s thinking on the issue in a recent town hall. He described how the state has helped guide local communities on what they can do in response to the pandemic, rather than rely on the state mandates.
“The governor asked us and advised us that we were to remove any of these mandates as soon as possible,” Crum said.
The legal basis for the last five mandates is set to expire on Nov. 15.
These mandates regulate commercial fishing; services by health care providers; the quarantine and isolation program for first responders, health care providers and homeless people; and travel.
Under Alaska law, a governor can only declare a disaster for 30 days without the Legislature extending it. The Legislature passed a bill in late March that extended Dunleavy’s declaration.
The law, Senate Bill 241, covered a lot of ground.
- It made it easier to quickly license health care professionals and others responding to the pandemic;
- Made it easier for health care providers to provide telehealth care;
- Allowed corporation and nonprofit boards to hold meetings electronically; and
- Prevented people experiencing pandemic-related hardship from having their utilities shut off, among other provisions.
Legislative leaders said the votes aren’t there to hold a special session to extend the declaration.
Senate President Cathy Giessel, an Anchorage Republican, said she’s not concerned about the state’s powers expiring. She said community public health efforts are more important.
“We have some good, functional logistics in place now in the state,” said Giessel, an advanced practice registered nurse. “Communities are very nimble in recognizing when they need to shut down. I’m thinking now of our rural communities who have historic trauma from these kinds of pandemics, and the city of Anchorage.”
There are limits to how much communities can protect themselves without help from the state. For example, some communities don’t have local governments.
And while Acting Attorney General Ed Sniffen said home-rule cities have the legal authority to impose their own restrictions, he said other kinds of local governments don’t.
“There are other communities who may not have that kind of a charter or those ordinances in place and if their authority springs from the governor’s disaster declaration, then when the governor’s disaster declaration ends, their authority would also end,” Sniffen said during a Sept. 22 town hall.
In response to a question about how Gov. Dunleavy is approaching the end of the declaration, his office emailed a one-sentence statement saying Dunleavy “is taking into consideration all options when it comes to the emergency declaration.”
It doesn’t appear that any state has failed to extend its emergency orders so far. While each state has different rules, many governors have the authority to act on their own without returning to their legislatures. For example, Tennessee Gov. Bill Lee extended Tennessee’s state of emergency on Tuesday, the day before it was set to expire.
There’s another consequence that legislative leaders and legal advisers said would result from the Legislature not holding a special session. All of Dunleavy’s appointments to state boards and commissions since April of 2019 would expire on Dec. 15, as well as the appointment of Revenue Commissioner Lucinda Mahoney.
That’s because the Legislature didn’t hold a joint session to vote on these appointments.
Giessel and House Speaker Bryce Edgmon said Dunleavy would be able to reappoint his choices when the Legislature meets in January. Giessel noted that boards and commissioners usually don’t meet in late December and early January.