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CSHB 96(FIN): "An Act making appropriations for the operating and capital expenses of the state's integrated comprehensive mental health program; and providing for an effective date."

00 CS FOR HOUSE BILL NO. 96(FIN) 01 "An Act making appropriations for the operating and capital expenses of the state's 02 integrated comprehensive mental health program; and providing for an effective date." 03 BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF ALASKA: 04 (SECTION 1 OF THIS ACT BEGINS ON PAGE 2)

01 * Section 1. The following appropriation items are for operating expenditures from the 02 general fund or other funds as set out in section 2 of this Act to the agencies named for the 03 purposes expressed for the fiscal year beginning July 1, 2007 and ending June 30, 2008, 04 unless otherwise indicated. A department-wide, agency-wide, or branch-wide unallocated 05 reduction set out in this section may be allocated among the appropriations made in this 06 section to that department, agency, or branch. 07 Appropriation General Other 08 Allocations Items Funds Funds 09 * * * * * * * * * * 10 * * * * * Department of Administration * * * * * 11 * * * * * * * * * * 12 Legal and Advocacy Services 1,700,100 1,700,100 13 Office of Public Advocacy 1,549,700 14 Public Defender Agency 150,400 15 * * * * * * * * * * 16 * * * * * Department of Corrections * * * * * 17 * * * * * * * * * * 18 Population Management 611,500 611,500 19 Offender Habilitation 611,500 20 Programs 21 It is the intent of the legislature that the Department will develop plans and proposals for 22 inmate habilitation and reentry programs that can be undertaken during FY08; identify federal 23 or other funding sources available for such programs; and seek receipt authority for those 24 identified funds. 25 Inmate Health Care 5,897,200 5,687,200 210,000 26 Inmate Health Care 5,897,200 27 * * * * * * * * * * 28 * * * * * Department of Education and Early Development * * * * * 29 * * * * * * * * * * 30 Teaching and Learning Support 349,400 49,400 300,000 31 Student and School 349,400

01 Achievement 02 Alaska Postsecondary 200,000 200,000 03 Education Commission 04 Program Administration & 200,000 05 Operations 06 * * * * * * * * * * 07 * * * * * Department of Health and Social Services * * * * * 08 * * * * * * * * * * 09 No money appropriated in this appropriation may be expended for an abortion that is not a 10 mandatory service required under AS 47.07.030(a). The money appropriated for Health and 11 Social Services may be expended only for mandatory services required under Title XIX of the 12 Social Security Act and for optional services offered by the state under the state plan for 13 medical assistance that has been approved by the United States Department of Health and 14 Human Services. This statement is a statement of the purpose of the appropriation and is 15 neither merely descriptive language nor a statement of legislative intent. 16 It is the intent of the legislature that the department continue implementing policies and 17 procedures to aggressively audit payments made to Medicaid service providers. Audit 18 procedures should be regulated to assure that findings are accurate and supported by 19 documentary evidence. The use of statistical extrapolation techniques to calculate and 20 determine overpayment errors are discouraged. Procedures should be established to assure 21 that any proposed audit findings are thoroughly reviewed to exclude, where appropriate, 22 errors in the audit process and providers' ministerial mistakes from overpayment calculations 23 prior to issuing any notice of findings to the provider. Regulatory procedures must be 24 established allowing providers a method for rebutting auditors' calculations. 25 It is the intent of the legislature that the Department continues to aggressively pursue 26 Medicaid cost containment initiatives. Efforts should continue where the Department 27 believes additional cost containment is possible including further efforts to contain travel 28 expenses. The Department must continue efforts imposing regulations controlling and 29 materially reducing the cost of Personal Care Attendant (PCA) services. Efforts must be 30 continued utilizing existing resources to impose regulations screening applicants for 31 Residential Psychiatric Treatment Center (RPTC) services, especially for out-of-state

