Legislature(1995 - 1996)
03/28/1995 03:35 PM Senate STA
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* first hearing in first committee of referral
+ teleconferenced
= bill was previously heard/scheduled
+ teleconferenced
= bill was previously heard/scheduled
SSTA - 3/28/95
SB 120 STATE VETERANS' HOME FACILITIES
SENATOR SHARP brings up SB 120 as the next order of business before
the Senate State Affairs Committee and calls the first witness.
Number 451
SENATOR TORGERSON relays information contained in the sponsor
statement for SB 120 to the committee. Senator Torgerson expresses
surprise at the amount of the fiscal note, and asserts SB 120 will
have no fiscal impact on the State of Alaska.
Number 423
CHAIRMAN SHARP asks Senator Torgerson to confirm that SB 120 will
simply modify existing law to state veteran's facilities would not
just be housing facilities, but would also have nursing care.
SENATOR TORGERSON responds that is the intent.
CHAIRMAN SHARP asks if he is correct in his belief that there are
currently no veteran's homes in the state, and that SB 120 does
nothing but set up enabling legislation.
SENATOR TORGERSON replies that is his understanding.
Number 408
JEFF MORRISON, Legislative Liaison, Department of Military &
Veterans' Affairs, states one of the department's duties is to
advise the legislature what we believe veterans would want. He
thinks it would be safe to say veterans would support SB 120.
Number 392
JIM KOHN, Deputy Director, Division of Senior Services, Department
of Administration, states the change made by SB 120 would not be
just a technical amendment to an existing law, which makes the
existing law operational. The state law will remain, even with
passage of SB 120, incompatible with the federal veterans' program
requirements. The present statute requires that the veterans'
homes be operated without state subsidy. Nothing in SB 120 changes
that. The Veterans' Administration (VA) requires that a state
receiving a construction grant for construction of a state
veterans' home provide assurance that the state will be responsible
for the operating costs of that facility. When the VA contributes
65% of the construction costs, and the state contributes 35%, the
agreement up front is that the state will provide assurance they
will foot the future operating costs, as well as maintaining the
building.
MR. KOHN states that replacing the term "domiciliary care" with the
term "nursing care" has only one effect: it increases the daily
rate paid by the VA from approximately $10.83 to $25.35 for
eligible veterans. Since the cost of a nursing home bed in Alaska
is approximately $250 per day, a resident without state subsidy
would be responsible for the difference. On a yearly basis, the VA
would pay approximately $10,000 of these costs, while the resident
would be required to pay approximately $80,000. Understandably,
few residents would be able to pay the costs involved. Yet it
would be required by the agreement with the VA that 75% of all
residents in a nursing home be eligible veterans, which means that
their income would have to be lower than the appropriate maximum
allowed. That puts them in the position of being unable to pay for
their care.
MR. KOHN reminds the committee that in Alaska there is a VA
community nursing home program right now. Under this program, the
federal government is obligated to pay the total costs of the care
of veterans placed in community nursing homes by the VA. We need
to realize, that if a veterans' home is opened, the state will be
exchanging federal money for state obligations. In addition,
though he understands that veterans' organizations would like to
see a veterans' home, he is not sure that individual veterans would
be favorably impressed when faced with the bill. At present,
veterans can enter nursing care homes in their own communities, and
continue to have their families nearby. If a centralized
veterans' home is created, people will have to move to that central
location to get any subsidy.
Number 310
MR. KOHN explains that the large fiscal note is to make disclosure
of costs, rather than following the actual law. The fiscal note
does not follow the law, because under the law, it is not possible
to even construct the home, or make the deal with the VA. The
fiscal note is based on the costs associated with building a home
similar to the Juneau Pioneer Home, with staff similar to the
Juneau Pioneer Home.
Number 332
CHAIRMAN SHARP asks Mr. Kohn if the veterans' homes in the rest of
the country all operate with only $25 a day from the federal
government.
MR. KOHN replies that is correct.
CHAIRMAN SHARP asks if that has always been the case. He thought
the federal government paid nearly all the costs associated with
veterans' homes.
MR. KOHN responds that since there is no veterans' home in Alaska,
the VA does pay the full cost of the care of eligible veterans
placed in a community nursing home. Eligibility is based upon
total income and assets. The VA also requires that 75% of the
residents in a veterans' home be of that eligible income status.
There is therefore the possibility that the costs to other veterans
ineligible for subsidy residing in the home will be increased, in
order to offset the loss caused by those unable to pay.
Number 298
DAVE WILLIAMS, Director, Division of Medical Assistance, Department
of Health & Social Services, states the division has followed the
development of home care for many years, and SB 120 seems to take
things in the opposite direction. The division is also aware that
many nursing home beds are pending construction. A home care
system is being set up in this state, and money will all come from
the same direction. If money is put into facilities, it will be
harder to develop a home care system. Also, when an eligible
veteran comes out of a hospital and placed in a nursing home, that
veteran will have 90 days of benefits in the nursing home. If care
goes beyond that, and a veteran is eligible for medicaid, then
medicaid pays the bill. In a state veterans' home, the home would
be eligible as a medicaid provider. The Department of Health &
Social Services has no position on SB 120, but the state will be
liable for 50% of the cost of care, under the medicaid program.
Number 268
SENATOR LEMAN asks Mr. Williams to explain his statement that the
money will come from the same direction.
MR. WILLIAMS responds there is a limited amount of money available
for long-term care. If that money is spent on nursing home care,
he assumes it will be more difficult to fund a home-care system.
Number 235
SENATOR TORGERSON reasserts that SB 120 does not build any
facilities or appropriate any money. It will give veterans in the
state the opportunity to build a nursing home.
Number 220
SENATOR RANDY PHILLIPS makes a motion to discharge SB 120 from the
Senate State Affairs Committee with individual recommendations.
CHAIRMAN SHARP, hearing no objection, orders SB 120 released from
committee with individual recommendations.
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