Legislature(2003 - 2004)
02/24/2004 03:06 PM House HES
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* first hearing in first committee of referral
+ teleconferenced
= bill was previously heard/scheduled
+ teleconferenced
= bill was previously heard/scheduled
HB 394-COMMISSION ON AGING
Number 0050
CHAIR WILSON announced that the first order of business would be
HOUSE BILL NO. 394, "An Act extending the Alaska Commission on
Aging."
Number 0092
REPRESENTATIVE GATTO moved to adopt CS HB 394, 23-LS1534\D,
Mischel, 2/19/04, as the working document. There being no
objection, HB 394, version D, was adopted as the working
document before the House Health, Education and Social Services
Standing Committee.
Number 0155
BARBARA COTTING, Staff to Representative Jim Holm, Alaska State
Legislature, presented the bill on behalf of Representative
Holm, sponsor of HB 394. She explained that the committee
substitute that the members just adopted as the working document
adds sections 2 and 3 to the original bill. The original bill
was very short because it consisted of one section that extended
the sunset [of the Alaska Commission on Aging].
MS. COTTING explained that in 2003, Executive Order 108 moved
many commissions to different departments. It is important to
note that at that time the Commission on Aging was moved from
the Department of Administration to the Department of Health and
Social Services. Legislative Legal and Research Services
believes that it is important to clarify that point and that is
the purpose of sections 2 and 3, she said. It is just a
housekeeping measure.
Number 0260
STEVE ASHMAN, Director, Division of Senior and Disability
Services, Department of Health and Social Services, testified in
support of HB 394 and answered questions from the members. He
explained that the division administers grant programs under the
Older Americans Act. These programs used to be administered by
the Commission on Aging, he added. The division has been
working very closely with the Commission on Aging as the
reorganization progresses, Mr. Ashman stated. He explained that
since the Alaska Commission on Aging was created in the late
1970s, it has done a great job of meeting the needs of the
elderly, and [the administration] supports its continuation.
Number 0302
REPRESENTATIVE COGHILL commented that he read the legislative
audit report [on the Alaska Commission on Aging, dated October
1, 2003] which was done before the commission was moved from
[the Department of Administration to the Department of Health
and Social Services]. Representative Coghill said that he is
concerned with the grant making process and asked Mr. Ashman to
explain the changes that have been made to that process. He
told the committee that he had the auditor come to his office
and discuss the report with him. Representative Coghill noted
that the auditor is at the meeting today should there be need
for clarification.
Number 0372
MR. ASHMAN replied that he has also read the audit report. He
said he believes the problems that Representative Coghill is
referring to occurred in fiscal year 2002, when the program was
over at the Division of Senior Services in the Department of
Administration. The first problem pertains to the Senior
Employment Program, [which was authorized] under federal law.
The program was supposed to be providing temporary training
services to older Alaskans, 55 years old or older, to enable
them to reenter the workforce, he said. However, what happened
was that many of the grantees were using those employees to fill
long-term positions within its organizations. This [practice]
was clearly against federal legislation, he stated. The
division has changed that practice, although some latitude has
been extended in rural areas where there is a lack of employment
opportunities. Mr. Ashman commented that approximately 80
percent of the seniors [in this program] are [moving from
training to employment] within six months, which means the state
is now in compliance with federal laws. There are still some
grantees that are administering the program, he acknowledged;
but assured the committee that the division is keeping an eye on
them.
Number 0501
MR. ASHMAN said he believes another problem the report cited was
the lack of reporting to ensure that the use of federal funds
was in compliance with federal program requirements. He
commented that the issue was the lack of on-site audits. A plan
was put together two years ago to focus on those two areas and
he told the members that he believes the division is on target.
REPRESENTATIVE COGHILL asked Mr. Ashman to confirm that [$13]
million in federal funds are administered through this program.
He asked what portion of those funds are general funds dollars.
Number 0574
MR. ASHMAN replied that historically the state's match is about
24 percent in general funds. The minimum match requirement is
15 percent. He pointed out that in the division's budget this
fiscal year there is a $200,000 reduction in general fund
contributions because grantees will be asked to pay 10 percent.
