Legislature(2001 - 2002)
04/21/2001 09:03 AM House STA
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* first hearing in first committee of referral
+ teleconferenced
= bill was previously heard/scheduled
+ teleconferenced
= bill was previously heard/scheduled
HB 88-PIONEERS' AND VETERANS' HOME/ADVISORY BD CHAIR COGHILL announced that the committee would take up HOUSE BILL NO. 88, "An Act changing the name of the Alaska Pioneers' Home to the Alaska Pioneers' and Veterans' Home and of the Alaska Pioneers' Homes Advisory Board to the Alaska Pioneers' and Veterans' Home Advisory Board; relating to services for veterans in the home; relating to the advisory board for the home; making other amendments to the statutes relating to the home; making conforming amendments to other statutes; and providing for an effective date." Number 0254 JIM DUNCAN, Commissioner, Department of Administration, began by noting that the idea of establishing a veterans' home in Alaska has been around for some time and the legislature has taken steps to move in that direction. For example, in 1992 the legislature passed legislation to establish a veterans' home in Alaska that would be fully funded by the residents of that home as well as federal funding. However, nothing really happened as a result of that legislation because there weren't the funds to do it. In 1998 an amendment, which allowed the proposed veterans' home to provide nursing care, was adopted to the [1992] statute. The hope with that amendment was that additional federal funding would be received such that it would be feasible to operate the home without state funding. Again, nothing happened. About 18 months ago Governor Knowles appointed a cabinet-level team to review the issue of establishing a veterans' home and return with a proposal. The cabinet-level team was comprised of Commissioner Purdue, Department of Health & Social Services; Commissioner Oates, Department of Military & Veterans' Affairs; and the Commissioner of Administration. COMMISSIONER DUNCAN pointed out that one of the options explored was a stand-alone veterans' home. However, that option was not adopted and moved forward by Governor Knowles, which was probably due to the cost. For an 80-bed stand-alone veterans' home it would cost about $25 million for construction alone. Of that $25 million, the federal government would pay two-thirds and thus the state would be left to cover $8.5 million in general funds. Additionally, there would be ongoing operating costs of about $7.2 million a year of which $2.4 million would be state funds, which comes close to the amount being requested for the proposal before the committee. Therefore, cost is a major consideration with a stand-alone veterans' home. Furthermore, a stand-alone veterans' home would be in one location, which would mean that veterans in other areas would have to move. Such a situation didn't seem ideal and thus the proposal encompassed in HB 88 was developed. Number 0705 COMMISSIONER DUNCAN endorsed the proposal and introduced HB 88. Commissioner Duncan informed the committee that HB 88 does the following: changes the name of the Alaska Pioneers' Home to the Alaska Pioneers' and Veterans' Home; designates a certain number of beds to veterans; and changes the name of the Alaska Pioneers' Home Advisory Board to the a Alaska Pioneers' and Veterans' Home Advisory Board and designates that at least two seats on the new board are filled by veterans. He noted that one of the veterans' seats on the new advisory board would be the Chair of the advisory board. Currently, there are two veterans that happen to sit on the advisory board. COMMISSIONER DUNCAN related his belief that the proposal before the committee is responsible and addresses the problems while utilizing the present infrastructure of the Alaska Pioneers' Home, a top-notch system. This proposal would allow the Alaska Pioneers' Home infrastructure to be utilized to its fullest, which seems to make fiscal sense. Furthermore, utilizing the current infrastructure of the six existing Pioneers' Homes will allow veterans and pioneers to access a home that is close to their present community and family, which is important. Moreover, this proposal would fulfill the state's long-standing commitment to veterans. Number 0940 COMMISSIONER DUNCAN turned to how the proposal works and said that changing the name is an important part of the process because it ensures the veteran community of the state that it is part of the Pioneers' Home system. Furthermore, the name change is important because work with the federal Veterans' Administration is occurring so that residents [can obtain] waivers to access federal benefits. Commissioner Duncan noted that the legislation includes a veterans' preference that would be defined by regulation such that 21 percent of the funded beds veterans would have a veterans' preference, which amounts to 125 beds. Commissioner Duncan pointed out that currently there are about 90 veterans in the Pioneers' Homes. At any time, the Pioneers' Home has from 90-100 vacant beds. Therefore, this legislation would allow those beds to be filled. He explained, "If we have 90 veterans presently in the homes, there would be a [veterans'] preference [for] 125 beds. We would then bring in another 35 veterans, who are on that waiting list. And we'd also bring in another 55 pioneers' who may be veterans ... [or] nonveterans; they'd come in in the order ... of the active waiting list." Therefore, this would be beneficial to veterans because 35 more veterans would have beds and this would also be beneficial to those [55] pioneers that may or may not be veterans. With the passage of HB 88 and adequate funding, 90 individuals would be able to enter the home in the near future. Number 1194 COMMISSIONER DUNCAN continued by addressing the funding that is required, which is $2.6 million in general funds and $2.6 million in pioneers' home receipts. Those receipts are payments made to the system by individual residents as part of paying for their full cost of care. Therefore, if the funding worked as planned, the 90 beds could be filled and the veterans' preference could be in place. Commissioner Duncan pointed out that the fiscal note doesn't indicate that there will be any federal dollars coming to the Pioneers' Home as a result of this legislation. Although there will not be any federal dollars that flow directly to the Pioneers' Home, there has been work with the Veterans' Administration to discuss a waiver to federal requirements so that veterans here can receive the same benefits