Legislature(1995 - 1996)
04/12/1996 01:35 PM House FIN
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* first hearing in first committee of referral
+ teleconferenced
= bill was previously heard/scheduled
+ teleconferenced
= bill was previously heard/scheduled
HOUSE FINANCE COMMITTEE
April 12, 1996
1:35 P.M.
TAPE HFC 96-116, Side 1, #000 - end.
TAPE HFC 96-116, Side 2, #000 - end.
TAPE HFC 96-117, Side 1, #000 - end.
CALL TO ORDER
Co-Chair Mark Hanley called the House Finance Committee
meeting to order at 1:35 p.m.
PRESENT
Co-Chair Hanley Representative Martin
Co-Chair Foster Representative Mulder
Representative Brown Representative Navarre
Representative Grussendorf Representative Parnell
Representative Kelly Representative Therriault
Representative Kohring
ALSO PRESENT
Harlan Knudson, Executive Director, Alaska Hospital and
Nursing Home Association; Connie Sipes, Division of Senior
Services, Department of Administration; Del Smith, Deputy
Commissioner, Department of Public Safety; Jay Livey, Deputy
Commissioner, Department of Health & Social Services; Roger
Poppe, Staff, Representative Kott; Karen Brand, Staff,
Senator Donley; Tom Walker, AACOP, Seward; Laurie H. Otto,
Deputy Attorney General, Criminal Division, Department of
Law; John Barnett, Storage Tank Assistance, Department of
Environmental Conservation; Larry Streuber, Chief Facilities
and Planning, Department of Health & Social Services; David
Pierce, Certificate of Need Coordinator, Department of
Health & Social Services.
SUMMARY
HB 456 An Act relating to the Board of Storage Tank
Assistance; and providing for an effective date.
CS HB 456 (L&C) was reported out of Committee with
a "do pass" recommendation and with a zero fiscal
note by the Department of Environmental
Conservation.
HB 528 An Act relating to applications for certificates
of need and licensing of nursing homes; amending
the standard of review for certificates of need
for health care facilities in the state;
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establishing a moratorium with respect to new
applications by prohibiting the issuance of a
certificate of need or a license for additional
nursing home capacity in the state until July 1,
1998; and providing for an effective date.
CSHB 528 (FIN) was reported out of Committee with
a "do pass" recommendation and with a zero fiscal
note by the Department of Health & Social
Services.
HB 543 An Act establishing a preference when entering
into state airport land leases.
HB 543 was rescheduled to another time.
SB 26 An Act providing for automatic waiver of juvenile
jurisdiction and prosecution of minors as adults
for certain violations of laws by minors who use
firearms to commit criminal offenses and relating
to the sealing of the records of those minors.
SB 26 was HELD in Committee for further
consideration.
HOUSE BILL NO. 528
"An Act relating to applications for certificates of
need and licensing of nursing homes; amending the
standard of review for certificates of need for health
care facilities in the state; establishing a moratorium
with respect to new applications by prohibiting the
issuance of a certificate of need or a license for
additional nursing home capacity in the state until
July 1, 1998; and providing for an effective date."
JAY LIVEY, DEPUTY COMMISSIONER, DEPARTMENT OF HEALTH AND
SOCIAL SERVICES discussed section 2. He observed that if
147 nursing home beds are built over the next five years it
will cost the State approximately $57.0 million dollars. He
stated that it is unclear where cost effectiveness review
will occur if it is not part of the legislation. He
stressed that cost effectiveness can be part of the
certificate of need process. He maintained that section 2
is critical to the legislation.
CONNIE SIPES, DIVISION OF SENIOR SERVICES, DEPARTMENT OF
ADMINISTRATION stressed that certificates of need are
appealed to the judicial branch. The judicial branch makes
a binding finding on whether or not a certificate of need
should be granted by the Department. Once a certificate of
need is granted, nursing home beds are a mandatory service
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under Medicaid that must be funded. She pointed out that
the courts ultimately rule.
Mr. Knudson provided members with the criteria for
certificates of need (Attachment 1). He maintained that the
primary purpose of the certificate of need is to assure that
none are issued if there is a less costly alternative. He
stated that if section 2 is adopted the certificate of need
would not be needed.
