Legislature(1999 - 2000)
04/13/2000 03:13 PM House HES
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* first hearing in first committee of referral
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SB 204 - EXTEND ALASKA COMMISSION ON AGING Number 0037 CHAIRMAN DYSON announced the first order of business as Senate Bill No. 204, "An Act extending the termination date of the Alaska Commission on Aging; and providing for an effective date." JERRY BURNETT, Staff to Senator Lyda Green, Alaska State Legislature, came forward to present SB 204. He noted there was a draft committee substitute (CS) in the packet. The CS moves the office of Long-Term Care Ombudsman (LTCO) from the Alaska Commission on Aging to the legislative branch. He gave the following testimony: In order for the long-term care of the elderly to be monitored and investigated properly, the Long-Term Care Ombudsman's office must be moved out of the current conflicted position. It is not possible for the Director of the Commission on Aging to neutrally monitor the Long-Term Care Ombudsman who may be investigating actions of that director, his/her employees, and colleagues within the Department of Administration. A recent legislative audit showed that the conflict exists under the present system. Alaskans have a right to be assured and have the public perception that they, or their friends and relatives who are under the care of a state-operated facility will be accorded the same rights to a full and fair investigation of care as are persons in the care of a private facility. The only way to be sure that investigations of public and private long-term facilities are seen equal is to move the responsibility for that investigation of complaints and advocacy for the rights of seniors away from the body that also operates or licenses some of these facilities. Number 0188 SHARON CLARK, Staff to Senator Mike Miller, Alaska State Legislature, came forward to testify. She read the following testimony: The Alaska Commission on Aging was first established as a single Planning and Service Area (PSA) in the Department of Administration as the Older Alaskans Commission in July of 1981 by AS 44.21. Being classified as a PSA means that the commission is the only agency in the state that plans, funds and oversees services to seniors statewide. In 1994, legislation was adopted (Chapter 131, SLA 1994) that changed the commission's name to Alaska Commission on Aging (ACOA). The commission is authorized to administer and coordinate state programs for older Alaskans and to administer federal programs provided under the Older Americans Act, 42 U.S. Code 3001-30451, as amended. Together, the provisions of AS 44.21 and the Older Americans Act establishes the commission's authority, purpose, and scope of work. On September 17, 1999, the Alaska State Legislature, Legislative Budget and Audit Committee's special report on the Department of Administration, Alaska Commission on Aging conclusion's were the following: The expiration date of ACOA should be extended. In our opinion, ACOA has demonstrated that there is a public need for this commission. According to AS 44.66.010, the commission is scheduled to expire June 30, 2000. We recommend that the legislature adopt legislation extending ACOA's expiration date to June 30, 2004. The purpose of SB 204 is to extend the termination date of the Alaska Commission on Aging to June 2004. MS. CLARK noted this had no fiscal impact because it is already in the Governor's budget. CHAIRMAN DYSON asked Ms. Clark if Senator Miller has seen the CS. MS. CLARK said they were aware in the Senate Finance Committee that Senator Green had an objection to the ombudsman being separated from this but they were not aware of the CS until a few hours ago. She said that the CS is fine with Senator Miller. Number 0457 JANE DEMMERT, Executive Director, Alaska Commission on Aging (ACOA), Division of Senior Services, Department of Administration, came forward to testify. She gave an overview of the ACOA and explained that the ACOA provides a function that is required under the Older Americans Act. The Meals on Wheels and the senior center programs are largely funded with dollars from the Older Americans Act. The commission administers other grants and also serves as the beneficiary board in relationship with the Alaska Mental Health Trust Authority as it relates to Alaskans who are affected by Alzheimer's and other dementia. Finally the ACOA is involved in extensive education which its newsletter provides to a growing statewide community of older Alaskans. MS. DEMMERT reported that over the last nine months, the ACOA has restructured its committee structure and bylaws to accommodate and address the issues in relation to an allegation of conflict of interest regarding the housing and function of the Long-Term Care Ombudsman. The commission has created a new standing committee which excludes from its membership any member of the commission who has even a glancing relationship with the pioneer homes and provides oversight for the ombudsman