as veterans who are in a home in the Lower 48. Those veterans currently in the Pioneers' Home don't receive veterans' benefits. Therefore, work is being done to have a waiver so that veterans can receive benefits directly in order to help pay for their cost of care. Furthermore, Commissioner Duncan hoped that this would get the Veterans' Administration more involved with paying for medications. Also, there may be some capital dollars that may be accessed that could help with upgrades, improvements, and renovations to the Pioneers' Home System. However, he noted that there is no firm commitment to such, but there [seems to be] a high level of interest and support from the federal government for this type of system. COMMISSIONER DUNCAN mentioned that he and Mr. Kohn, Director, Division of Military & Veterans' Affairs, met with General Oates, Commissioner, Department of Military & Veterans' Affairs; the Secretary of Veterans' Affairs Principi; and U.S. Senator Murkowski during a recent visit to Alaska. Secretary Principi was very impressed with Alaska's Pioneers' Home system and was supportive of the approach [embodied in HB 88]. Additionally, U.S. Senator Stevens, in his recent speech to the legislature, spoke of this proposal and was supportive of this approach also. COMMISSIONER DUNCAN clarified that [the administration] isn't interested in making this part of the federal system. The commitment is to maintain the Pioneers' Home system as a state- owned and -operated system within the Department of Administration. There is no desire to fall under federal regulations and guidelines and rules, which is why [the administration] is seeking a waiver. Furthermore, the one-year residency requirement and the age requirement couldn't be maintained under the federal system. COMMISSIONER DUNCAN informed the committee that the committee packet should include a letter from him to Mr. Bob Huffman, Chair of the Pioneers of Alaska Legislative Committee, dated March 29, 2001. Attached to that letter is a letter Commissioner Duncan had written to Senator Therriault. Commissioner Duncan also informed the committee that as it considers the bill he would like some amendments, which are contained in the letter [to Mr. Huffman], to be considered. The administration supports these amendments. One of the amendments would insert an intent section in HB 88 in order to make it clear that the Pioneers' and Veterans' Home system be maintained as a state-owned and -operated system within the Department of Administration and not fall under the federal system. Commissioner Duncan encouraged the committee to adopt an amendment that would delete AS 47.55.010(c)(1), regarding cooperation with the federal government, which is in HB 88 as well as the Pioneers' Home statute. Although that language has never been used nor is it necessary, some people read it and wonder whether [the Pioneers' Home] would fall under federal management. COMMISSIONER DUNCAN turned to the third amendment, which is included in the letter he wrote to Senator Therriault. The letter was in response to Senator Therriault's question regarding what the regulations would look like. Therefore, the letter contains a draft of what the [department] intends the regulations to look like. Commissioner Duncan acknowledged that Mr. Huffman has expressed interest in having assurances beyond those in regulation and thus Commissioner Duncan agreed that the regulations could be put in statute as has been done in the past. Therefore, the statute would say that there is a veterans' preference and specify how that veterans' preference would work. A change to that [statute] would require an act of a legislative body. The second part of the [third] amendment includes the definition of a spousal preference. COMMISSIONER DUNCAN related his belief that the three amendments would address the major concerns that he has heard. In conclusion, Commissioner Duncan urged the committee to give HB 88 favorable consideration because it builds upon and strengthens Alaska's Pioneers' Home system. Number 1891 COMMISSIONER DUNCAN, in response to Representative Wilson, clarified that the residency requirement change is really a cleanup of the statutes necessitated by the courts striking down the 15-year residency requirement. That court decision took place a number of years ago and the one-year residency requirement has been in effect since that decision. However, the statute was never made to conform. REPRESENTATIVE WILSON turned to Commissioner Duncan's request to amend spousal qualifications and inquired as to why the language on page 5, lines 26-30, isn't adequate. Number 2004 JIM KOHN, Director, Division of Alaska Longevity Programs, Department of Administration, explained that the proposed regulation would put into regulation, and possibly statute, a practice that has been followed in policy. That is, to allow spouses wanting to enter the home at the same time to do so. He remarked that it was felt that this would be an appropriate time to put this policy into regulation. Mr. Kohn said that the [new language] merely goes beyond what is in the bill and defines the process more clearly. MR. KOHN, in response to Representative James, answered that presently about 20 percent of the current [Pioneers' Home] residents are veterans. Approximately 30 percent of those on the waiting list are veterans. REPRESENTATIVE JAMES inquired as to what the 21 percent preference would do to the existing (indisc.). COMMISSIONER DUNCAN noted that there are 180 people on the active waiting list, which includes 85 veterans. Therefore, there would be 35 who would go in to the first 90 [beds] because there would be a [veterans] preference for 125 beds. If the system was fully funded, then the number of veterans in the home would be increased from 90-125. Therefore, of those 90 beds that are fully funded, the first 35 would be for veterans. REPRESENTATIVE JAMES asked how many veterans would come in if nothing was done. MR. KOHN explained that under the present admissions process if the next 90 people were admitted, 21 veterans and 69 other applicants, who may or may not be veterans, would be added. Under HB 88, 32 veterans and 58 nonveterans would come into the home. Number 2330 REPRESENTATIVE JAMES turned to the federal waiver, which she understood to be a waiver so that the veteran would directly receive the federal dollars to help pay for their care. These are funds that go directly to veterans' homes in other states. Because Alaska doesn't have such, she wondered if the name change is a requirement to