01 services. The department must address the entire matrix of optional Medicaid services, 02 reimbursement rates and eligibility requirements that are the basis of the Medicaid growth 03 algorithm. This work is to utilize the results of the Medicaid Assessment and Planning 04 analysis. The legislature requests that by January 2008 the Department be prepared to present 05 projections of future Medicaid funding requirements under our existing statute and regulations 06 and be prepared to present and evaluate the consequences of viable policy alternatives that 07 could be implemented to lower growth rates and reducing projections of future costs. 08 It is the intent of the legislature that the Department of Health and Social Services actively 09 participate in the development and growth of Alaska's therapeutic courts. 10 It is the intent of the legislature that the department evaluate establishing an asset test to be 11 incorporated in Denali KidCare and Child Care Benefits programs' eligibility determinations 12 that includes the value of assets leased and not owned by the applicant. The department 13 should report to the legislature, no later than January 15, 2008, possible asset test structures, 14 their projected consequences on program participants and any necessary changes to statute, 15 regulation or Alaska's Medicaid State Plan. 16 Alaskan Pioneer Homes 12,511,600 12,511,600 17 It is the intent of the legislature that the Department maintain regulations requiring all 18 residents of the Pioneer Homes to apply for all appropriate benefit programs prior to a state 19 subsidy being provided for their care from the State Payment Assistance program. 20 It is the intent of the legislature that all pioneers' homes and veterans' homes applicants shall 21 complete any forms to determine eligibility for supplemental program funding, such as 22 Medicaid, Medicare, SSI, and other benefits as part of the application process. If an applicant 23 is not able to complete the forms him/herself, or if relatives or guardians of the applicant are 24 not able to complete the forms, Department of Health and Social Services staff may complete 25 the forms for him/her, obtain the individuals' or designee's signature and submit for eligibility 26 per AS 47.25.120. 27 Alaska Pioneer Homes 64,300 28 Management 29 Pioneer Homes 12,447,300 30 Behavioral Health 87,303,800 63,703,500 23,600,300 31 Alcohol Safety Action 305,400

01 Program (ASAP) 02 Behavioral Health Medicaid 32,156,100 03 Services 04 Behavioral Health Grants 16,418,900 05 It is the intent of the legislature that the department continue developing polices and 06 procedures surrounding the awarding of recurring grants to assure that applicants are regularly 07 evaluated on their performance in achieving outcomes consistent with the expectations and 08 missions of the Department related to their specific grant. The recipient's specific 09 performance should be measured and incorporated into the decision whether to continue 10 awarding grants. Performance measurement should be standardized, accurate, objective and 11 fair, recognizing and compensating for differences among grant recipients including acuity of 12 services provided, client base, geographic location and other factors necessary and appropriate 13 to reconcile and compare grant recipient performances across the array of providers and 14 services involved. 15 Behavioral Health 2,473,100 16 Administration 17 Community Action Prevention 958,100 18 & Intervention Grants 19 Rural Services and Suicide 2,115,200 20 Prevention 21 Psychiatric Emergency 6,103,400 22 Services 23 Services to the Seriously 9,399,300 24 Mentally Ill 25 It is the intent of the legislature that the department provide the legislature, no later than 26 January 15, 2008, a report on the progress and funding to-date for the Bring the Kids Home 27 initiative and a five-year projected plan of development and anticipated funding requirements 28 including in-state infrastructure needs, care levels, in-state bed counts, out-of-state bed counts, 29 waitlists, Mental Health Trust Authority participation and expected outcomes and 30 improvements in the lives of clients expected to be achieved. 31 Designated Evaluation and 1,211,900

01 Treatment 02 Services for Severely 9,000,200 03 Emotionally Disturbed Youth 04 Alaska Psychiatric Institute 7,162,200 05 Children's Services 11,728,600 11,548,600 180,000 06 Children's Medicaid Services 3,830,000 07 Children's Services 64,100 08 Management 09 Front Line Social Workers 148,600 10 Foster Care Augmented Rate 500,000 11 Foster Care Special Need 747,900 12 Residential Child Care 1,956,300 13 Infant Learning Program 4,481,700 14 Grants 15 Adult Preventative Dental 1,425,000 1,425,000 16 Medicaid Services 17 Adult Preventative Dental 1,425,000 18 Medicaid Services 19 Juvenile Justice 558,600 369,400 189,200 20 McLaughlin Youth Center 348,400 21 Fairbanks Youth Facility 94,700 22 Bethel Youth Facility 55,700 23 Probation Services 59,800 24 Public Health 716,600 466,600 250,000 25 Women, Children and Family 500,000 26 Health 27 It is the intent of the legislature that the Department of Health and Social Services maintain 28 fiscal accountability for Alaska's Breast and Cervical Cancer screening population by 29 amending the age eligibility criteria based on the amount of federal resources appropriated on 30 an annual basis. It is incumbent upon the Department of Health and Social Services to revise 31 criteria appropriately to ensure that federal resources remain the sole source of financial

