04/29/1998 03:13 PM House HES

HB  44 - ADMISSION TO PIONEERS' HOMES                                          
                                                                               
Number 0062                                                                    
                                                                               
REPRESENTATIVE TOM BRICE, Sponsor of HB 44, said the concept of                
this legislation was brought to his attention during the last                  
campaign by one of his constituents who, while on the waiting list             
for the Alaska Pioneers' Home, inquired if he would be denied                  
admission if the monthly rent increased to a point where he                    
couldn't afford it.  While it is current policy that the Pioneers'             
Home will not disqualify a person based on failure to make an                  
initial payment or provide security for monthly payments, his                  
concern is that policy could change during the annual policy                   
update.  House Bill 44 would place that policy in statute, thus                
protecting the state's senior population from being denied                     
admission into the Pioneers' Home.                                             
                                                                               
Number 0140                                                                    
                                                                               
REPRESENTATIVE BRICE made a motion to adopt Amendment 1 which                  
reads:                                                                         
                                                                               
     Page 1, line 10:                                                          
                                                                               
          Following "on"                                                       
          Insert "financial"                                                   
                                                                               
CHAIRMAN BUNDE objected for the purpose of discussion.                         
                                                                               
REPRESENTATIVE BRICE withdrew Amendment 1 because his concern was              
addressed on line 13.                                                          
                                                                               
Number 0260                                                                    
                                                                               
CHAIRMAN BUNDE pointed out the Department of Administration had                
submitted a zero fiscal note, yet there would be people at the                 
Pioneers' Home at state expense.  He inquired at what point is it              
determined that a person cannot pay.                                           
                                                                               
REPRESENTATIVE BRICE said a person would be required to pay as much            
as possible based on the current determination process.  This                  
legislation basically states a person unable to provide security or            
make an initial payment will not be denied admission.                          
                                                                               
CHAIRMAN BUNDE remarked the zero fiscal note is misleading in that             
it does cost money, just not additional money.                                 
                                                                               
Number 0335                                                                    
                                                                               
REPRESENTATIVE JOE GREEN asked if that's the case, is HB 44                    
necessary?                                                                     
                                                                               
REPRESENTATIVE BRICE responded it is necessary because policy is               
just that - policy, and given that policies can change without                 
legislative approval, he wants that policy codified to statute.                
                                                                               
REPRESENTATIVE GREEN said, "Last summer, I visited the Pioneers'               
Home in Anchorage and there were several people in there who were              
not Alzheimer or dementia people and because they were up to some              
80 percent of the people that lived there suffering from some form             
of dementia, the costs were escalating extremely rapidly.  Now if              
that's the case - and these people were saying they were in danger             
of being thrown out - if the policy is that if they can't pay, they            
get to either come in or get to stay in, there's a confusion factor            
here because the people were already there and fearful that they               
were going to be thrown out because they could not longer afford               
these elevated prices."                                                        
                                                                               
REPRESENTATIVE BRICE agreed that was a good point and added the                
purpose of HB 44 is to alleviate some of that concern and fear.                
                                                                               
REPRESENTATIVE GREEN said, "If that's the case and people will make            
application, the costs are going up because you're treating                    
dementia patients, is that going to exacerbate the problem at the              
Pioneers' Home because costs are going up to cover the cost of                 
operation, but these people are coming in not paying the costs,                
which makes them go up even higher."                                           
                                                                               
REPRESENTATIVE BRICE responded this will ensure that individuals               
will not be denied admission to the Pioneers' Home because of their            
inability to pay.  Individuals living at the Pioneers' Home have               
never paid the full cost of care, yet it is true that individuals              
are helping to pay the increased costs of having to care for                   
individuals with dementia.  He added, "What this might help us with            
is possibly ensuring that those - as the prices increase and the               
costs are shifted, that folks still have access because frankly, I             
don't know too many people who come from the era of the folks who              
are involved in the Pioneers' Home, who could afford to pay the                
full cost on the fixed level of retirement they're getting out of              
jobs they had in the 70s ...."                                                 
                                                                               
REPRESENTATIVE GREEN said, "If that's happening - if we're treating            
more and more dementia related illnesses, mental illnesses if you              
will, in Pioneers' Home, have we lost the idea of the Pioneers'                
Home originally, should we go back to having a Pioneers' Home and              
if we have that many mental illness faces, then I think Mental                 
Health ought to come in and take care of those people and not                  
confuse the issue with the Pioneers' Home."                                    
                                                                               
REPRESENTATIVE BRICE shared Representative Green's point of view               
and has drafted legislation that would codify the role of the                  
Pioneers' Home as a communal living environment, breaking off the              
dementia related illnesses to a separate facility so as to become              
Medicaid eligible, and refinance their care by 50 percent of                   
federal funds.                                                                 
                                                                               
Number 0660                                                                    
                                                                               
CHAIRMAN BUNDE observed there have been a number of policy                     
decisions made relating to the Pioneers' Homes.  He asked if there             
was further discussion on HB 44.  Hearing none, he closed public               
testimony and asked the wish of the committee.                                 
                                                                               
Number 0697                                                                    
                                                                               
REPRESENTATIVE BRICE made a motion to pass HB 44 out of committee              
with individual recommendations and attached zero fiscal notes.                
                                                                               
CHAIRMAN BUNDE asked if there was objection.  There being none,                
HB 44 moved from the House Health, Education and Social Services               
Standing Committee.