obtain the waiver, or does the veterans' preference allow the waiver, or are both necessary. COMMISSIONER DUNCAN related his belief as well as the administration's belief that it's important to do both: change the name and implement a veterans' preference. REPRESENTATIVE JAMES related her belief that the best way to take care of elderly people in need of care is in assisted living homes located in the person's community. If "we" are requesting that certain veterans receive a subsidy to help pay for their care, then "we" should insist that those veterans be served wherever they choose to be served and as close to home as possible. She asked whether a veterans' waiver would be requested if this legislation didn't move forward and if so, will assisted living homes throughout the state be include? COMMISSIONER DUNCAN answered that Mr. Kohn would continue his work with the Veterans' Administration in the area of support for medicines for veterans. However, he didn't believe that the federal government or Veterans' Administration would be interested in proceeding with a waiver that would allow benefits to flow to the Pioneers' Home system without some recognition of veterans in the name or through a preference. REPRESENTATIVE JAMES remarked that she didn't have as much difficulty with the preference as she did with the name change. She felt that a statewide veterans' preference would be recognized by the federal government. Number 2529 MR. KOHN noted his agreement with Representative James' comments regarding assisted living homes, which HB 88 takes into consideration as much as possible. However, the VA is interested in creating a demonstration project that would illustrate that veterans can be cared for in assisted living homes, outside of a traditional veterans' stand-alone home. At this point, that hasn't been done. Therefore, changing the name would illustrate a large amount of commitment to veterans in order to obtain the demonstration project. REPRESENTATIVE JAMES remarked that nursing homes should also be included. REPRESENTATIVE FATE inquired as to how the fiscal note could have zero dollars for travel. COMMISSIONER DUNCAN said that there is no travel involved. The money fiscal note is for [increasing] staffing and supplies in the homes due to the additional beds. In further response to Representative Fate, Commissioner Duncan noted that there is already travel for the Pioneers' Home Board and there will be travel for the Pioneers' and Veterans' Home Board, but that is part of [the department's] budget. COMMISSIONER DUNCAN, in further response to Representative Fate, reiterated that the committee packet should include the letters that he wrote to Mr. Huffman and Senator Therriault, which specify the three items that he suggests including in a committee substitute (CS). Number 2751 REPRESENTATIVE FATE asked if, in the event, the 21 percent isn't filled, would the beds lay vacant because of the veterans' preference. MR. KOHN answered that if the funding occurs, then the beds will be filled. It won't take long to bring in the approximately 35 people to reach the 125. Mr. Kohn didn't expect there to be any vacant beds. REPRESENTATIVE FATE asked if there are provisions that would deal with the possibility of a decline in veterans that would result in unoccupied veteran-designated beds. MR. KOHN directed attention to page 5, Section 9 (B), which provides for a nonveteran to be considered for admission to an unoccupied bed reserved for a veteran when there is no veteran applicant. Number 2880 REPRESENTATIVE STEVENS applauded work done across the state with assisted living. He related his assumption that this legislation wouldn't impinge on that effort. Representative Stevens expressed interest in hearing more about whether this would open up to federal low-cost medication for veterans. Representative Stevens inquired as to how the Pioneers' Homes had 90-100 unoccupied beds while there is a waiting list of 180. He assumed that the answer lies in the funding and thus he wondered if it would be better to apply for the additional funding. COMMISSIONER DUNCAN said that if there was $2.6 million in general funds, then those beds could be filled without a veterans' preference. Over the years there have been requests for more [funds] ... TAPE 01-45, SIDE B COMMISSIONER DUNCAN continued by explaining that with the present funding and the level of care provided, there is only enough funding and staff to fill the beds that are filled. CHAIR COGHILL stressed that the aforementioned funding situation illustrates that the funding is necessary regardless of the veterans' preference. Chair Coghill requested that questions regarding [the low-cost] medication be held. Number 2918 REPRESENTATIVE WILSON inquired as to how spouses of veterans would be counted; will spouses count for veteran slots or pioneer slots? She also asked how the percentage, the 21 percent veterans' preference, will be balanced because some of the Pioneers' Homes are full now. MR. KOHN answered that spouses of veterans wouldn't be counted as veterans. In further response, he explained that the 21 percent is systemwide. That is, 21 percent of the funded beds. Therefore, if all 600 beds are funded, then it would be 125 beds wherever open. Although the major vacant beds are located in three homes, there are vacancies in all the homes, in a rotating fashion, all the time. Number 2770 GEORGE PAUL testified via teleconference. Mr. Paul informed the committee that he has been a member of the Alaska Veterans' Advisory Council since 1997 and currently serves as the President of the Alaska Native Brotherhood Camp 1. Mr. Paul identified this [legislation] "as a stroke of genius" because it maximizes the dollars available. He noted that he liked Representative James' comments regarding placing elders as close to the homes of their family as possible. Furthermore, this proposal would seem to open the possibility of asking the federal government for additional funds for veterans as well as nonveterans. Mr. Paul felt that this proposal would empower the state. The renaming of the Pioneers' Home would provide some ownership to the veterans. Mr. Paul related his belief that utilizing the existing system's infrastructure would provide the "biggest bang for the buck." Number 2528 WILLIE CLARK testified via teleconference. Mr. Clark agreed that veterans should be closer to their families. Regardless of the name change, Mr. Clark felt that the funding should go forward because the beds need to be filled. RUTH BOHMS testified via teleconference in opposition to