Legislature(2001 - 2002)

02/08/2001 03:30 PM STA

Audio Topic
* first hearing in first committee of referral
+ teleconferenced
= bill was previously heard/scheduled
          SB  55-PIONEERS' AND VETERANS' HOME/ADVISORY BD                                                                   
CHAIRMAN THERRIAULT  asked Major General  Oates if he would  like to                                                            
testify on SB 55.                                                                                                               
MAJOR  GENERAL OATES  said  he was  in support  of SB  55 and  would                                                            
testify after Commissioner Duncan.                                                                                              
Number 1787                                                                                                                     
JIM DUNCAN,  Commissioner  of Administration,  said  that SB 55  was                                                            
introduced by the Governor  and would require a number of changes to                                                            
the  current  Pioneer  Home  system. It  would  rename  the  present                                                            
Pioneer Home system  to Pioneer and Veterans' Home  system; it would                                                            
provide, in statute,  a preference for veterans admission;  it would                                                            
change the  name of the Pioneer Home  Advisory Board to the  Pioneer                                                            
and Veterans'  Home Advisory  Board; it would  require at least  two                                                            
members of  the board to be veterans;  and finally it would  require                                                            
that one  of those board  members be the  chairman of the  Veterans'                                                            
Advisory Council.                                                                                                               
COMMISSIONER   DUNCAN   then  gave   some   background  information                                                             
explaining  why  the Governor  has  introduced  the bill.  In  1992,                                                            
legislation was  passed to establish a veterans' home  in Alaska. It                                                            
was to  be operated by  the Department of  Administration but  would                                                            
meet  federal  requirements  so  that  the  residents  payments  and                                                            
federal  funding would  cover the  costs of operation.  In 1998  the                                                            
legislature  amended   the  1992  statute  to  allow   the  proposed                                                            
veterans' home to provide  nursing care. The idea behind this was to                                                            
increase federal  funding so that  the state didn't have  to make up                                                            
operational  shortfalls.  However,  this  wasn't  successful.  State                                                            
funding  would  still  be  required  because   federal  funding  and                                                            
veterans payments wouldn't  cover the nursing costs in Alaska. Thus,                                                            
there is still the unrealized  intent and definite need to serve the                                                            
Number 1914                                                                                                                     
Governor Knowles  recently appointed a cabinet level  team comprised                                                            
of  the Commissioner  of  Administration,  Major General  Oates  and                                                            
Commissioner  of Health and  Social Services  to explore options  to                                                            
fulfill  the  commitment  made to  veterans  in  the 1992  and  1998                                                            
legislation. One  of the options explored was to determine  the cost                                                            
of a stand-alone veteran's  home. The capital construction costs for                                                            
an 80-bed facility  would be about $24 million with  federal funding                                                            
providing  about 65  percent. This  would require  state funding  of                                                            
about  $8.5 million  for construction  and then  an additional  $7.2                                                            
million  annually  for operational  costs.  The  federal  government                                                            
would  contribute  about  $4  million,  residents  would  pay  about                                                            
$900,000 and the  state would have to contribute the  balance, which                                                            
is about $2.4 million per year.                                                                                                 
Number 2000                                                                                                                     
Looking  at  other  options,  the team  determined  that  using  the                                                            
current  Pioneer   Home  infrastructure   would  be  more   fiscally                                                            
responsible.  There are  six Pioneer  Homes located  throughout  the                                                            
state  and   they  are   not  being  fully   utilized.  Using   this                                                            
infrastructure  would  make  it easier  to  provide long  term  care                                                            
needs, closer to the veterans'  homes and communities, than if there                                                            
was just one veterans' hospital in the state.                                                                                   
COMMISSIONER  DUNCAN  emphasized  the quality  of the  Pioneer  Home                                                            
System  and pointed  out  that it  is  a system  that  is not  fully                                                            
utilized. There  are 600 beds in the  six homes and there  are about                                                            
90 vacant beds  at any given time.  SB 55 designates 125  beds or 21                                                            
percent of the  total beds for veterans. It would  say veterans have                                                            
a preference  in statute,  while  the 125-bed  designation would  be                                                            
instituted through regulation.                                                                                                  
In the system  now, there are about  78 veterans. Of the  167 people                                                            
on the  active waiting  list, 44  are veterans.  If funds were  made                                                            
available  to  fill the  empty  beds,  those  44 veterans  would  be                                                            
accommodated as  well as close to 50 pioneers who  are on the active                                                            
waiting list.                                                                                                                   
SB 55 would provide  needed funding for 24 hour nursing  care, which                                                            
is the level of care that  is needed for those beds. The fiscal note                                                            
accompanying  the bill indicates $2.6  million in general  funds and                                                            
about the  same in  pioneer home  receipts which  would provide  the                                                            
funding to hire necessary staff to fill the 90 vacant beds.                                                                     
COMMISSIONER  DUNCAN explained  that the  fiscal note intentionally                                                             