Co-Chair Hanley summarized that the Department determines if
there is a need. The Legislature does not have the option
of rejecting the construction of new beds. Mr. Knudson
agreed that if the need is identified the Department is
instructed to approve the beds and request funding from the
Legislature.
Mr. Knudson suggested that the Legislature identify how many
nursing home beds will be in each region of the State. He
noted that there is a proposal in the Mat-Su Valley to build
60 new beds which will create 40 new jobs and cost $6.0
million dollars a year to operate. The nursing home spent
$200.0 thousand dollars to meet the requirements of the
certificate of need. He pointed out that 30 of the nursing
home beds in Anchorage are occupied by individuals from Mat-
Su.
LARRY STRIVER, DIVISION OF ADMINISTRATIVE SERVICES,
DEPARTMENT OF HEALTH AND SOCIAL SERVICES noted that 18
states have moratoriums on nursing home beds.
DAVID PIERCE, CERTIFICATE OF NEED COORDINATOR, DEPARTMENT OF
HEALTH AND SOCIAL SERVICES noted that 10 states had
moratoriums in 1985.
Representative Martin asked how much money has been spent on
beds that are empty. The Department could not answer. Mr.
Livey explained that the Department pays on a per day, per
patient basis. This cost is calculated based on the total
Medicaid cost to operate each facility. The fixed cost is
spread across the beds.
Representative Brown asked why the Department does not find
against the certificate of need if there is a surplus of
beds. Ms. Sipes explained that criteria for the certificate
of need is based on rescinded federal regulation. She
stressed that it is difficult to argue against the need for
long term care due to the growing population of elderly.
She emphasized that if the service being offered is nursing
home beds that the argument can be made to support their
construction. She observed that there are states that have
75 nursing home beds for every 1,000 people over the age of
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65 years of age. Florida has limited nursing home beds to
29 per 1,000 people over 65 years of age. She pointed out
that there is great disagreement as to what is the need of
nursing home beds. She stressed that there will be a 30 -
60 year commitment for each bed that is built. She
emphasized the importance of cost effective review.
Co-Chair Hanley asked what percentage of the cost of a
nursing home bed is paid for by the State.
Mr. Knudson explained that each bed costs approximately $250
dollars. Mr. Livey stated that between 85 - 90 percent of
all nursing home expenditures are paid through public funds.
Co-Chair Hanley pointed out that the Legislature would be
critical of adding new beds which will result in an
increased Medicaid budget when the State is having
difficulty funding existing beds. He acknowledged that
there is a need. He expressed frustration with the lack of
legislative input. He expressed a preference for a two year
moratorium. He noted that section 2 would provide a
statutory change but is not part of an overall strategy. He
suggested that section 2 would not be necessary if the
moratorium is longer than one year. He suggested that
section 2 be deleted, the moratorium be extended, section 1
be deleted, and an additional member be added to the working
group.
Representative Martin noted that Medicaid is the fastest
growing program in the State.
Mr. Knudson suggested that the study group identify the
total number of nursing home beds to be authorized by the
State. He noted that in New York community based care is
the fastest growing Medicaid cost. He stressed that
assisted living and other alternatives should be addressed.
Co-Chair Hanley pointed out that if community based care is
added and nursing home beds remain the same there would be
an expansion of service. He noted that community based care
is generally cheaper than institutional care. He stated
that the legislature should determine the number of nursing
home beds or the number of eligible nursing home and
community based slots. He emphasized that nursing home beds
are the most expensive way to expand care. He pointed out
that the monetary aspect is a limiting factor. He
emphasized that the legislature needs to have oversight.
Representative Mulder MOVED to conceptually adopt an
amendment to: Delete section 1; delete section 2; after
"services" add "one of whom is a licensed nursing home
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administrator, who operates a community nursing home in
Alaska on page 3, line 24; delete July 1, "1997" and insert
July 1, "1998" in section 6; and amend the title to reflect
the changes. Co-Chair Hanley reviewed the amendment.
Representative Mulder questioned if the report of the
working group should be delivered to the second regular
session. Representative Brown pointed out that the
legislature would have more time to act if the report is
presented to the first session.