HB 88. She pointed out that the language "veterans' preference" is spread throughout documents from the state. Ms. Bohms informed the committee of her family history, which includes much military service. She informed the committee of a friend who, during World War II, was classified as physically and mentally fit for military service. Although he wanted to enlist, he was ordered to remain on the home front because he was a craftsman. This man "obeyed the military and worked in hazardous conditions, building the bombers and other war time planes, which enabled us to win the war," she said. After the war was over, veterans utilized the GI Bill to go to school and purchase homes. However, her friend wasn't eligible for the many benefits of the GI Bill. Today, her friend, now in his late 70s, has lived in Alaska for over 50 years and has been on the Pioneers' Home inactive list for many years. Now the state is saying, "Sorry, but you may have thought you were eligible for any one of the 600 beds in the Pioneer Homes, but we are going to set aside 125 beds exclusively for veterans." Since her friend isn't a veteran, that leaves only 475 possible spots for her friend. Furthermore, Ms. Bohms charged that women are being denied access to the full 600 beds. She pointed out that the majority of persons needing care in Pioneers' Homes are nonveteran women. Therefore, HB 88, which proposes treating veterans differently than nonveterans, is discrimination and against the law. She also pointed out that the Alaska State Constitution's equal protection clause closely follows that of the United States Constitution and thus people may not be treated differently unless there is a compelling reason to do so. In conclusion, Ms. Bohms said that HB 88 is ill-conceived legislation that is unconstitutional and violates both the Alaska State Constitution and the U.S. Constitution. Number 2275 HARRY JENKINS testified via teleconference. Mr. Jenkins expressed his concern that the age requirement will be dropped in a few years. He was also concerned that disabled veterans would receive a priority over others. Number 2244 VINCE DORAN testified via teleconference. Mr. Doran informed the committee that he is a lifetime member of the Pioneers of Alaska, a veteran of military service, and a resident of the Anchorage Pioneers' Home. Mr. Doran announced his support of HB 87 and HB 88. Alaska is one of two states that doesn't have a state facility for aging veterans. There are 100 beds available now that could be filled. Number 2164 ED BARBER testified via teleconference. He informed the committee that he is a member of the Pioneers of Alaska. Although HB 88, on "first blush," sounds like a good deal, he inquired as to where the funds will come from to provide the additional care for the Pioneers' Homes. Even if the funds were available for the next fiscal year, he questioned the fate of future years. Although the governor has assured that a waiver from the federal government will be obtained, Mr. Barber pointed out that neither a waiver of federal funds have been done before. Furthermore, Mr. Barber asked, "What about the rest of the veterans in other facilities? Are they not equal and deserving?" He suggested a pilot project that coordinated with the VA and the federal VA to cover existing veterans that reside in the homes. MR. BARBER said, "There is no evidence of any such funding to fill the vacant 90 to 100 vacant beds within the homes." Furthermore, one of the things that has [exacerbated] the existing shortfall is the imposition of rate increases by this administration in 1995. In 1995 a single room for low residential care cost $735 a month whereas this July it will cost $1936. He specified that low-end residential care is a single room with a shared bathroom. This increase in rates has caused people to move out of the homes and thus many of the receipts were lost. The vacant beds and nursing care [shortage] has contributed to an increase in cost. MR. BARBER questioned, "Where are the feds? ... What is in it for the feds? Where are the dollars?" He charged that even if the funds were available, the homes couldn't be staffed in Alaska due to the critical lack of nursing staff in this state. Therefore, this could be interpreted as an unfunded mandate for the veterans. In conclusion, Mr. Barber announced his opposition to HB 88 until there is admission protection for nonveterans should there be a funding shortfall. Number 1960 JOE MONTGOMERY testified via teleconference. Mr. Montgomery said that he [concurred] with everything that Mr. Barber said. Mr. Montgomery informed the committee that he is a member of the Pioneers' Legislative Committee and a combat pilot in World War II. He stated his opposition to HB 88. Number 1904 EDWARD ZASTROW testified via teleconference. Mr. Zastrow informed the committee that he is a member of the State of Alaska Pioneer Advisory Board and a veteran. Mr. Zastrow also informed the committee that the advisory board unanimously voted in favor of this concept. The reasoning was to fill the 90 vacant beds and find some form of funding for this. He informed the committee that he had given presentations to Pioneer Igloos in Ketchikan from which he gathered that the majority of those pioneers were in favor of this concept. However, they were concerned with the possibility of federal government intervention, which has been addressed. Mr. Zastrow felt that there is major support for HB 88 and thus he encouraged its passage. Number 1822 JIM RHODES testified via teleconference. Mr. Rhodes announced that he opposes HB 88 due to the lack of admission protection for nonveterans. Furthermore, he expressed concern with possible funding shortfalls. Number 1765 LEO KAYE testified via teleconference. He informed the committee that he is a World War II veteran and Chair of the Veterans Wall of Honor. Mr. Kaye stressed that he is speaking on behalf of all Alaska veterans. The concept of a Veterans' and Pioneers' Home system is good. He expressed his pleasure in such a concept being able to meet the needs of the veterans in all regions. Furthermore, this concept will be financially reasonable by using existing facilities. Mr. Kaye announced support of HB 88 and SB 55 and thus he urged moving [HB 88] forward. He recalled past efforts to develop [veterans' homes]. Mr. Kaye read the committee the following letter from Secretary of Veterans' Affairs Principi: I was pleased to receive your recent letter regarding establishment of the Alaska State Veterans' Home and the State Pioneers' Home. ... This is truly an