Mr. Ashman explained that currently between 95 percent and 98
percent of the grantees do have a 10 percent cash match. The
state picks up 15 percent and the federal government covers the
balance.
REPRESENTATIVE COGHILL asked if the movement of the division
from one department to another has changed its mission.
MR. ASHMAN responded that there is no change [in the mission] of
the Alaska Commission on Aging because the mission was
established under the Older Americans Act which created the
Commission on Aging, formerly the Older Alaskans Commission.
The only change that has occurred in this reorganization is the
removal of grant making ability from the Alaska Commission on
Aging and transferring those duties to the Division of Senior
and Disability Services. The Department of Health and Social
Services has some very well defined procedures in how the grant
process works, whereas the Department of Administration did not
have that type of process in place, he added.
REPRESENTATIVE COGHILL asked if there will be a change in
accountability.
MR. ASHMAN explained that while the Commission on Aging will not
be making any grants, the state plan is developed by the
Executive Director of the Commission on Aging, and then is
presented in a series of public meetings. The Commission on
Aging finalizes the plan and presents it to the governor for
approval. In that plan is the intra-state funding formula which
says how the funds will be distributed statewide, so the
commission is key in that respect, he said. Mr. Ashman
emphasized that the commission will not be [awarding] any
grants. The division will work with the commission closely to
ensure that the grants are being managed consistently with the
desires of the Commission on Aging and the state plan, he added.
REPRESENTATIVE COGHILL commented that he misunderstood a
commission member's testimony in the House State Affairs
Standing Committee [on that point]. He asked if the commission
members look at allocation parameters.
MR. ASHMAN responded that the commission members look at the
intra-state funding formula that is included in the state plan,
and which identifies the priorities and areas where funding will
go.
REPRESENTATIVE COGHILL asked if the commission members are made
up of regional representatives or are the members appointees.
Number 0784
MR. ASHMAN responded that according to Alaska law the commission
members are appointed by the governor. No geographical
representation is required, he added. However, over the past 15
years that he has been associated with the commission, there
have always been representatives from both the rural and urban
areas of Alaska. One requirement for appointment is that
members must be a user of services either under the home
community-based Older Americans Act programs and/or the Medicaid
programs. In summary, he said there is good representation
statewide.
Number 0833
MS. COTTING directed the members' attention to the handout in
the members' packets from the Office of Boards and Commissions
which highlights the requirements of members. She said part of
those requirements read as follows:
Appointments shall be made to assure representation of
low-income and minorities and rural/urban areas and
statewide geographical representation.
MS. COTTING stated that the requirements are well defined in the
Boards and Commission statute.
CHAIR WILSON referred to the Legislative Audit report [dated
October 1, 2003, page 17, paragraph two] which read:
We continue to recommend the agency establish and
follow procedures to ensure that costs reported by
subrecipients comply with federal requirements ...
CHAIR WILSON said one point that was noted [in the report] was
that there was a lack of periodic site visits. She asked Mr.
Ashman what specific steps he has taken to ensure that concern
is being addressed.
Number 0915
MR. ASHMAN responded that under the corrected plan the division
put together, desk audits are being done. He noted it was not
being done before. He agreed that the last two audit reports
cited the lack of periodic site visits as a problem. Mr. Ashman
explained that there are 78 grantees and the division has a
staff of 3, so it is not physically or financially possible to
visit every grantee every year. The visits are being done on a
rotation basis; however, desk audits are being done [regularly].
He told the members that whenever someone else from the Division
of Senior and Disability Services happens to be in a particular
community, the division is making an effort to visit the
grantees while there. There may not be a review of the books at
that time, he commented. Mr. Ashman emphasized that there have
been increased audits over what was done in previous years.
Number 0963
CHAIR WILSON commented that there have been several statements
made that in the grant process there was a bias in the awarding
of grants. She asked Mr. Ashman to address those [charges].
