Legislature(2009 - 2010)CAPITOL 106
04/11/2009 03:00 PM House HEALTH & SOCIAL SERVICES
| Audio | Topic |
|---|---|
| Start | |
| SB32 | |
| HB223 | |
| HB50 | |
| Adjourn |
* first hearing in first committee of referral
+ teleconferenced
= bill was previously heard/scheduled
+ teleconferenced
= bill was previously heard/scheduled
| += | HB 50 | TELECONFERENCED | |
| + | SB 13 | TELECONFERENCED | |
| + | SB 32 | TELECONFERENCED | |
| + | TELECONFERENCED | ||
| += | HB 223 | TELECONFERENCED | |
SB 32-MEDICAID:HOME/COMMUNITY BASED SERVICES 3:09:55 PM CO-CHAIR KELLER announced that the first order of business would be CS FOR SENATE BILL NO. 32(FIN), "An Act relating to medical assistance payments for home and community-based services and provision of personal care services in a recipient's home; and providing for an effective date." 3:10:21 PM MAX HENSLEY, Staff to Senator Johnny Ellis, Alaska State Legislature, explained that SB 32 was a collaborative effort. He stated that home and community based services were the key to improving the quality of life for seniors and the developmentally disabled. He emphasized that SB 32 was not intended to take anything away from care providers, but instead to create an equitable and predictable process. He observed that home and community based services were less expensive than institutional care. He pointed out that long term care costs were a very large percentage of projected Medicaid expenses. He stated that most providers had not seen an increase to payment structure since 2004. He explained that SB 32 gave Department of Health and Social Services (DHSS) the flexibility to devise a cost based system for all providers. He explained that Section 1 set rates for home and community based services, as well as personal care services. He shared that it also reviewed the rates of payment, but he emphasized that nothing in the bill appropriated money for the future. He explained that DHSS would forward its cost proposal survey of suggested rates, which would become part of the budget process. He noted that there would be an annual rate review, but that the cost survey would only be every four years. He pointed out that the inflation rate would also be considered. 3:15:17 PM MR. HENSLEY directed attention to Section 2, and confirmed that DHSS would report the trends and the elements in established payment rates. He explained that Section 3 repealed Section 2 on June 30, 2014. He pointed out that Section 4 made the bill effective on July 1, 2011, in order to allow DHSS the time to develop the methodology. He reviewed the fiscal notes and said that one was for three DHSS positions, of which 50 percent would be federally funded. He explained that the second fiscal note was a projection for the rate increases, in anticipation of the cost survey results. 3:18:19 PM JON SHERWOOD, Medicaid Special Projects, Office of the Commissioner, Department of Health and Social Services (DHSS), said that the department had worked with the sponsor, and DHSS was comfortable with the bill language. 3:18:51 PM CO-CHAIR KELLER opened public testimony. 3:19:02 PM MARIANNE MILLS, President, AgeNet, explained that AgeNet was a group of 25 statewide organizations which provided services in the homes of the elderly, the community centers, and the adult day facilities. She reported that AgeNet, along with the Beneficiary Boards of Alaska, Alaska Mental Health Trust Authority (AMHTA), and other provider groups, had declared regular rate reviews to be the first priority. She noted that this coalition had met with Commissioner Hogan (DHSS) and Senator Ellis. She offered her support for SB 32. She expressed that the goal of the coalition was to find good objective data for the actual costs of home and community based services. She indicated that this would allow for the best decisions. 3:21:08 PM REPRESENTATIVE CISSNA said that rate reviews were very important. She asked if this would study potential care giver positions, as well as existing ones. MR. HENSLEY explained that SB 32 covered rate reviews for the service providers listed under the four current Alaska Medicaid waivers, as well as rate reviews for the providers of personal care attendants. 3:22:31 PM REPRESENTATIVE CISSNA asked if other potential positions would be covered. MR. HENSLEY replied that an earlier study had reviewed a broader group of DHSS funded service providers. He clarified that the providers referenced in SB 32 were currently ready for rate reviews. He agreed that other care givers may be included in future rate reviews. 3:23:29 PM REPRESENTATIVE CISSNA asked how long this would take to put into effect. MR. HENSLEY said that the prior study was for a year. He noted that DHSS requested 2 years to develop the rate methodology. He reported the annual rate review would go into effect in FY2012. 3:24:23 PM STEVE LESKO, President, KEY Coalition of Alaska, said that it was urgent to pass SB 32 right away. He shared that the goal to eliminate the wait list [for services] was restrained by the lack of a rate review process for the community programs. He opined that this had resulted in difficulties for the programs with recruitment and retention of staff. He noted that benefit cuts, increases in deductibles, and the inability to staff had resulted in a lack of service. He cited that the community programs did not have equal access to the rate increase reviews which hospitals were allowed. He declared that this was a labor intensive profession with big challenges to ensure an adequate workforce. He stressed that the health and safety of Alaska's most vulnerable citizens was the paramount concern. He emphasized that the KEY Coalition supported SB 32. 3:27:38 PM CO-CHAIR KELLER stated that he was a cross sponsor for SB 32. 3:27:59 PM REPRESENTATIVE COGHILL suggested that the rate review and the methodology review should go hand in hand. He noted that the pressure to raise rates would necessitate that all were treated fairly. 3:29:58 PM REPRESENTATIVE CISSNA agreed that it was necessary to address the work force issue immediately. 3:30:25 PM CO-CHAIR HERRON posed that the legislation should oblige DHSS to implement the program in 2012. MR. HENSLEY replied that there was every reason to believe that DHSS would do the required methodology work to institute a cost rate when the bill takes effect. 3:31:22 PM MR. SHERWOOD asked that DHSS have administrative support in order to start in two years. He declared that the providers were not prepared to submit the cost reporting which the department needed for analysis. He explained that it was necessary to tell the providers in advance what information was necessary, and then collect and analyze the responses. He opined that DHSS had the authority to move forward prior to the effective date of the bill. 3:33:03 PM REPRESENTATIVE COGHILL cautioned to be aware of the cost to providers for collecting information. MR. SHERWOOD replied that the current language allowed for a less burdensome cost survey for the providers. 3:34:12 PM CO-CHAIR HERRON moved to report CSSB 32 (FIN) out of committee with individual recommendations and the accompanying fiscal notes. There being no objection, CSSB 32 (FIN) was reported from the House Health and Social Services Standing Committee. 3:34:40 PM
| Document Name | Date/Time | Subjects |
|---|---|---|
| 50.PDF |
HHSS 4/11/2009 3:00:00 PM |