exciting time for the Department of Veterans' Affairs. The VA State Home Per Diem Grant Program provides federal payments to states for eligible veterans in state veterans' homes recognized by VA. It appears that Alaska would like to place veterans in six regional Pioneers' Homes. VA may recognize an entire facility or a specific area, such as a wing or floor within a larger facility like the Pioneer Home. This ensures the veterans receive consistent levels of care in accordance with VA standards. During VA's recognition process, a designated team from the local VA's medical center of jurisdiction conducts an onsite survey to establish the potential state veteran home that will provide payments for each day an eligible veteran resides at that location. We look forward to working closely with the State of Alaska to meet the federal grant requirements. In this partnership program, VA may also share in up to 65 percent of the cost to build a new or renovate an existing facility for use as a state home for veterans. ... We have a Dr. Judith Solerno(ph), Chief Consultant, Geriatrics, Extended Strategic Health Care, is also available to assist you in establishing the state veterans' homes. Number 1446 ED LYNCH testified via teleconference. Mr. Lynch indicated that he was in support of HB 88. Number 1377 DONALD BURFORD informed the committee that he is the third generation of pioneers. Mr. Burford made the following points. Firstly, the Pioneers of Alaska is merely an advisory position. Secondly, many pioneers are veterans and as such are sympathetic to this idea. Thirdly, due to the fact that the Pioneers' [Homes] have been and continue to be underfunded, it is difficult to believe that will change based on conversation. Fourthly, he related his personal belief that unless the money is put on the table, it would be irresponsible for pioneers to further burden the homes without requesting full funding to allow the homes to function for all parties. RALPH HUNT indicated that he seconded Mr. Burford's comments. Number 1271 AL SKONDOVITCH testified via teleconference. Mr. Skondovitch wondered why existing facilities for veterans, such as the hospital [at Fort Wainwright], aren't utilized. Apparently that hospital is going to be torn down and thus he questioned why. He commented on the fact that this is complicated. Number 1113 GERALD BOHMS testified via teleconference in opposition to HB 88. He informed the committee that he is a member of the Pioneers and Post 11 American Legion. Mr. Bohms said that [the earlier mentioned numbers of veterans in the Pioneers' Homes] illustrates that the veterans are already taken care of under the current system. Due to testimony, Mr. Bohms felt that the federal government would be highly involved in the operation of the Pioneers' Homes. Therefore, he couldn't believe that the federal government wouldn't implement their regulations anyway. Mr. Bohms concluded with his belief that HB 88 isn't the way to go. Number 0939 BERT SHARP, Former Representative, Alaska State Legislature, testified via teleconference. Mr. Sharp remarked that a veterans' home in Alaska is a long-sought after and noble goal. However, the proposals contained in HB 88 are the wrong way to go. This legislation creates the illusion of creating many veterans' facilities throughout Alaska, but he believes it will eliminate future success in obtaining a stand-alone veterans' home because the federal government would charge that such already exists in Alaska. Furthermore, he expressed concern that HB 88 would divide elderly Alaskans and groups competing for critically needed services. Moreover, HB 88 is highly discriminatory against women and other major groups in Alaska. MR. SHARP echoed earlier testimony regarding [the fact] that the 100 or so vacant beds are empty due to the lack of funds to provide adequate qualified personnel services to staff these empty beds. Although he appreciated that the legislature has basically held the Pioneers' Homes harmless from funding reductions in the past, costs have risen. He concluded by specifying that the 100 vacant beds are a money problem. The percentage of veterans in Pioneers' Homes are high and will continue to be so if those 100 beds are put on line. Therefore, the problem will take care of itself if the funding is obtained. He related his belief that appropriating the funds necessary to offer these vacant beds will result in full occupancy and the new residents will contribute enough to help offset the additional cost, in at least as much as would be anticipated from federal funds. He remarked that it would be a stretch of the imagination to think that federal funds would be obtained. MR. SHARP urged the committee to disregard HB 88 and continue the Alaska Pioneers' Homes and their quality elderly facilities that are available to Alaskans in a fair and unbiased manner. He turned to the issue of veterans receiving medicine care in the homes and characterized it as a "straw man." Veterans can already receive medicine care from several facilities in Alaska. Furthermore, Mr. Sharp related his belief that a veterans' waiver should be based on the veteran receiving care not the name or preference. Number 0604 CAROLYN TUOVINEN testified via teleconference in full support of HB 88 because this approach makes sense in Alaska, where the population is small and spread over a large area. Ms. Tuovinen felt that it would be a "stretch" to think that the legislature will be generous for social service programs because that hasn't been the case in the past. However, she did hope that the legislature gives the homes money. Number 0470 DAVID RING testified via teleconference. Mr. Ring remarked that it is interesting that this meeting was listed as a public invitation to comment. Although there has been a considerable amount of comment, it hasn't been public comment. Mr. Ring felt that it is a disservice to both [the pioneers and the veterans], who have achieved some entitlement, to pit them against one another. The existing [Pioneers'] facilities speak well for the people of Alaska. In regard to the veterans, Mr. Ring said that the veterans have earned something from the federal government. Although he appreciated the work done for veterans by the state, he felt that the principle burden for caring for veterans should fall to the federal government. Mr. Ring expressed his desire to have [separate] facilities maintained for veterans in order to avoid conflict or competition. In regard to discussions about the number of unoccupied beds, Mr. Ring remarked that many of those