MR. ASHMAN explained that in FY 04 and FY 05 a new state plan
needed to be developed. Part of that plan is the intra-state
funding formula which is based on census information. The
previous census information and plans were based upon the 1990
census. When the new census came out there was a redistribution
of [funding based on] senior citizen [populations]. For
instance, there may have been a higher growth of seniors in one
region over another region, so the funding formula changed.
There were winners and losers financially. He surmised that
there could have been some grantees who had been receiving more
funding under the 1990 census, but then lost funding with the
new census report. Mr. Ashman emphasized that the number of
seniors has increased in all areas. The Commission on Aging
requested that rather than having communities take the whole hit
in one year, it was requested that the federal government allow
a phase-in of that [redistribution in a] three-year plan. He
summarized that he does not believe the grantees had a problem
with the process, but rather with [the way the census impacted]
the outcome.
CHAIR WILSON asked Mr. Ashman if he could confidently tell her
that there will be improvement.
MR. ASHMAN assured Chair Wilson that there will be improvement.
Number 1097
REPRESENTATIVE CISSNA told Mr. Ashman that an hour or two ago
she listened to seniors who had teleconferenced in to a meeting
from ten or more communities. She was told that Alaska has the
second fastest growing aging population in the United States,
second to Nevada. Seniors now make up something like 6 percent
of the population, she said. Representative Cissna commented
that in not many years it will grow to 12 percent. These
seniors told of the gaps in services for conditions such as
Alzheimer's disease. She asked how Mr. Ashman views this
growing problem.
Number 1188
MR. ASHMAN agreed with Representative Cissna's comments. The
Alaska Commission on Aging and the local senior networks are
looking at what level of services are being provided currently.
Once that assessment is made, the [program] can be tailored to
meet the needs of the community. The division will be looking
to see where the funds are being spent and pointing out that,
for example, 52 percent of funds are being spent on
transportation services and then assure that is where the need
is for a particular community. Some of the senior networks may
not be aware of the way funds are being spent. Mr. Ashman said
that the division and the commission will be having those
discussions on a local level.
REPRESENTATIVE COGHILL noted that it is helpful to understand
that this is an evolving plan and a change of administration.
He asked how these changes impact the scrutiny of grants. Are
there any major changes in the delivery of the plan.
Representative Coghill stated that based on what he has heard,
he is still not satisfied that he understands what the changes
will be.
MR. ASHMAN responded that he is not sure what Representative
Coghill is asking. He commented that when working with the
grantee agencies, the division will be saying historically here
is where the funds have been used and the types of services
[provided] in this particular market. The division will be
asking if these services have been meeting the needs of the
community. Mr. Ashman noted that many of the grantees are
Medicaid waiver providers and the division will work to ensure
that they are maximizing the funds received. He assured
Representative Coghill that the division has regulations that
will be followed to ensure that those receiving the grants
administer them appropriately, and that the grantees are
submitting reports on time before any advances are provided.
Number 1559
REPRESENTATIVE COGHILL asked how this plan fits with the home
and community-based waiver program, assisted-living homes, and
the huge network of agencies out there. Obviously, he said,
this group is very attuned to the needs of the communities. He
told Mr. Ashman he would like to have some clarity in how the
needs are being identified and how the grants meet those needs.
For example, doesn't the commission look at the number of people
and the limited number of dollars to meet those needs, and then
evaluate what is the wisest expenditure of those funds. He
asked if there is any change in the way these points are
examined.
MR. ASHMAN responded that the division will take a look at what
services are being provided currently in a community and make
sure the services that are needed [are met], and if not, what
kind of changes need to be made [to address those deficiencies].
Mr. Ashman commented that he believes that is a local issue that
the division will be working on to assure the right services are
being provided. This will be done in conjunction with the
division and the commission because while the division
administers the grant programs; it is the commission that puts
together the state plan, reviews it, does the public comment,
and works with the local communities. The commission will work
side-by-side with [the division]. Ultimately, the state plan is
the plan that is submitted by the governor, he stated. He added
that the division will ensure that the administration of grants
are in compliance with that state plan.