function. The commission has made an extraordinary commitment to address those dimensions and considerations that speak to a conflict of interest. MS. DEMMERT pointed out that a search committee, which includes members of the standing Long-Term Care Ombudsman committee of the commission, and two members of the Alaska Mental Health Trust Authority: its executive director and Nelson Page, the former chair, are in the relatively late stages of a search for a Long- Term Care Ombudsman. Finalist interviews are expected to be held in a couple weeks. If it is the will of the legislature to transfer this function, she suggested it would be better if the effective date was immediately rather than July 1, 2001. Otherwise there might be a vacancy for a year or the position would be filled with an interim person, and the legislature would have to do its own search. Number 0678 REPRESENTATIVE BRICE asked if she supports the extension but opposes moving the Long-Term Care Ombudsman. MS. DEMMERT answered yes, but the ACOA feels also that it has done all that it can so if it is going to move, the effective date should be adjusted just to be as supportive of the well- being of that function. CHAIRMAN DYSON noted that recently there have been many complaints about senior care around the state as well as positive comments about how well the seniors are being taken care of and that no problems exist. He asked: why has senior care been so controversial, with so many reports of abuse and the huge controversy surrounding the ombudsman's office? He also asked what has precipitated the real and imaginary problems. MS. DEMMERT answered that this is a dynamic in Alaska and around the country. Assisted living is a new industry and has minimal regulation at this point across the country. Therefore, people have different expectations of what will be provided. All of those expectations should be spelled out very clearly when a contract is signed for service. This is a growing area. The other dimension is that people are living longer so someone may have been accepted into an assisted living facility with the understanding that he/she would age in place and be there forever. However, often the individuals receiving that care begin to have such extreme conditions that they can't be adequately provided for and that is problematic. This is a continuing area of work; there are no black and white answers and the concerns are legitimate. Some people are very pleased, and some are extremely frustrated. There have been situations where there has been illegal or inappropriate care, and there have been others where the care has been adequate, but there is a great difference between adequate and ideal. There is no easy answer. Alaska's overall quality of care is considerably higher than just about any state in the country. However, that does not excuse illegal or inappropriate types of care. Number 0894 CHAIRMAN DYSON said there have been reports of seniors being left unattended in a bathtub or falling and having broken bones, or being mismedicated. He asked if there had been any substance to any of those reports. MS. DEMMERT answered in some instances yes. In some instances she believes there were different assessments of what had actually occurred. CHAIRMAN DYSON asked what was the situation that produced so much controversy around the ombudsman's office. MS. DEMMERT answered she wasn't sure. When the ombudsman's office is doing its work she believes there will inevitably be a degree of controversy. It is hard to know what he has in mind. CHAIRMAN DYSON asked where the senior ombudsman resides structurally in other jurisdictions. MS. DEMMERT answered it varies across the country. In some [states the ombudsman's office] is in the Department of Health and Human Services, some have a Department of Aging and Adult Services, and at least one resides in the Office of the Governor. In further response to Chairman Dyson, Ms. Demmert believes [that in some states the ombudsman's office] is in the legislative branch. Number 0992 REPRESENTATIVE BRICE asked Ms. Demmert how she would address the argument or conflict of having the ombudsman's office in the Department of Administration and having the funding and the programs in the same department. MS. DEMMERT answered the commission is composed of eleven members. The appointments to commissionship are made by the governor and the reporting relationship for the commission is to its commission. Administratively there is a link with the Division of Senior Services, but there is a clear distinction between the commission and the Division of Senior Services within the overall departmental structure. REPRESENTATIVE BRICE asked where the Long-Term Care Ombudsman fits into that structure. MS. DEMMERT replied the Long-Term Care Ombudsman is under the Alaska Commission on Aging. The committee took an at-ease from 3:30 p.m. to 3:31 p.m. Number 1093 REPRESENTATIVE COGHILL made a motion to adopt the proposed House committee substitute (CS) for SB 204, version 1-LS1288\D, Lauterbach, 4/10/00, as a work draft. Number 