Ms. Sipes referred to page 3, lines 6 - 10. She noted that
this section refers back to section 1. Mr. Livey explained
that any applications on file when the bill becomes
effective would be reviewed. He noted that (b) would allow
these applications to be reviewed based on the findings. He
stressed that the findings would allow a more balanced look
at applications in terms of whether services could be
provided in the community.
Ms. Sipes suggested that section 1, subsections (1) and (2)
be deleted and the remaining subsections of section 1 be
retained.
Representative Mulder WITHDREW his motion to amend HB 528.
There being NO OBJECTION, it was so ordered.
In response to a question by Representative Grussendorf, Mr.
Knudson asserted that a one year moratorium would be
sufficient. Mr Livey stated that the Department would
prefer to retain section 2. He added that a two year
moratorium would be better than a one year moratorium.
Representative Mulder MOVED to conceptually adopt an
amendment to: Delete section 1, subsections (1) and (2);
delete section 2; on page 3, line 24 after "services" add
"one of whom is a licensed nursing home administrator, who
operates a community nursing home in Alaska; delete July 1,
"1997" and insert July 1, "1998" in section 6; and amend the
title to reflect the changes.
Representative Martin expressed concern with the deletion of
section 2. Ms. Sipes clarified that a standard of review
will remain in statute. The added requirement for cost
effectiveness review will not exist.
Co-Chair Hanley spoke in support of the two year moratorium.
(Tape Change, HFC 96-116, Side 2)
Representative Mulder pointed out that a repealer of May
would be better than July in regards to the construction
season.
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Representative Mulder MOVED to AMEND his conceptional
amendment to delete "July 1, 1988" and insert "May 1, 1998".
Representative Kelly suggested that April would be better.
Co-Chair Hanley noted that May would allow time for
legislative changes. There being NO OBJECTION, it was so
ordered.
Representative Brown spoke in support of section 2.
There being NO OBJECTION, a conceptional amendment was
adopted to: Delete section 1, subsections (1) and (2);
delete section 2; on page 3, line 24 after "services" add
"one of whom is a licensed nursing home administrator, who
operates a community nursing home in Alaska; delete July 1,
"1997" and insert July 1, "1998" in section 6; delete "July
1, 1988" and insert "May 1, 1998"; and amend the title to
reflect the changes.
Representative Martin MOVED to reinstate section 2.
Representative Kohring OBJECTED. A roll call vote was taken
on the MOTION to reinstate section 2.
IN FAVOR: Brown, Navarre, Martin
OPPOSED: Grussendorf, Kelly, Kohring, Mulder, Parnell,
Therriault, Foster, Hanley
The MOTION FAILED (3-8).
Representative Mulder MOVED to report CSHB 528 (FIN) out of
Committee with individual recommendations and with the
accompanying fiscal note. There being NO OBJECTION, it was
so ordered.
CSHB 528 (FIN) was reported out of Committee with a "do
pass" recommendation and with a zero fiscal note by the
Department of Health & Social Services.
SENATE BILL NO. 26
"An Act providing for automatic waiver of juvenile
jurisdiction and prosecution of minors as adults for
certain violations of laws by minors who use firearms
to commit criminal offenses and relating to the sealing
of the records of those minors."
KAREN BRAND, STAFF, SENATOR DAVE DONLEY testified on behalf
of SB 26. She observed that the legislation would
automatically treat juveniles who are 14 years of age and
older and who has committed a second offense with the use of
a deadly weapon as an adult. She noted that violent crimes
are identified under AS 11.41. She explained that "firearm"
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was replaced with "deadly weapon" in the Senate Finance
Committee. A deadly weapon is defined as a firearm, axe,
metal knuckles, club, knife, or explosives. She stressed
that SB 26 is supported by the National Rife Association,
National Education Association, Spenard Community Council,
and the Anchorage, Juneau and Fairbanks police departments.
She observed that five other states have adopted similar
legislation. She emphasized that jail time is required for
a first time offense for a juvenile gun related charge in
these five states.
In response to a question by Representative Martin, Ms.
Brand noted that there are approximately 16 juveniles
incarcerated that would have been affected by the
legislation. The Department of Law estimates that 18
juveniles would be affected a year.