REPRESENTATIVE COGHILL said he would like some clarification on
where the commission's [duties] start, where the
administration's [duties] start, and at what point it converges.
How do to the two work together, and is there tension between
the two, he asked.
MR. ASHMAN told the committee that under Alaska statutes the
executive director prepares the state plan. The Older American
Act requires a state plan and a senior advisory committee, which
in Alaska is the Alaska Commission on Aging. The executive
director works for and is hired by the Alaska Commission on
Aging, subject to the governor's appointment because it is a
partially exempt position. He reiterated that the executive
director puts together the plan in conjunction with the desires
of the commission. After the plan is developed, the commission
spends approximately six months conducting public hearings on
that plan. The comments and feedback received in those public
hearings are incorporated into the plan, he said.
REPRESENTATIVE COGHILL asked if the division's move from the
Department of Administration to the Department of Health and
Social Services affects how the plan works. Has the move
impacted how different agencies work together. Representative
Coghill asked how the plan affects people at home. Are there
changes in the categories that are being offered, he asked.
MR. ASHMAN responded that the reorganization does make sense
because the division is the "one-stop-shop" for all long-term
care services. The Division of Senior and Disability Services
not only manages the Medicaid Waiver Program, but also the other
three long-term care options. He said the division is looking
at the broader picture of how all these programs fit together to
make sure the needs are being met with whatever types of
programs are available. He said that he would not want to see
the division go into a community and tell it that it needs
respite [care], for example. He said he wants the division to
say to a community here's what is currently offered; here's
what's available; ask what is working and what is not; and offer
some programs that are available to meet the needs of seniors in
the community.
Number 1678
REPRESENTATIVE COGHILL said that he still needs further
clarification on the grants issue before he can vote for the
reauthorization of the Alaska Older Alaskans Commission.
MR. ASHMAN replied that, for example, when there are Title III
funds [available] for nutrition transportation services (NTS),
it is the grantees that comes to the division with a proposal.
The division knows how much money is available based on the
inter-state funding formula. So regionally it is known how much
money can go into that particular region, he said. It is the
grantee that tells the division how much it wants to spend on
transportation, information referral, and other categories.
Within the big picture, it is the grantee that is deciding what
level of services are being made. He told the members that the
question the division has is when there are multiple grantees
within a particular region, do the grantees all know what's
going on, and are the dollars that are being spent the best use
of those funds.
Number 1743
REPRESENTATIVE COGHILL said that the need is great and he wants
to ensure that he has a clear understanding of the plan. He
said he has one other question which he believes cannot be
answered in this committee, but which he would welcome
suggestions from Mr. Ashman. He said he is aware of the fact
that there is a huge federal dollar contribution, and a huge
amount of federal money that does not go through the state, but
goes directly to the community. Representative Coghill said his
concern is that many of these dollars are going into the same
service market for similar needs. He said he wants to make sure
that one funding source is not competing with another source in
the same market.
Number 1797
CHAIR WILSON commented that she is concerned because funds are
so limited and seniors are so precious to Alaska. She asked Mr.
Ashman where the lieutenant governor's faith-based initiatives
fits into this. Chair Wilson said that what neighbors and
family use to do for each other, is no longer being done on a
volunteer basis because it is being paid for. She added that
she is concerned that something is driving this machine. Chair
Wilson asked if the division is looking at encouraging
volunteerism. For example, there are many things such as
grocery shopping, babysitting, and household chores which could
be done free of charge by a volunteer. She encouraged this kind
of volunteerism so that the things that really need to be paid
for can be funded in a larger scope. In some cases, grandma use
to baby-sit for free, but now she's being paid. Chair Wilson's
said it is not that she doesn't want grandma to have some extra
spending money, but that when money is spent on things that
could be accomplished through volunteerism it may not be
possible to fund things that are really needed.
