Legislature(2005 - 2006)HOUSE FINANCE 519
04/06/2006 01:30 PM House FINANCE
| Audio | Topic |
|---|---|
| Start | |
| HB307 | |
| HB493 | |
| HCR30 | |
| HB105 | |
| Adjourn |
* first hearing in first committee of referral
+ teleconferenced
= bill was previously heard/scheduled
+ teleconferenced
= bill was previously heard/scheduled
| += | HB 488 | TELECONFERENCED | |
| + | TELECONFERENCED | ||
| += | HCR 30 | TELECONFERENCED | |
| += | HB 307 | TELECONFERENCED | |
| += | HB 493 | TELECONFERENCED | |
| += | HB 105 | TELECONFERENCED | |
3:29:09 PM HOUSE BILL NO. 105 An Act relating to coverage for adult dental services under Medicaid; and providing for an effective date. Representative Foster MOVED to ADOPT work draft #24-GH108\F, Mischel, 4/5/06, as the version of the bill before the Committee. There being NO OBJECTION, it was adopted. 3:30:03 PM BILL HOGAN, DEPUTY COMMISSIONER, DEPARTMENT OF HEALTH AND SOCIAL SERVICES, explained that the Department is proposing changes to the range of adult dental services allowed in the Medicaid program. The adult dental coverage currently provides only emergency dental care. The legislation would enhance the existing emergency dental program to include preventive and restorative care. The expanded program would benefit those most in need as well as Alaskan seniors. A proposed cap of $1150 per year would allow for a full set of dentures over a two-year period. 3:33:15 PM Mr. Hogan continued, infections of the mouth can result in all sorts of physical problems. Dental infections can be passed to unborn infants and can keep a person unemployed given the decayed teeth. The Alaska Mental Health Trust (AMHT) has a mini grant program, annually dispersing over $700 thousand dollars on dental care programs for their beneficiaries. If the bill passes, those Medicaid dollars could be used. The Division of Vocational Rehabilitation has noted they spend annually about $100 thousand dollars to help people with dental concerns, increasing the possibility they can become employed. 3:34:31 PM JANET CLARKE, ASSISTANT COMMISSIONER, DIVISION OF FINANCE AND MANAGEMENT SERVICES, DEPARTMENT OF HEALTH AND SOCIAL SERVICES, pointed out that the revised fiscal note was based on the committee substitute and was reduced from the original note. FY07 number reduction of $3.5 million dollars estimate to $2.6 million dollars providing a reduction to general funds. The fiscal note request for the first year assumes coverage for 25% of a full year. Ms. Clarke explained how the fiscal note had been reduced. She mentioned the utilization assumptions. In looking back at those assumptions, it was changed to a 15% utilization the first year, 25% the second year and then up to 35% the following year, which reduces some costs. She indicated how much the State spends on emergency dental coverage, factoring in the savings. When HB 105 was introduced last year, it was based on a federal-Medicaid percentage of 50%; our congressional delegation was able to change that to 57.5% federal participation, saving in the General Fund requirement. The Alaska Mental Health Trust Authority has agreed to maintain their funding level. AMTA will be investing significant dollars during the next four years. Ms. Clarke pointed out that the committee substitute sunsets after FY09. She offered to answer questions of the Committee. 3:37:44 PM Representative Kelly inquired about the reallocation of funding within the Department. Ms. Clarke advised that making cuts to the Medicaid program is complicated and difficult. She stated that if the Department is not aligned with the Legislature on what direction it is going into the Medicaid program, there will be many criticisms for making such reductions. To find money internally would be difficult. 3:39:14 PM Representative Kerttula inquired if most similar programs begin with a sunset. Ms. Clarke replied that there have been programs with a sunset such as Senior Care; sunsets are becoming a trend of this Legislature. Representative Kelly was not comforted with the sunset concept, realizing the enormity of the Department's budget. 