1100 REPRESENTATIVE GREEN objected. REPRESENTATIVE BRICE commented that over the years he has seen a continuous eroding of financial support to the legislative ombudsman's office which he believes is a dangerous thing. He asked how is the Long-Term Care Ombudsman's office funded in the Department of Administration and will it be jeopardized by bringing it over to the legislative ombudsman's office. MS. DEMMERT replied that function is federally funded through the Older Americans Act from funding that comes to the Alaska Commission on Aging. Number 1185 MR. BURNETT said he understands that the funding through the Older Americans Act could be transferred from the Alaska Commission on Aging to the legislative branch to pay for this function. REPRESENTATIVE BRICE asked if a clear bright line distinction is made in the CS of funding sources so the LTCO doesn't get thrown into the whole pot of the other ombudsman. MR. BURNETT noted this LTCO is separate from the state ombudsman's office. REPRESENTATIVE KEMPLEN asked if there has been a senior group that has advocated for the move of the LTCO or any documented request by any senior constituent groups. MR. BURNETT answered no, not specifically. CHAIRMAN DYSON mentioned that he has heard some seniors mention moving it in the past, but not through any formal action of some group. REPRESENTATIVE BRICE asked why they are waiting to this point in time to meld this idea. MR. BURNETT explained that Senator Green floated this idea when the bill was in the Senate and spoke to the ACOA and other people. She agreed to withdraw the amendment at that point and after further conversations decided to bring it back at this time. CHAIRMAN DYSON suggested that the committee amend the CS, even though it hadn't formally been adopted as the work draft. He recommended striking "2001" on page 13, line 7, and replacing it with "2000." Number 1319 REPRESENTATIVE BRICE made a motion to change "2001" to "2000" on page 13, line 7. CHAIRMAN DYSON asked whether there was any objection. There being none, Amendment 1 was adopted. Number 1349 REPRESENTATIVE COGHILL noted there were other places in the bill that still said 2001. Number 1365 REPRESENTATIVE BRICE changed Amendment 1 to be a conceptual amendment to replace 2001 with 2000 [throughout] the bill. CHAIRMAN DYSON asked whether there was any objection. There being none, Amendment 1, as amended, was adopted as a conceptual amendment. CHAIRMAN DYSON said the ombudsman idea is a wonderful idea. The independence of the ombudsman has been jealously guarded, and the person can only be taken to task for not being an advocate for whatever group it is. The independence of that is important, and that is an argument for taking it away from the administration. He doesn't know if there has been a problem with it but the commissioners are appointed by the governor and then the ombudsman reports to those commissioners, it could be the perception that that person would struggle to expose things going wrong. However, he noted that he has no evidence whatsoever regarding such a problem. REPRESENTATIVE KEMPLEN asked why it is just not acceptable to have the LTCO in another line agency such as the Department of Health and Social Services. He gave the example of the Foster Care Review Board. He wondered why the LTCO had to be moved over into the legislature. MR. BURNETT answered that the governor eliminated funding for the Foster Care Review Board, and the concern exists that it is still the same executive. Alaska is unique in that the governor is the only statewide official elected; most states have other departments run by statewide elected officials. Since Alaska only has a single executive, that is why there is this proposal to move [the LTCO to] the legislative branch. REPRESENTATIVE BRICE agrees it should be out of the Department of Administration; he gets antsy when they talk about putting it into the legislature because he has seen what has been done to the general ombudsman. Over the next couple of days he will see if there is a possibility to put a bright line in the bill so if it is in the legislature it has a certain amount of independence to ensure that funding stream doesn't go off to other things. REPRESENTATIVE GREEN said an ombudsman can be adversarial as opposed to some other shifts within a commissioner's fiefdom. When that occurs it is in harm's way and an arm's length is always good. A roll call vote was taken. Representatives Whitaker, Green, Morgan, Brice, Coghill and Dyson voted in favor of adopting the House CS [version 1-LS1288\D, Lauterbach, 4/10/00, as amended] as the work draft. Representative Kemplen voted against it. Therefore, Version D [as amended] was adopted by a vote of 6-1. Number 1659 REPRESENTATIVE BRICE made a motion to move the HCS for SB 204, as amended, out of committee with individual recommendations and attached fiscal notes. There being no objection, HCS SB 204(HES) was moved from the House Health, Education and Social Services Standing Committee.
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