MR. ASHMAN replied that one of his staff is assigned to the
lieutenant governor's faith-based initiatives. He said he
believes that many would be surprised at the number of grantees
that are working with the same [faith-based] organizations. For
example, if it is known that a particular person does not have
any food in their cupboard, a faith-based organization will
provide that. Faith-based organizations, through the 501(c)(3)
or nonprofit status, will participate in some of these same
programs that the division has.
Number 1922
MR. ASHMAN shared his concern that what [families and neighbors]
use to do for each other seems to be shifting somewhere else.
He said that he believes that many have heard about the
regulatory changes that reflect cost-containment measures in the
division's budget to eliminate some of those expenses. There
are instances where the division is paying for respite services
to a paid family member, so they can go out and provide services
to someone else. The division is saying that it will not
respite a paid care provider, he commented. There is a higher
dependence on family members, in that the division is
eliminating the use of respite and chores services and saying
that if there is someone in that household who can provide those
services, then he/she needs to be doing them. Our proposed
regulations [which reflect those changes] have gone out to the
public for comment, and should be adopted shortly.
CHAIR WILSON reiterated that she is not saying that people do
not need a break, but that perhaps a neighbor could come in and
help out and it would not cost anything.
MR. ASHMAN responded that the division is limiting respite to 10
hours per week or 520 hours per year. He said he believes that
is fair and consistent with what other states have been
providing. He agreed that there certainly should be respite
[assistance].
MS. COTTING told the members that she has a copy of the draft
plan for the next four years, which was obtained from the
Department of Health and Social Services.
Number 2018
REPRESENTATIVE WOLF replied that he would like a copy. He asked
Mr. Ashman to elaborate on the regulations that are being
proposed.
MR. ASHMAN asked if he and one of his staff, who is very
knowledgeable, could meet with him to discuss the regulations in
detail.
REPRESENTATIVE WOLF shared that this past summer his mother-in-
law had a stroke, and said that he was surprised by the
discouraging attitude his family encountered in choosing to care
for her at home. He said this was a family stepping-up to care
for her; it was not going to cost anyone anything. He asked Mr.
Ashman to comment on that prevailing attitude.
Number 2086
MR. ASHMAN commented that his response would be dangerous. He
shared that his family recently did the same thing. His father
passed away in his own home, he said. When his wife's mother
was dying, during the last six months of her life his wife cared
for her for four months. He said he believes that it is the way
a person is raised, more than anything else. Mr. Ashman said
that is where personal beliefs come in. He said he could not
say why [Representative Wolf's family was discouraged from
caring for his mother-in-law]. He reiterated that he believes
it is how a person is raised.
REPRESENTATIVE WOLF shared that his mother-in-law taught school
for 36 years in California. She's 74 years old now and upset
that this is happening to her. He said it took a while for him
to convince her that she is on the biggest teaching assignment
that she ever encountered, because now she's teaching her kids
compassion. It is a very valuable lesson.
Number 2168
MARIE DARLIN, Coordinator, Capital City Task Force, AARP Alaska,
testified in support of HB 374. She told the members that AARP
Alaska fully supports the continuation of the Commission on
Aging. Over the years AARP Alaska has worked with the
commission on may issues and looks to them, and hopes to
continue to look to them, as a group that will be working with
organizations such as AARP to ensure that there is a plan that
will meet the needs of communities. Ms. Darlin explained that
currently AARP Alaska is one of the groups the commission works
with in determining what the needs are. Many of the issues that
have been discussed today are concerns of AARP Alaska as well.
She added that she served on the Juneau Commission on Aging for
about six years, and said that it is important for the state
commission to go to the local commissions on aging when
determining the needs of the community. Some communities do not
have a local commission, but most communities are interested in
having one, she added.
Number 2255
REPRESENTATIVE COGHILL commented that he believes every member
should attend at least one commission debate.
Number 2263
REPRESENTATIVE CISSNA moved to report CS HB 394, 23-LS1534\D,
Mischel, 2/19/04, out of committee with individual
recommendations and the accompanying fiscal notes. There being
no objection, CS HB 394(HES) was reported out of the House
Health, Education and Social Services Standing Committee.
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