01 support for this program. 02 Certification and Licensing 118,300 03 Community Health Grants 98,300 04 Senior and Disabilities 13,904,400 13,156,600 747,800 05 Services 06 It is the intent of the legislature that the department continue improving procedures for 07 maintaining the disabilities waitlist to assure that criteria for listing are consistent, objective 08 and meaningful. The list should be accurately maintained without unnecessary action by 09 individuals on the list, identify services already being received by those on the list and be 10 utilized to promote parity in the provision of service throughout the social services system. 11 It is the intent of the legislature that the department act expeditiously in the administrative 12 processing of individuals on the waitlist so that they may begin receiving services as quickly 13 as possible utilizing the funding increment initiated in the fiscal 2007 budget. 14 It is the intent of the legislature that regulations related to the General Relief / Temporary 15 Assisted Living program be reviewed and revised as needed to minimize the length of time 16 that the state provides housing alternatives and assure the services are provided only to 17 intended beneficiaries who are actually experiencing harm, abuse or neglect. The department 18 should educate care coordinators and direct service providers about who should be referred 19 and when they are correctly referred to the program in order that referring agents correctly 20 match consumer needs with the program services intended by the department. 21 It is the intent of the legislature that the department continues the Inventory of Client and 22 Agency Planning (ICAP) process as recommended in the Ad Hoc Committee on the 23 Developmental Disability Waitlist Recommendations for Change report. It is further the 24 intent of the legislature that the Department move forward with implementation of the report 25 recommendations as appropriate and submit a progress report to the Legislature by January 26 15, 2008, which includes information regarding the number of individuals on the waiting list 27 that have had an ICAP completed as well as the Department's recommended action for those 28 recommendations contained in the Ad Hoc report with which they may disagree. 29 Senior and Disabilities 2,294,900 30 Services Administration 31 Protection and Community 740,300

01 Services 02 Senior Community Based 2,944,400 03 Grants 04 Community Developmental 7,924,800 05 Disabilities Grants 06 Departmental Support Services 1,739,000 1,659,000 80,000 07 Office of Program Review 98,400 08 Administrative Support 393,100 09 Services 10 Health Planning and 80,000 11 Infrastructure 12 Information Technology 817,500 13 Services 14 HSS State Facilities Rent 350,000 15 Boards and Commissions 1,611,500 568,900 1,042,600 16 AK Mental Health & Alcohol 819,400 17 & Drug Abuse Boards 18 Commission on Aging 130,600 19 Governor's Council on 536,000 20 Disabilities and Special 21 Education 22 Suicide Prevention Council 125,500 23 * * * * * * * * * * 24 * * * * * Department of Law * * * * * 25 * * * * * * * * * * 26 Civil Division 76,700 76,700 27 Human Services and Child 76,700 28 Protection 29 * * * * * * * * * * 30 * * * * * Department of Natural Resources * * * * * 31 * * * * * * * * * *

01 Resource Development 1,794,000 1,794,000 02 Mental Health Trust Lands 1,794,000 03 Administration 04 * * * * * * * * * * 05 * * * * * Department of Revenue * * * * * 06 * * * * * * * * * * 07 Alaska Mental Health Trust 2,365,900 2,365,900 08 Authority 09 Mental Health Trust 2,365,900 10 Operations 11 * * * * * * * * * * 12 * * * * * University of Alaska * * * * * 13 * * * * * * * * * * 14 University of Alaska 1,285,800 200,800 1,085,000 15 Statewide Services 300,000 16 Anchorage Campus 945,800 17 Fairbanks Campus 40,000 18 * * * * * * * * * * 19 * * * * * Alaska Court System * * * * * 20 * * * * * * * * * * 21 Alaska Court System 693,100 455,300 237,800 22 Trial Courts 693,100 23 (SECTION 2 OF THIS ACT BEGINS ON PAGE 10)

01 * Sec. 2. The following sets out the funding by agency for the appropriations made in sec. 1 of 02 this Act. 03 Funding Source Amount 04 Department of Administration 05 1037 General Fund / Mental Health 1,700,100 06 *** Total Agency Funding *** $1,700,100 07 Department of Corrections 08 1037 General Fund / Mental Health 6,298,700 09 1092 Mental Health Trust Authority Authorized 210,000 10 Receipts 11 *** Total Agency Funding *** $6,508,700 12 Department of Education and Early Development 13 1037 General Fund / Mental Health 49,400 14 1092 Mental Health Trust Authority Authorized 500,000 15 Receipts 16 *** Total Agency Funding *** $549,400 17 Department of Health and Social Services 18 1037 General Fund / Mental Health 103,984,200 19 1092 Mental Health Trust Authority Authorized 8,622,200 20 Receipts 21 1180 Alcohol and Other Drug Abuse Treatment & 18,892,700 22 Prevention Fund 23 *** Total Agency Funding *** $131,499,100 24 Department of Law 25 1037 General Fund / Mental Health 76,700 26 *** Total Agency Funding *** $76,700 27 Department of Natural Resources 28 1092 Mental Health Trust Authority Authorized 1,794,000 29 Receipts 30 *** Total Agency Funding *** $1,794,000 31 Department of Revenue