Ms. Brand referred to the Sponsor's response to the
Department of Corrections' fiscal note for SB 26 (copy on
file). She noted that Senator Donley disagrees with the
estimated impact of the fiscal note. She observed that the
Department of Corrections took into consideration of the
fiscal note that a new facility would have to be constructed
to house juveniles, including juveniles that are already
incarcerated. She maintained that SB 26 does not require
the construction of a new facility.
DEL SMITH, DEPUTY COMMISSIONER, DEPARTMENT OF PUBLIC SAFETY
testified in opposition to the automatic waiver of fourteen
year old juveniles to adult status. He emphasized the need
for a comprehensive approach to juvenile crime. He noted
that current law allows the waiver of fourteen year old
juveniles when appropriate.
LAURIE OTTO, DEPUTY ATTORNEY GENERAL, DEPARTMENT OF LAW
noted that automatic waiver provisions are in AS 47.10.010.
She referred to page 2 of the legislation. She observed
that there are provisions for discretionary waivers in cases
that are not covered by the automatic waiver law that would
allow waiver when appropriate. She added that AS 47.10
allows discretionary waiver of anyone regardless of age if
the State can show that they are not amenable to treatment
as a juvenile.
Representative Kelly asked if juveniles under 16 are being
currently waived to adult status.
Ms. Otto pointed to her experience in the criminal justice
system. She stressed that the legislation would waive
eighth and ninth graders into adult prisons for misdemeanor
crimes that include kicking people with boots. She observed
that the legislation applies to any crime in AS 11.41, not
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just felony crimes. She noted that "deadly weapons" can
include feet shod in boots. She emphasized that the
legislation requires that all 14 year old offenders that
have committed a second offense with a deadly weapon belong
in adult jails. She asserted that 14 year old juveniles do
not belong in adult jails. She acknowledged that the State
does need to deal with juveniles more seriously. She
maintained that the major problem in the juvenile system is
with those that commit minor crimes. She asserted that it
needs to be clear that there are consequences for breaking
the law at an early age.
Ms. Otto stated that the Department is not aware of a case
where a juvenile has fallen through the cracks and deserves
to be put in an adult jail. She maintained that the
McLaughlin facility does a good job of getting kids through
school and treatment. She stressed that these children will
be held in the juvenile system for six years. She stated
that lack education contributes to adult criminal behavior.
She emphasized that juveniles do not have to receive an
education in adult jails.
Ms. Otto noted that the Governor's Conference on Youth and
Justice, Juvenile Offenders Work Group has developed a
strong statement of philosophy for the juvenile offender's
system. She stressed that the group did not want to extend
waivers to children under sixteen. She observed that many
states are going to a three tier system. Juveniles in the
third tier can be given a juvenile sentence and an adult
sentence. If they complete their time in the juvenile
system without any problems the adult sentence is dissolved.
If they violate their juvenile sentence the adult sentence
is imposed. She maintained that this approach is an
appropriate middle ground.
Representative Kelly expressed support for juvenile
adjudication. Ms. Otto noted that all the children that
would come under the bill would be adjudicated.
Representative Kelly expressed frustration that juveniles
need to come before the court. Ms. Otto acknowledged that
consequences need to be swift.
Representative Therriault noted that steps have already been
taken to make waiver into adult status easier.
Representative Grussendorf asked if Ms. Otto would be more
supportive if "deadly weapon" was changed to "firearm". Ms.
Otto replied that if the bill applied to sixteen year olds,
firearms and felonies she would be more supportive. She
reiterated that there is not currently a problem. She spoke
in support of a three tier system.
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TOM WALKER, ALASKA ASSOCIATIONS OF CHIEF OF POLICE, SEWARD
spoke against the legislation. He agreed with remarks by
Ms. Otto. He emphasized that fourteen year old juveniles
should not be automatically waived to adult status.
Mr. Smith stated the Anchorage Police Department does not
support the legislation.
Representative Brown referred to the fiscal note.