3:41:24 PM Representative Hawker disagreed. The point of establishing a short windowed sunset, offers the Legislature the option of making a policy call, rather than creating it into perpetuity; the sunset offers a trial time. He noted that the bill has been restructured to avoid concerns of continued growth. 3:43:22 PM ANDY POPE, JUNEAU, spoke in support of the legislation. He noted that he represented the seniors at Mountain View Senior Center, many of whom are low-income and have fallen through the cracks of dental care reimbursement. He commented that the $1100 dollar threshold would help tremendously for initial dental care expenses and then the seniors could pay the rest with their Permanent Fund Dividend (PFD). He urged passage of HB 105. 3:46:17 PM MIKE FORD, ALASKA NATIVE HEALTH BOARD, JUNEAU, stated that they completely support HB 105. The committee substitute provides a cautious approach and allows taking a look at the program. The proposed legislation is a prudent, practical and critical for many residents of the State. He urged that it pass quickly from Committee. 3:47:15 PM DR. KATHINKA WHITE, (TESTIFIED VIA TELECONFERENCE), REPRESENTATIVE FOR THE ALASKA PRIMARY CARE ASSOCIATION, ANCHORAGE, testified in strong support of the proposed legislation. Dental infections of the tooth, gums, tissue and bone are infectious diseases. Dental problems, except in early stages, are irreparable and cumulative. Dr. White stated that oral disease is associated with many other problems. As many as 80% of the premature infants born in the United States can be attributed to the infectious oral diseases. Providing emergency dental care may relieve acute symptoms. She urged passage of the bill, stressing the need to address oral health and improved access to dental care. 3:51:04 PM JEFF JESSE, (TESTIFIED VIA TELECONFERENCE), CEO, ALASKA MENTAL HEALTH TRUST AUTHORITY, ANCHORAGE, reiterated support for HB 105. He mentioned the seriousness of the sunset provision and offered to answer questions of the Committee. 3:52:09 PM CARLA SHELTON, (TESTIFIED VIA TELECONFERENCE), PARENT ADVOCATE, emphasized the importance of adult dental services and urged passage of the bill. 3:55:05 PM EMILY ENNIS, (TESTIFIED VIA TELECONFERENCE), EXECUTIVE DIRECTOR, FAIRBANKS RESOURCE AGENCY, FAIRBANKS, testified in support of dental care for adults & children with developmental disabilities. Preventative dental care is a necessary investment that goes hand-in-hand with the other disability services offered by the State. She urged the Committee's support in passage of the legislation. 3:56:23 PM STACY MESSERSCHMIDT, (TESTIFIED VIA TELECONFERENCE), TOK, spoke in support of HB 105. 3:56:50 PM SYDNEY STREDICKET, (TESTIFIED VIA TELECONFERENCE), PARTNERS IN POLICY, spoke in strong support of HB 105. 3:58:00 PM PAT LUBBY, (TESTIFIED VIA TELECONFERENCE), ADVOCACY DIRECTOR, ALASKA ASSOCIATION OF RETIRED PERSONS (AARP), ANCHORAGE, noted that Medicaid has never provided any dental care coverage and consequently, some older people stay away from dentists because they cannot afford it. The result is bad oral health, which adds to other physical health concerns. He stressed it is a real concern faced by real Alaskans. He urged passage of HB 105, because it is good public health legislation. MEG MITCHELL, (TESTIFIED VIA TELECONFERENCE), HOMER, cited her experience in working with individuals with disabilities, noting the need for adults on Medicaid to receive dental care. She expressed strong support of the legislation, pointing out there are 40,000 adults in Alaska that need the coverage but cannot afford it. She urged passage of HB 105. STAN STEADMAN, (TESTIFIED VIA TELECONFERENCE), EXECUTIVE DIRECTOR, CENTER PENINSULA HEALTH CENTER, ASPEN DENTAL CENTER, KENAI, stated that his clinic has seen many patients that desperately need such services. He urged passage of HB 105. JENNIFER MCELROY, (TESTIFIED VIA TELECONFERENCE), DENTAL HYGENIST, SOLDOTNA, noted the great need for adult Medicaid recipients to receive dental benefits and echoed support for passage of the legislation. DR. MARGUERITE MCINTOSH, (TESTIFIED VIA TELECONFERENCE), FAMILY DOCTOR, SOLDOTNA, testified in support of the legislation. As a family practioner in private practice, she noted costs for medical