Department of Health outlines public health budget changes, SHARP expansion and fund shifts

The Department of Health on Tuesday told the House Finance Subcommittee that the Division of Public Health will use remaining multiyear federal COVID-19 appropriations for one-time modernization projects while seeking designated general fund authority for an increase to the SHARP 1 recruitment program.

The presentation, delivered by Dr. Robert Lawrence, chief medical officer for the Department of Health, and Heather Rogers, administrative operations manager for the division, showed the department expects roughly $70,000,000 of COVID-related federal funds to move into fiscal year 2026 and that remaining federal COVID dollars will fund data and laboratory modernization work.

The spending choice reflects the division’s stated intent to direct multiyear COVID dollars to one-time capital and systems upgrades rather than ongoing operational commitments. “The funds are in a multiyear appropriation with carryover capability, and therefore, we do not request authority through the governor's budget process,” Heather Rogers said. She added that remaining one-time expenditures will support “data and laboratory modernization efforts to improve the public health laboratories and various other outdated systems.”

Why it matters: senior legislators on the subcommittee pressed for clarity about which programs will require ongoing funding after COVID appropriations end and whether savings now would create gaps later. Members also questioned whether certain fund classifications (for example, designated general fund versus statutorily designated program receipts) are appropriate for different SHARP program components.

SHARP program and fund sources

Committee members asked about the SHARP program, which Dr. Lawrence described as a recruitment program aimed at medical professionals, behavioral health professionals and dentists. “SHARP stands for strengthening healthcare access recruitment program,” Dr. Lawrence said. The department requested an additional $1,600,000 in designated general funds to support SHARP 1, which the presenters said helps with loan repayment and early-career retention in Alaska.

Committee members discussed distinctions among SHARP program variants. Rogers said SHARP 1 has a DGF (designated general fund) component and employer matching; SHARP 3 is supported partly by “statutorily designated program receipts” (SDPR) and other fund sources depending on employer choices. The department said it has examined whether the programs should be consolidated or reclassified over time.

Tobacco and marijuana education/treatment funds

Rogers told committee members that the department is proposing decrements to the tobacco and marijuana education/treatment funds because revenue collections have declined. “Adjustments are being made to align the funding with anticipated revenue collection,” she said. Committee members asked whether reduced revenues would reduce education or treatment programming; the presenters said the division will prioritize reducing contracts and reversible service agreements before cutting grants and noted statutory obligations to provide education.

Nursing position reallocations and medical examiner workload

The presentation also noted the transfer of seven public health nursing positions within the division to other components to meet current needs. The department said the positions were not eliminated but reclassified and moved; two of the seven went to the state medical examiner to help handle increased caseloads driven in part by overdoses. “Those positions were moved within the division to other components of the budget,” Rogers said. She added the funding remained within the division and that some positions had been difficult to recruit for.

Committee members pressed for a line-item list of where each of the seven positions were moved; the department said two went to the medical examiner, one to labs and one to chronic disease prevention, and that it would provide a full list to the committee.

Overdose trend and opioid settlement oversight

Lawrence and department staff told the committee that increases in deaths reported to the state medical examiner are “somewhat driven by the increase in overdoses.” Department staff said about three-quarters of opioid overdose deaths reviewed recently were directly related to fentanyl, and they described an oversight committee for opioid settlement funds chaired by the director of the Division of Public Health and co-chaired by the Division of Behavioral Health. That committee includes representatives from tribal and community organizations and is charged with distributing settlement dollars for prevention, treatment and recovery programs.

Other program notes and follow-ups

Committee members raised suicide prevention and the possible contribution of social media to youth mental health trends; Lawrence said suicide-prevention work involves coordination between the division of public health and the division of behavioral health. The department acknowledged it would follow up with additional detail on program lists for remaining COVID-funded projects and a line-item report on the seven reclassified nursing positions.

The subcommittee moved to the next division at the end of the presentation; no formal votes were recorded on the items discussed.

Ending: The department pledged to supply follow-up materials requested by committee members, including a list of one-time COVID-funded projects and the full allocation of the seven reclassified public health nursing positions.