beds are unoccupied due to the increase in cost to the resident. The state has simply priced people out of the beds. REPRESENTATIVE CRAWFORD related his experience with his father entering a veterans home and his mother not being allowed, which separated the family. Representative Crawford felt that [HB 88] is a much better solution in that husbands and wives can stay together. TAPE 01-46, SIDE A MR. RING remarked that he wouldn't expect a facility to be built that would house an able-bodied, employed person for the sake of spousal privileges. Number 0116 PETER RAISKUMS testified via teleconference in support of HB 88. Mr. Raiskums felt that it is time that the federal government and the state provides some incentives for veterans, including pioneers, to stay in the state. He was bothered that many people leave the state because there are no facilities for them to remain. Mr. Raiskums remarked that he liked the notion of being able to share a retirement or nursing home with a spouse. Mr. Raiskums felt that [HB 88] is a win-win situation for veterans and pioneers alike. Number 0250 DENNIS SPURGEON testified via teleconference. He informed the committee that he is with the Veterans of Foreign Wars Post 4352 in Ketchikan. Although he appreciated the efforts to provide a veterans home in the state, he and many others found it difficult to support this action due to the fact that federal money would be used to support the veterans in the facility. Each time the federal government is involved in state action, the state facility is always the loser. Therefore, [the Veterans of Foreign Wars Post 4352] cannot support HB 88. Number 0334 JOSEPH CRAIG, National Executive Committeeman, Department of Alaska, American Legion, testified via teleconference. Mr. Craig informed the committee that during a walk through Juneau with the [Joint Service Organizations] not too long ago, the American Legion, the Veterans of Foreign Wars, and the Disabled American Veterans voted to support a pioneer/veteran home. That position hasn't changed. However, he pointed out that a veteran under the age of 65 can't be admitted into the pioneer/veteran home and thus the question of what to do with those veterans under the age of 65 remains. Mr. Craig informed the committee that the [Joint Service Organizations] support this position. He explained that he has been involved with the veterans' home issue for over 30 years. He felt that veterans need to get their foot in the door some way and thus he was sympathetic to whatever manner veterans could enter. There are over 60,000 veterans in Alaska that deserve some form of care. Number 0550 JIMMEY MAYO testified via teleconference. Mr. Mayo remarked that [HB 88] is a win-win situation for veterans and pioneers. He indicated that additional funding will be requested for those veterans under the age of 65. JUDY PUSTI testified via teleconference in support of HB 88, which she viewed as a start to obtaining a veterans' home while taking care of seniors. Number 0680 JOE STRUNKA testified via teleconference in opposition to HB 88. Prior to any action on HB 88, Mr. Strunka suggested taking the veterans already in the pioneers' homes as a pilot program and make sure that those veterans as well as all that qualify get the federal benefits that they are entitled. After about a year of assessment, it could be evaluated how much the federal government has nosed into the state's business. He also suggested not changing the name until the pilot program was completed. Mr. Strunka turned to the veterans' preference and noticed that veterans can enter this new home in two ways, either through the veterans' preference or as a pioneer. Therefore, there is the possibility that in a community 100 percent of the residents could be veterans. If that becomes the case, Mr. Strunka questioned what would happen with the others in the community that have needs. He asked if those others would have to go outside their community to obtain support. MR. STRUNKA informed the committee that he first went to the homes to visit with the old-timers in 1965. Mr. Strunka described the rooms and how small they are once a bed, dresser and chair are inside. He suggested that perhaps the entire [Pioneers' Home] system could be turned over the mental health program because 80 some percent of its residents are suffering from Alzheimer's and dementia. As Representative James implied, the funding for assisted living could be raised so that all qualifying individuals can enter a facility near their home. Number 1008 FRANCES PURDY testified via teleconference. Ms. Purdy informed the committee that there are items that haven't been addressed such as the cost of the stipend. The cost of the subsidy for people who can't afford to stay in a Pioneers' Home has continued to increase. She said, "That fiscal note is not added to the bill and is not discussed." The actual cost that has been addressed is that the average veteran would pay $2,417 a month. However, the actual cost of $50 a day hasn't been addressed. Ms. Purdy pointed out that when the $5.2 million is divided by the 126 proposed employees, the result is approximately 126 employees being paid $12.89 a hour, which is the actual cost of a CNA [certified nurses assistant]. Therefore, there would be no supervisors, no extra money for food, and no extra money for housekeeping. Ms. Purdy emphasized her belief that HB 88 deserves substantial study in terms of what actually is going to be given as a service. "The idea of the home is great; the actual mechanics of what is being proposed, I believe is not studied enough. And I believe that we're getting ourselves into one heck of a financial mess." Ms. Purdy noted that the committee should have her written testimony. Number 1122 BRUCE GAZAWAY testified via teleconference in favor of HB 88. Mr. Gazaway informed the committee that he is the president of the Alaska National Guard Enlisted Association and a member of the American Legion. Mr. Gazaway remarked that politics is the "art of compromise," which often means that giving a little bit can achieve much. From personal experience, Mr. Gazaway knows that the veteran community has been working to achieve a veterans' home for many years. He identified the crisis as being inadequate funds for a veterans' home in Alaska as well as inadequate funds for a pioneers' home in Alaska. Therefore, Mr. Gazaway expressed the need to focus on the achievable rather than the ideal. Although there are some operational details that need to be resolved in this experiment, HB 88 permits additional funds