MARGARET PUGH, COMMISSIONER, DEPARTMENT OF CORRECTIONS spoke
in support of the fiscal note. She noted that 14 to 15
juveniles would be added per year. She noted that there are
currently 20 juveniles in adult facilities. She stressed
that a few juveniles can be incorporated, but that a large
population of juveniles cannot be accommodated in existing
adult facilities. She stated that it is not in the State's
or the juvenile's best interest to have 14 year olds in with
convicted adult felons. She emphasized that they would be
subject to sexual and other assaults. She acknowledged that
SB 26 does not require additional education. She maintained
that lack of education is a major contributing factor in
juvenile crime. She stressed the moral obligation to
provide education at a higher level than what is available
for adult offenders.
Representative Brown asked what level of education is being
provided to juvenile offenders currently in adult jails.
Commissioner Pugh noted that the Department of Education is
concerned that the level being provided does not meet
federal requirements.
Commissioner Pugh noted that it is impossible to keep
juveniles separated from adults offenders 24 hours a day.
She stressed that every effort is made to provide a safe
environment.
Commissioner Pugh explained that the McLaughlin school model
was used to estimate operation costs.
Representative Mulder observed that the fiscal note was not
attached until the House Finance Committee. Commissioner
Pugh stated that she believes that separate services would
need to be provided for juveniles in adult facilities.
Representative Mulder stressed that discussion in the Senate
would have been altered if there had been a fiscal impact
note.
SB 26 was HELD in Committee for further consideration.
(Tape Change, HFC 96-117, Side 1)
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HOUSE BILL NO. 456
"An Act relating to the Board of Storage Tank
Assistance; and providing for an effective date."
ROGER POPPE, STAFF, REPRESENTATIVE KOTT testified in support
of HB 456. He noted that the legislation would extend the
sunset of the Board of Storage Tank Assistance and add an
additional member to the Board. He noted that the Board was
originally created in 1990 to deal with regulations and laws
involving environmental concerns relating to underground
storage tanks. The Board oversees regulations regarding
spills, building new tanks, provisions of grants and loans
and provides mediation between the Department of
Environmental Conservation and owners. The Board is due to
sunset on June 30, 1996. The Legislative Budget and Audit
Committee Report recommended the Board be extended to the
year 2000. He pointed out that on December 22, 1998 new
federal regulations will go into effect. There are
currently seven members on the Board. The Legislative
Budget and Audit Committee recommended that an eighth member
from the public at large be added.
Representative Brown questioned the cost of the Board.
JOHN BARNETT, EXECUTIVE DIRECTOR, BOARD OF STORAGE TANK
ASSISTANCE replied that the Board's annual budget is $114.0
thousand dollars. This covers travel, public assistance
expenses and one employee.
Representative Brown questioned if the purpose of the Board
is to decide who gets state subsidizes in the form of
cleanup assistance. Mr. Barnett acknowledged that one of
the Board's functions is to set the ranking system which
determines the priorities for receipt of funds. The
program is focussed on smaller businesses with a priority to
public health threats. The Board also mediates disputes.
The Board is a judicial appeal board.
Representative Brown asked if the ranking system could be
administered by the Department of Environmental
Conservation. Mr. Barnett noted that the ranking system is
subject to dispute. The tank owner has the ability to
appeal decisions. There are approximately 1,000
applications on file. Only 2 or 3 cleanups are being funded
annually. There are a constant number of disputes that must
be mediated. The ranking is reviewed each year and changed
through regulation and public notice and review.
Representative Brown questioned if costs could be reduced by
the use of the teleconference network. Mr. Barnett noted
that travel costs have been reduced. The savings has been
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spent on educational assistance in the form of a newsletter.
He observed that their budget has not increased over the
past five years.
Representative Brown noted that the Board of Public
Broadcasting is being eliminated. She maintained that the
Storage Tank Assistance Program is an unnecessary subsidy to
people that have a responsibility through their businesses.
Mr. Barnett noted that the Board has proposed ideas for
possible changes to the program in the future.
Consideration is being given to a loan or grant program
based on need.
Representative Brown maintained that the program is a
blatant form of corporate welfare.
Representative Kohring MOVED to report CSHB 456 (L&C) out of
Committee with individual recommendations and with the
accompanying fiscal note. There being NO OBJECTION, it was
so ordered.
CS HB 456 (L&C) was reported out of Committee with a "do
pass" recommendation and with a zero fiscal note by the
Department of Environmental Conservation.
ADJOURNMENT
The meeting adjourned at 3:30 p.m.
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