does not include  federal receipts. Care has been  taken so that the                                                            
Pioneer Home  system is  not changed to  require federal  regulation                                                            
such as would  happen if it were under  the Veterans Administration                                                             
system.   Otherwise,  many   Pioneer  Home   requirements  such   as                                                            
residency, age and building codes would have to be changed.                                                                     
Number 2225                                                                                                                     
While  federal dollars  aren't being  solicited,  they are  actively                                                            
exploring  options  with the  federal  government to  discover  what                                                            
might  be available  in  terms  of federal  assistance  and  federal                                                            
COMMISSIONER DUNCAN said  that they had worked closely with affected                                                            
interest groups  and that there were a number of supporting  letters                                                            
in the committee packets  one of which was from Senator Ted Steven's                                                            
office. He  went on to point out a  paper giving the background  and                                                            
history  of the proposal  as well  as a number  of frequently  asked                                                            
COMMISSIONER  DUNCAN concluded  his  testimony and  said that  Major                                                            
General Oates had some comments on SB 55.                                                                                       
CHAIRMAN THERRIAULT  asked for questions  first. There were  none so                                                            
he  asked  Major  General  Oates to  address  his  comments  to  the                                                            
Number 2300                                                                                                                     
MAJOR GENERAL OATES thanked  Chairman Therriault for the opportunity                                                            
to testify. He went on  to say that it was important to consider why                                                            
Alaska does  not have a veterans home  since Alaska ranks  second of                                                            
the  50 states  in terms  of  its number  of veteran  residents.  In                                                            
addition, Alaska is the  only state in the Union that does not have,                                                            
or is not in the process of building, a state veterans' home.                                                                   
He assured members that  the lack of a veterans' home was not due to                                                            
apathy, but  rather due to uncertainty  of where such a home  should                                                            
be located and how you  afford such a facility when you already have                                                            
a costly pioneer  home system. Because of the size  on the state, it                                                            
would also  be very  difficult to  meet veterans'  needs state  wide                                                            
with  just one  facility.  Veterans would  be displaced  from  their                                                            
communities when they needed care.                                                                                              
Side B                                                                                                                          
Number 2320                                                                                                                     
Looking for  creative solutions, they  came up with the idea  to use                                                            
existing  resources. There  are Pioneer Homes  in Ketchikan,  Sitka,                                                            
Juneau,  Palmer, Anchorage  and  Fairbanks  with empty  beds due  to                                                            
under staffing.  If these facilities  were utilized, there  would be                                                            
no  new  construction  costs,  the  problems   associated  with  one                                                            
regional center  would be ameliorated  and there would be  more beds                                                            
for less operating  costs than if  a single 80-bed home were  built.                                                            
Senator  Stevens has  expressed a  willingness to  help but says  he                                                            
can't move  ahead until the state  takes the first step.  He will do                                                            
all he can  to help make this a model  of federal/state cooperation                                                             
on veteran's issues.                                                                                                            
Senator Frank Murkowski  is bringing Secretary of Veterans' Affairs,                                                            
Anthony Principi,  to Alaska and one  of the important items  on his                                                            
agenda  is to visit  the Anchorage  Pioneer's Home  and discuss  the                                                            
merits of  this proposal.  The Veterans'  Administration is  looking                                                            
for creative  proposals to  meet the needs  of its veterans  because                                                            
the  current veterans'  home  system  is expensive,  not  regionally                                                            
located and isn't meeting  the care needs of veterans. This proposal                                                            
is a first step in meeting those needs.                                                                                         
Number 2237                                                                                                                     
MAJOR GENERAL  OATES said that veterans  need to be shown  that they                                                            
are important.  Providing for  their care needs  is one way  to show                                                            
the measure of their importance.  He went on to say that many of the                                                            
veteran  organizations  statewide have  indicated  support for  this                                                            
proposal.  There is  also support  from  many of  the state  pioneer                                                            
organizations.  He reiterated  the need  to take  the first step  to                                                            
provide for veterans living  in Alaska and said that the state could                                                            
have a nationally recognized model program.                                                                                     
CHAIRMAN  THERRIAULT  asked for  questions.  He said  that  although                                                            
there were  letters  of support there  were some  seniors that  have                                                            
questions  and it is the  duty of the committee  to ensure  that the                                                            
move is  advantageous. Some  of the letters  of support indicated  a                                                            
very limited understanding of the details.                                                                                      
COMMISSIONER   DUNCAN  said  that   the  proposal  wasn't   easy  to                                                            
understand  but that  the  Department of  Administration  is in  the                                                            
process of  organizing statewide visits  to provide information  and                                                            
answer questions.  He emphasized that  this proposal should  benefit                                                            