to flow into the underfunded pioneers' homes and provide services to veterans that don't currently exist. Thus, HB 88 will strengthen the state by strengthening the pioneers' home system. Number 1281 BERNADINE WESTON-RAISKUMS testified via teleconference. She informed the committee that she is a former employee of the Veterans' Administration regional office in Alaska. Ms. Weston- Raiskums said that she has long been distressed by the fact that Alaska's veterans have been sent outside to veterans' hospitals and domiciliaries. "They deserve a veterans' home in Alaska," she charged. Ms. Weston-Raiskums announced her support of HB 87, but noted that she referred to "veterans, dependents, and survivors in Alaska" versus HB 87's language, "state veteran." She pointed out that these people are veterans of the United States who reside in Alaska and thus they are the responsibility of the United States. "We in the State of Alaska cannot afford to relieve the United States of their responsibility by withholding funds from our own elders in the hope that the federal government will step forward," she said. She related her belief that the federal government will step forward when it sees the number of veterans in need rather than reducing the number at the expense of others in need. In regard to the $2.6 million in general funds that would allow 90 beds to be filled, Ms. Weston-Raiskums charged that either we have that money or we don't. Further, Ms. Weston-Raiskums said that the hope that veterans will come forward with the funds due to the state's commitment hasn't been supported by evidence and thus she believes that HB 88 remains premature and may excuse the federal government from its responsibility at the expense of Alaska's elders, particularly women. She doubted that the Department of Military & Veterans' Affairs will provide any funding to support these homes in Alaska as long as [the state] is unwilling to comply with federal regulations, especially in regard to the younger veterans. If HB 88 is passed, Ms. Weston-Raiskums didn't support the cleanup amendment for the longevity requirement. Number 1517 MARTY MARGESON testified via teleconference. Ms. Margeson informed the committee that her father has been a resident of the Anchorage Pioneers' Home Alzheimer unit since 1997. In his three year residency, his rates have doubled. Furthermore, the staffing shortage is so acute that there are 45 vacant beds. Although the acuity level for Alzheimer's Disease and Related Dementia (ADRD) has increased, staffing has been cut and supplies for handicap residents are in short supply. For example, the Pioneers' Home doesn't have enough lift chairs for its residents. Furthermore, most residents are only bathed once a week. Unannounced visitors may find residents sitting in a circle of "loneliness, sleeping, and boredom" because there isn't enough staff to provide activities and no geriatric specialist to design a therapeutic activity program. Ms. Margeson said, "The new budget will not address the current short falls." Furthermore, she didn't believe that HB 88 will provide enough staffing for incoming residents because it only staffs at the enhanced assisted living needs. She believes that most of the veterans entering the homes will come in at a level requiring comprehensive care. Institutional care is the last resort. However, there are smaller assisted living homes that will serve people at the enhanced level of care for less money. Therefore, HB 88 will encourage those veterans needing a higher level of care in the ADRD comprehensive unit to enter the Pioneer Home, but the bill won't furnish enough staff to cover their needs. Thus, current residents will continue to suffer more shortages. Furthermore, this bill will continue to incur state costs. She explained that veterans such as her father don't qualify for nursing home or assisted living home VA benefits because that requires a 70 percent service-related mental or physical disability. She inquired as to the percentage of Pioneers' Home veterans that would meet this disability requirement. Ms. Margeson said, "The state can no longer afford a 100 percent coverage. We need to look to federal monies. Veterans and pioneers can qualify for Medicaid if they have skilled nursing needs." Small assisted living homes already take advantage of federal funds through the Medicaid Choice waiver program. Ms. Margeson related her belief that the Pioneers' Home should reinstate the nursing license for half the home. Number 1756 MIKE HIGDON, Commander, Post 30, American Legion, testified via teleconference. Mr. Higdon noted his support of HB 88. KATHLEEN DALTON testified via teleconference and noted that she is a member of the Pioneers of Alaska. She pointed out that the word "pioneer" is being used as if everyone is a pioneer. However, the requirements to enter the Pioneers' Home now are age 65 and one-year residency, which she stressed is not a pioneer. Although HB 88 has some merit, she felt that as drafted it is ill-conceived. Ms. Dalton echoed earlier testimony that there are so many empty beds in the Pioneers' Homes because of the cost. She pointed to the most recent regulations. Ms. Dalton suggested that the committee vote this proposal down and that Commissioner Duncan return next year with a better proposal. Number 1894 HAROLD HUME testified via teleconference in opposition to HB 88. He informed the committee that he is a Korean veteran, a member of the Pioneers of Alaska, and Chaplain of Igloo 4. Mr. Hume said, "I believe that fundamentally the state has an obligation to the pioneers and the federal government has a responsibility to the veterans." HELEN BARKLEY testified via teleconference. She informed the committee that she serves as a member of the AVAK and the current commander of the Department of Disabled American Veterans. Ms. Barkley, a disabled veteran herself, also informed the committee that she has visited the Pioneers' Homes and is sympathetic to both sides. She expressed sadness that funding to fully staff the Pioneers' Homes hasn't happened in the past and people aren't receiving the care that they need. Ms. Barkley said that she attended the visit to Juneau with the Joint [Service Organizations], which supports HB 88 because it is a win-win situation for both the pioneers and the veterans. She noted the desire to see a stand-alone veterans' home in the future, which the $200,000 study should address. CHAIR COGHILL announced that he would not close public testimony on HB 88. Number 2063 MG GENERAL PHIL OATES, Adjutant/Commissioner, Department