concerns that begin with dental issues. She pointed out incidents of adults contracting lung infections resulting from a lack of dental care over the years. She urged passage of HB 105. PAMELA HAWK, (TESTIFIED VIA TELECONFERENCE), DENTAL OPERATIONS MANAGER FOR ANCHORAGE NEIGHBORHOOD HEALTH CENTER, ANCHORAGE, noted that she had seen many patients suffering from dental infections, and that those people can only receive tooth extractions. She noted, many individuals would like to receive preventative care prior to the extraction. She addressed the high cost for root canals and restorative treatments; she stated that dental care is completely prohibitive for anyone that does not have dental health benefits and insurance. Ms. Hawk thanked the Committee for consideration of the bill and urged passage. PUBLIC TESTIMONY CLOSED. Co-Chair Meyer MOVED to ADOPT Amendment #1. Vice Chair Stoltze OBJECTED. SUZANNE CUNNINGHAM, STAFF, REPRESENTATIVE KEVIN MEYER, explained that the amendment was brought forward at the request of the Department of Health and Social Services, because the wording in the draft committee substitute was of concern. The proposed change to Page 2, Line 6, clarifies that the Department will pay for preventive and restorative dental services as well as minimum treatment. The second change on Page 2, Lines 16-18, instead of only palliative treatment, the Department requests "immediate relief of pain and/or the spreading of infection and provided by a licensed dentist". Janet Clarke acknowledged they had requested the change for clarity purposes. Vice Chair Stoltze WITHDREW his OBJECTION. There being NO further OBJECTION, it was adopted. Representative Weyhrauch MOVED to ADOPT Amendment #2. Vice Chair Stoltze OBJECTED. Representative Weyhrauch explained that amendment would remove the initial portion of the bill, making it into intent language and putting it into a House Finance Committee Letter of Intent. Representative Hawker indicated his support of the amendment, pointing out the precedent to include intent in a Letter of Intent rather than in the bill itself. 4:12:57 PM Vice Chair Stoltze REMOVED his OBJECTION to the amendment. There being NO further OBJECTIONS, conceptual Amendment #2 was adopted. In response to Co-Chair Meyer, Representative Hawker noted that a great deal of time was spent on the revised fiscal note, which adequately reflects an excellent return on the investment. 4:14:32 PM Representative Kelly asked clarification between emergency and continuing care. Ms. Clarke responded that the statute clarifies emergency dental care very well as the "immediate relief of pain and acute infection". That definition is maintained in the legislation. She noted that other services were defined as "preventative and restorative" and that restorative services were being added in the legislation, while emergency services remain in tact. She reiterated that there is a cap of $1,150 for total restorative services each year. 4:17:18 PM Representative Hawker addressed the criticism of the bill as a "new program". He emphasized that dental services were provided under the existing Medicaid program; he explained that the readjusted program toward preventative maintenance, in the hope that emergency services would then be reduced in the new model. He stressed the cap as being unique to the program, which allows his strong support of the bill. Representative Kelly noted he too supports the bill, however, expressed concern regarding the sustainability of the program within the Department's budget. He noted the escalation of that Department's budget in addition to what is going on with the public employee retirement system. Representative Weyhrauch MOVED to REPORT CS HB 105 (FIN) out of Committee with individual recommendations and with the accompanying fiscal notes. There being NO OBJECTION, it was so ordered. CS HB 105 (FIN) was reported out of Committee with a "do pass" recommendation, House Finance Committee Letter of Intent and with fiscal notes #1 and #2 by the Department of Education & Early Development and a new fiscal note by the Department of Health and Social Services.
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