both pioneers and veterans in the state.                                                                                        
Number 2103                                                                                                                     
CHAIRMAN THERRIAULT  asked for a breakdown  on the vacancy  rates in                                                            
each of the homes and number of veterans in each of the homes.                                                                  
COMMISSIONER  DUNCAN said that a portion  of the information  was in                                                            
the packet but that he  would provide the number of veterans in each                                                            
home and the  information about which  home each of the 44  veterans                                                            
on the active waiting list had requested.                                                                                       
CHAIRMAN  THERRIAULT  wanted  information  on how  many individuals                                                             
might have to move to a  different location due to lack of bed space                                                            
in the community of first request.                                                                                              
COMMISSIONER  DUNCAN  said  that  the  vacancies  are  primarily  in                                                            
Palmer, Anchorage and Sitka.                                                                                                    
MAJOR GENERAL  OATES added  that the plan  stipulates that if  a bed                                                            
isn't available  in the community  of your choice you may  enter the                                                            
home in another community  then move to the community of your choice                                                            
when a bed becomes available.                                                                                                   
CHAIRMAN THERRIAULT called for teleconference testimony.                                                                        
MR. MERRILL HAKALA  testified via teleconference saying  that he was                                                            
a  veteran   and  was   opposed  to  the   pioneer  homes   becoming                                                            
pioneer/veteran  homes but was in  favor of a stand-alone  veteran's                                                            
home.  If the  proposal were  adopted,  there would  be a  "complete                                                            
change in  what the  pioneer homes  were meant to  be." He said  all                                                            
veterans  are welcome  as long  as they  meet the  current  entrance                                                            
requirements and it should  stay this way. He went on to say that if                                                            
the state would  recognize Alzheimer's disease and  related dementia                                                            
as a mental disease  there would be Medicaid coverage  and therefore                                                            
costs to the state and individual residents would be reduced.                                                                   
MR. GERALD  BOHMS testified  via teleconference  saying that  he too                                                            
was a veteran and not in  favor of changing the current Pioneer Home                                                            
System.  He didn't  think  it  was fair  for  veterans  to be  given                                                            
preference.  He pointed  out that  the state could  fund the  vacant                                                            
beds now and they wouldn't be empty.                                                                                            
MR.  GARY   BERRY  testified  in   person  and  said  that   he  was                                                            
representing  the  American Legion,  Veterans  of Foreign  Wars  and                                                            
Disabled American  Veterans. These Alaska service  organizations are                                                            
in favor of designating  125 beds in the Pioneer Homes for veterans.                                                            
They  feel that  all Alaskan  veterans  deserve long  term care  for                                                            
physical and  mental disabilities.  It is time to show appreciation                                                             
to these men and women.                                                                                                         
CHAIRMAN THERRIAULT called  upon Lt. Colonel (Retired) Pat Caruthers                                                            
to testify.                                                                                                                     
LT. COLONEL  PAT  CARUTHERS   said that  he supports  this  proposal                                                            
because it benefits both  veterans and pioneers. If this proposal is                                                            
passed, critical  care nursing will be funded and  it is the lack of                                                            
funding  for  this   highest  nursing  tier  that   is  causing  the                                                            
Number 1474                                                                                                                     
MR. JOHN  DAPCEVICH said  he was  a member of  the American  Legion,                                                            
Veteran  of Foreign  Wars,  Disabled  American Veteran,  Pioneer  of                                                            
Alaska  and has  served  the last  four  governors on  the  Pioneers                                                            
Advisory  Board. The Pioneer  Advisory Board  has unanimously  given                                                            
its support to SB 55. He  said that veterans are just as eligible in                                                            
the  current   pioneer  homes  as   non-veterans  and  their   entry                                                            
requirements will  be the same as non-veterans. This  proposal isn't                                                            
going to displace pioneers who are not veterans.                                                                                
SENATOR  PHILLIPS asked  for  the make  up of the  Pioneer  Advisory                                                            
MR. DAPCEVICH  said that the Governor  appoints a member  from every                                                            
community having  a home; there is one at large appointment  and the                                                            
chairperson of the Older Alaska Commission serves on the board.                                                                 
Number 267                                                                                                                      
MR. JIM  KOHN, Director  of Alaska Longevity  Program that  includes                                                            
the Pioneers'  Homes, wanted to comment on two points  made earlier.                                                            
First  was preference.  It should  be understood  that Pioneer  Home                                                            
beds are currently  filled with about  17 percent veterans  and over                                                            
30 percent  of those on  the waiting list  are veterans. Looking  at                                                            
the statistical  makeup of  the waiting list,  it is apparent  that,                                                            
over time,  there will be  more than 21 percent  of the beds  filled                                                            
with veterans whether they  are given a preference or not. After the                                                            
125 beds are filled,  it is unlikely that a veteran  would ever need                                                            
to be given preference.                                                                                                         
The second  issue he wanted  to address was  about Medicaid  funding                                                            