of Military & Veterans Affairs, informed the committee that he is present as an advocate for both the pioneers and the veterans because he believes this situation helps both. General Oates also informed the committee that he would provide the committee with written answers to many of the questions from today. In regard to [HB 88] being discriminatory, General Oates pointed out that there are male and female veterans. Although there are more male veterans than female veterans, the female veterans live longer. Currently, the home has a 3:1 ratio of women to men. Furthermore, 9 of the 90 veterans in the [Pioneers' Home] are women. General Oates pointed out that spouses are allowed into the homes in appropriate situations, which will increase accessibility for women. Therefore, he didn't believe [HB 88] is discriminatory. Furthermore, [HB 88] gives more beds to the pioneers than the veterans. GENERAL OATES turned to the issue of a possible decrease in funding in the future. If funding is decreased, it's based in statute per the amendment and is based on a percentage. Therefore, the percentage would change accordingly and thus the veterans wouldn't receive a disproportionately higher number of beds if funding is decreased. GENERAL OATES then addressed the notion that veterans are the responsibility of the federal government. He informed the committee that the federal government is treating veterans in Alaska the same as in other states. Alaska has the second highest per capita number of veterans of any state in the U.S. However, Alaska is the only state without a veterans' home or not in the process of building a veterans' home. The poorest state in the nation, Mississippi, has four veterans' homes. General Oates quoted Abraham Lincoln as saying the following: "Care for him who has borne the battle, his widow, and his children." He then quoted the following from Tom Brokaw's book, The Greatest Generation: "They answered the call, they faced great odds, they did not protest, they succeeded, they won the war, they saved the world." However, "we're" not prepared to give them the benefits these [veterans] have earned. General Oates charged that the responsibility for veterans lies in the hands of both the federal and the state government. In fact, in every case the federal government carries the majority of the funding. The federal government has said that if [the state] comes forward with a plan, it will either help build and pay for a veterans' home or participate in a pilot project. The federal government has indicated that it is standing by to help, but the state must take the first step as has been the case in the 49 other states. Again, he pointed to Mississippi with its four veterans' homes, which cost that state $4.6 million a year in general funds. The federal VA brings in $73.6 million to support those homes. General Oates said, "The federal [government] will pay the majority of the cost, but they're not going to pay if the state's not willing to put up something for its veterans." Furthermore, a veterans' home is a symbol. GENERAL OATES turned to the proposal embodied in HB 88, which provides more for less across the state. If a stand-alone veterans' home was built, it would cost approximately $4 million in state construction funds and the state would have to provide the land. In such a situation, the federal government would pay about three-quarters of the construction but the state would have to pay the operating cost. The design under review is for 100 beds. Number 2341 GENERAL OATES recalled the testimony of Dr. Ural Cohen(ph), an Israeli paratrooper who is now a professor of architecture at the University of Wisconsin and author of many books about care and dementia situations. General Oates quoted Dr. Cohen(ph) as follows: "This is a potentially rich resource to shape the programs and environment of the pioneers and the veterans. It will accelerate the homes transformation into exemplary care environments." He also noted that Secretary Principi says that Alaska's Pioneers' Homes system is equal, if not better than all he has visited because the focus is on the resident's quality of life. General Oates informed the committee that Secretary Principi has said that he would like to use [the proposal in HB 88] as a pilot program. The $200,000 not being discussed here is to be utilized in order to determine how best to leverage other federal programs now that our foot is in the door to meet the long-term care needs of veterans. General Oates echoed earlier testimony regarding the fact that Ms. Solerno(ph) is standing by to visit us. He reviewed the other [options] that are available. GENERAL OATES informed the committee that the state puts about $540,000 in his budget, which results in additional benefits on the order of about 64:1, $35 million. This is good business and good for veterans and the nation. General Oates concluded by saying that [Alaska] will never achieve a stand-alone veterans' home because the state's share of the funding will never come. "This is our only chance to meet the needs of the veterans," he charged. "If this opportunity is passed, then he said he would turn to the [legislature] for ideas. Although General Oates saw the sincerity of this committee, he saw it as casting the "yes or no vote." If HB 88 isn't passed to the House Finance Committee, it will have been the House State Affairs Standing Committee that cast the "no vote." He said that this committee is too good for that. In conclusion, General Oates requested that this committee forward HB 88 as quickly as possible. Number 2564 REPRESENTATIVE JAMES announced that she was personally [offended] by General Oates' concluding remarks. She clarified that she wanted to do everything possible for veterans. Representative James emphasized the diversity of Alaska and pointed out that lots of veterans live in rural areas. Therefore, she noted her mixed feeling regarding whether there should be a veterans' home in one area of the state or whether veterans' benefits should be funneled to wherever they live. She asked if the state could get a waiver for funds to go directly to the veteran, couldn't the waiver allow for the veterans to be cared for wherever they are in the state. CHAIR COGHILL said that he wouldn't allow the answer because that goes to the core debate on the bill. Furthermore, he didn't want to have a cursory answer as the committee is trying to adjourn. Chair Coghill reiterated that he would not close public testimony. [HB 88 was held.]
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