01 1094 Mental Health Trust Administration 2,365,900 02 *** Total Agency Funding *** $2,365,900 03 University of Alaska 04 1037 General Fund / Mental Health 200,800 05 1092 Mental Health Trust Authority Authorized 1,085,000 06 Receipts 07 *** Total Agency Funding *** $1,285,800 08 Alaska Court System 09 1037 General Fund / Mental Health 455,300 10 1092 Mental Health Trust Authority Authorized 237,800 11 Receipts 12 *** Total Agency Funding *** $693,100 13 * * * * * Total Budget * * * * * $146,472,800 14 (SECTION 3 OF THIS ACT BEGINS ON PAGE 12)

01 * Sec. 3. The following sets out the statewide funding for the appropriations made in sec. 1 of 02 this Act. 03 Funding Source Amount 04 General Funds 05 1037 General Fund / Mental Health 112,765,200 06 ***Total General Funds*** $112,765,200 07 Federal Funds 08 ***Total Federal Funds*** $0 09 Other Non-Duplicated Funds 10 1092 Mental Health Trust Authority Authorized 12,449,000 11 Receipts 12 1094 Mental Health Trust Administration 2,365,900 13 1180 Alcohol and Other Drug Abuse Treatment & 18,892,700 14 Prevention Fund 15 ***Total Other Non-Duplicated Funds*** $33,707,600 16 Duplicated Funds 17 ***Total Duplicated Funds*** $0 18 (SECTION 4 OF THIS ACT BEGINS ON PAGE 13)

01 * Sec. 4. The following appropriation items are for capital projects and grants from the 02 general fund or other funds as set out in section 5 of this Act by funding source to the 03 agencies named for the purposes expressed and lapse under AS 37.25.020, unless otherwise 04 noted. 05 Appropriation General Other 06 Allocations Items Funds Funds 07 * * * * * * * * * * 08 * * * * * Department of Health and Social Services * * * * * 09 * * * * * * * * * * 10 MH Southcentral Foundation 7,000,000 7,000,000 11 Eklutna Residential 12 Psychiatric Treatment 13 Center - Match for Bring 14 the Kids Home (HD 13-16) 15 MH Cost Share Match for 1,000,000 1,000,000 16 Bring the Kids Home (HD 17 1-40) 18 MH Treatment and Recovery 750,000 250,000 500,000 19 Based Special Needs Housing 20 (HD 1-40) 21 MH Home Modification and 250,000 250,000 22 Upgrades to Retain Housing 23 (HD 1-40) 24 MH Deferred Maintenance and 2,000,000 2,000,000 25 Americans with Disabilities 26 Act Improvement Grants to 27 Service Providers and for 28 Trust Beneficiaries (HD 29 1-40) 30 MH Essential Program 350,000 350,000 31 Equipment (HD 1-40)

01 * * * * * * * * * * 02 * * * * * Department of Natural Resources * * * * * 03 * * * * * * * * * * 04 Mental Health Trust Land 350,000 350,000 05 Facilities Maintenance (HD 06 1-40) 07 * * * * * * * * * * 08 * * * * * Department of Revenue * * * * * 09 * * * * * * * * * * 10 Alaska Housing Finance 11 Corporation 12 Beneficiary and Special 1,750,000 1,750,000 13 Needs Housing (HD 1-40) 14 Emergency Assistance Grants 200,000 200,000 15 for Mental Health Trust 16 Beneficiaries (HD 1-40) 17 Homeless Assistance Program 1,500,000 1,500,000 18 (HD 1-40) 19 * * * * * * * * * * 20 * * * * * Department of Transportation/Public Facilities * * * * * 21 * * * * * * * * * * 22 Coordinated Transportation 300,000 300,000 23 and Vehicles (HD 1-40) 24 (SECTION 5 OF THIS ACT BEGINS ON PAGE 15)

01 * Sec. 5. The following sets out the funding by agency for the appropriations made in sec. 4 of 02 this Act. 03 Funding Source Amount 04 Department of Health and Social Services 05 1037 General Fund / Mental Health 10,600,000 06 1092 Mental Health Trust Authority Authorized Receipts 500,000 07 1139 Alaska Housing Finance Corporation Dividend 250,000 08 *** Total Agency Funding *** $11,350,000 09 Department of Natural Resources 10 1092 Mental Health Trust Authority Authorized Receipts 350,000 11 *** Total Agency Funding *** $350,000 12 Department of Revenue 13 1092 Mental Health Trust Authority Authorized Receipts 700,000 14 1139 Alaska Housing Finance Corporation Dividend 2,750,000 15 *** Total Agency Funding *** $3,450,000 16 Department of Transportation/Public Facilities 17 1092 Mental Health Trust Authority Authorized Receipts 300,000 18 *** Total Agency Funding *** $300,000 19 * * * * * Total Budget * * * * * $15,450,000 20 (SECTION 6 OF THIS ACT BEGINS ON PAGE 16)