for the  home. He said  that the homes would  be changed  completely                                                            
with Medicaid  funding because residency and age requirements  would                                                            
have to be  abolished. They would  no longer be Pioneer Homes.  This                                                            
needs  to be  understood  if  you're  looking  at other  sources  of                                                            
CHAIRMAN THERRIAULT  asked, "If you're  the next person on  the list                                                            
and you  weren't a veteran  and a veteran  space was open would  you                                                            
get that spot?"                                                                                                                 
MR. KOHN said  that it was more complicated than that.  He explained                                                            
that  people  generally  apply to  the  waiting  list in  their  own                                                            
communities. If  an opening was to occur in Anchorage,  for example,                                                            
and  veterans  were occupying  124 beds,  the veteran priority  list                                                            
would  be  given  preference.  If  there were  no  veterans  on  the                                                            
Anchorage waiting list  then the next person would be given the bed.                                                            
Then, the next  bed opening in any community would  be given veteran                                                            
priority. If  the number of veterans  filling the beds rose  to more                                                            
than 125,  there would be  no veterans preference  given until  that                                                            
number fell below 125.                                                                                                          
ALFREDA DORE asked the  chair if she could address a question to Mr.                                                            
Kohn. She came forward  and asked if widows and widowers of eligible                                                            
veterans would be given  preference in the Pioneer Homes as they are                                                            
in Veteran Homes in the Lower 48.                                                                                               
MR. KOHN said  that the Pioneers'  Homes have always made  an effort                                                            
to keep spouses  together when one needs to enter  the home and they                                                            
would  continue to  do  so. However,  this issue  would  have to  be                                                            
looked  at carefully  to decide  whether  or not  spouses and  other                                                            
family members of qualified  veterans were given preference. He said                                                            
to keep in mind that in  Veterans' Homes, family members of veterans                                                            
may not occupy  more than 25 percent  of available beds.  He went on                                                            
to  say that  this should  be  resolved  through regulation  as  the                                                            
process moves forword.                                                                                                          
CHAIRMAN  THERRIAULT   asked  if  a  regulation  packet   was  being                                                            
developed for this legislation.                                                                                                 
MR. KOHN said  none had been started officially but  that an outline                                                            
was being prepared.                                                                                                             
CHAIRMAN THERRIAULT asked  for a copy of what had been developed. He                                                            
then asked for any other questions.                                                                                             
Number 665                                                                                                                      
SENATOR DAVIS  asked them to address  the question as to  whether or                                                            
not it  is a regulation  to give  spouses and  other family  members                                                            
MR. KOHN  said that  they want to  make sure  that the Pioneer  Home                                                            
System not come under federal  regulation. They have made this clear                                                            
to both  the Alaska Delegation  and Secretary  of Veterans'  Affairs                                                            
Principi  who has  expressed  interest  in innovative  programs  for                                                            
veteran  homes. He  said that  perhaps the  Veterans Administration                                                             
would  be able  to waiver  funds designated  for  a Pioneer/Veteran                                                             
Number 549                                                                                                                      
CHAIRMAN THERRIAULT  said that when  looking at the fiscal  note for                                                            
SB 55 it  shows it to be  general fund and  program receipts  so all                                                            
the  vacant beds  could  be opened  with  these funding  sources  to                                                            
anyone on the waiting list.                                                                                                     
MR. KOHN  said that  is correct.  The vacant beds  are general  care                                                            
beds and  the people  on the waiting  list need  high level  care so                                                            
providing additional  funding for  high level care would  fill those                                                            
beds.  However,   if  that  were  done  there  would   be  a  missed                                                            
opportunity  to  work  with  the  Veterans  Administration  to  find                                                            
innovative  ways to care for veterans  in assisted living  programs.                                                            
Number 381                                                                                                                      
SENATOR PHILLIPS asked  if the opportunity became available recently                                                            
and whether there is urgency to act.                                                                                            
MR. KOHN  said he  does believe  that time  is of  the essence.  The                                                            
Governor has  given a mandate to find  a program that will  work and                                                            
this  is what  the three  commissioners  have  devised and  it is  a                                                            
program   that   has  ignited   the   interest   of   the   Veterans                                                            
CHAIRMAN  THERRIAULT asked  if there was anyone  else who wanted  to                                                            
testify either  in person or via teleconference.  There was  no one.                                                            
He said  that if  there is  a bill requiring  more  work or if  work                                                            
needs to  be done on the  wording of an  amendment the bill  will be                                                            
brought up again as bills  previously heard. However, because of the                                                            
level of interest  in this bill he will give generous  notice before                                                            
this bill is heard again.                                                                                                       

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