01 * Sec. 6. The following sets out the statewide funding for the appropriations made in sec. 4 of 02 this Act. 03 Funding Source Amount 04 General Funds 05 1037 General Fund / Mental Health 10,600,000 06 ***Total General Funds*** $10,600,000 07 Federal Funds 08 ***Total Federal Funds*** $0 09 Other Non-Duplicated Funds 10 1092 Mental Health Trust Authority Authorized 1,850,000 11 Receipts 12 1139 Alaska Housing Finance Corporation Dividend 3,000,000 13 ***Total Other Non-Duplicated Funds*** $4,850,000 14 Duplicated Funds 15 ***Total Duplicated Funds*** $0 16 (SECTION 7 OF THIS ACT BEGINS ON PAGE 17)

01 * Sec. 7. PURPOSE. In accordance with AS 37.14.003 and 37.14.005, the appropriations 02 made by this Act are for the state's integrated comprehensive mental health program. 03 * Sec. 8. NONGENERAL FUND RECEIPTS. (a) Alaska Mental Health Trust Authority 04 authorized receipts (AS 37.14.036) or administration receipts (AS 37.14.036) that exceed the 05 amounts appropriated by this Act are appropriated conditioned upon compliance with the 06 program review provisions of AS 37.07.080(h). 07 (b) If Alaska Mental Health Trust Authority authorized receipts (AS 37.14.036) or 08 administration receipts (AS 37.14.036) fall short of the estimates appropriated in this Act, the 09 affected appropriation is reduced by the amount of the shortfall in receipts. 10 * Sec. 9. SALARY AND BENEFIT ADJUSTMENTS. (a) The appropriations made in sec. 11 1 of this Act include amounts for salary and benefit adjustments for public officials, officers, 12 and employees of the executive branch, Alaska Court System employees, employees of the 13 legislature, and legislators and to implement the terms for the fiscal year ending June 30, 14 2008, of the following collective bargaining agreements: 15 (1) Alaska Public Employees Association, for the Confidential Unit; 16 (2) Alaska Public Employees Association, for the Supervisory Unit; 17 (3) Alaska State Employees Association, for the General Government Unit; 18 (4) Marine Engineers Beneficial Association, representing licensed engineers 19 employed by the Alaska marine highway system; 20 (5) Public Employees Local 71, for the Labor, Trades and Crafts Unit; 21 (6) Inlandboatmen's Union of the Pacific, representing the unlicensed marine 22 unit; 23 (7) International Organization of Masters, Mates, and Pilots, for the Masters, 24 Mates, and Pilots Unit; 25 (8) Public Safety Employees Association, representing regularly 26 commissioned public safety officers; 27 (9) Alaska Correctional Officers Association, representing correctional 28 officers; 29 (10) Alaska Vocational Technical Center Teachers' Association - National 30 Education Association, representing employees of the Alaska Vocational Technical Center; 31 (11) Teachers' Education Association of Mt. Edgecumbe.

01 (b) The operating budget appropriations made to the University of Alaska in sec. 1 of 02 this Act include amounts for salary and benefit adjustments for the fiscal year ending June 30, 03 2008, for university employees who are not members of a collective bargaining unit and for 04 implementing the monetary terms of the collective bargaining agreements including the terms 05 of the agreement providing for the health benefit plan for university employees represented by 06 the following entities: 07 (1) Alaska Higher Education Crafts and Trades Employees; 08 (2) Alaska Community Colleges' Federation of Teachers; 09 (3) United Academics; 10 (4) United Academics-Adjuncts. 11 (c) If a collective bargaining agreement listed in (a) or (b) of this section is not ratified 12 by the membership of the respective collective bargaining unit, the appropriations made by 13 this Act that are applicable to that collective bargaining unit's agreement are reduced 14 proportionately by the amount for that collective bargaining agreement, and the corresponding 15 funding source amounts are reduced accordingly. 16 (d) Appropriations made in sec. 1 of this Act for salary and benefit adjustments as 17 described in (a) and (b) of this section are for the benefit of the state's integrated 18 comprehensive mental health program only and do not necessarily affect every group of non- 19 covered employees or every collective bargaining unit listed in (a) and (b) of this section. 20 * Sec. 10. This Act takes effect July 1, 2007.