Legislature(2019 - 2020)ADAMS ROOM 519
02/03/2020 01:30 PM House FINANCE
Note: the audio ![]()
and video ![]()
recordings are distinct records and are obtained from different sources. As such there may be key differences between the two. The audio recordings are captured by our records offices as the official record of the meeting and will have more accurate timestamps. Use the icons to switch between them.
| Audio | Topic |
|---|---|
| Start | |
| HB205 || HB206 | |
| Fy 21 Budget Overview: Department of Health and Social Services and Medicaid | |
| Medicaid Budget Update | |
| Adjourn |
* first hearing in first committee of referral
+ teleconferenced
= bill was previously heard/scheduled
+ teleconferenced
= bill was previously heard/scheduled
| += | HB 205 | TELECONFERENCED | |
| += | HB 206 | TELECONFERENCED | |
| + | TELECONFERENCED | ||
HOUSE FINANCE COMMITTEE
February 3, 2020
1:34 p.m.
1:34:52 PM
CALL TO ORDER
Co-Chair Foster called the House Finance Committee meeting
to order at 1:34 p.m.
MEMBERS PRESENT
Representative Neal Foster, Co-Chair
Representative Jennifer Johnston, Co-Chair
Representative Dan Ortiz, Vice-Chair
Representative Ben Carpenter
Representative Andy Josephson
Representative Gary Knopp
Representative Bart LeBon
Representative Kelly Merrick
Representative Colleen Sullivan-Leonard
Representative Cathy Tilton
Representative Adam Wool
MEMBERS ABSENT
None
ALSO PRESENT
Adam Crum, Commissioner, Department of Health and Social
Services; Sana Efird, Assistant Commissioner, Department of
Health and Social Services; Albert Wall, Deputy
Commissioner, Medicare and Health Care Policy, Department
of Health and Social Services; Gennifer Moreau-Johnson,
Acting Director, Division of Behavioral Health, Department
of Health and Social Services; Renee Gayhart, Health Care
Services Director, Department of Health and Social
Services.
SUMMARY
HB 205 APPROP: OPERATING BUDGET/LOANS/FUNDS
HB 205 was HEARD and HELD in committee for
further consideration.
HB 206 APPROP: MENTAL HEALTH BUDGET
HB 206 was HEARD and HELD in committee for
further consideration.
FY 21 BUDGET OVERVIEW: DEPARTMENT OF HEALTH AND SOCIAL
SERVICES AND MEDICAID
PRESENTATION: MEDICAID BUDGET UPDATE
Co-Chair Foster reviewed the agenda for the day.
HOUSE BILL NO. 205
"An Act making appropriations for the operating and
loan program expenses of state government and for
certain programs; capitalizing funds; making
appropriations under art. IX, sec. 17(c), Constitution
of the State of Alaska, from the constitutional budget
reserve fund; and providing for an effective date."
HOUSE BILL NO. 206
"An Act making appropriations for the operating and
capital expenses of the state's integrated
comprehensive mental health program; and providing for
an effective date."
1:36:02 PM
^FY 21 BUDGET OVERVIEW: DEPARTMENT OF HEALTH AND SOCIAL
SERVICES AND MEDICAID
Co-Chair Foster invited testifiers from the Department of
Health and Social Services (DHSS).
1:36:36 PM
ADAM CRUM, COMMISSIONER, DEPARTMENT OF HEALTH AND SOCIAL
SERVICES, (DHSS) introduced himself.
1:37:03 PM
SANA EFIRD, ASSISTANT COMMISSIONER, DEPARTMENT OF HEALTH
AND SOCIAL SERVICES, introduced the budget overview
presentation for the Department of Health and Social
Services and Medicaid (copy on file). She began with slide
2 which depicted the total budget comparison between FY 19
to FY 21. The comparison of 2 years showed a small
reduction in the budget across the 2 years. She highlighted
that in looking at the bar graph looking at the federal
authority equaled 60 percent.
Vice-Chair Ortiz wondered whether the comparison between FY
19 and FY 21 referred to the actuals and not the budget.
Ms. Efird responded that the comparison was to the
management plan, which was the passed FY 19 budget with the
department's adjustments. She remarked that there were some
minor changes to the budget within the management plan.
Vice-Chair Ortiz asked if supplementals were included form
FY 19.
Ms. Efird responded that FY reflected supplemental numbers.
Ms. Efird continued to slide 3 showing a comparison between
FY 20 to FY 21 operating budget. She highlighted an
increase of $133.747 million, which was a 13.8 difference
in the UGF.
Ms. Efird turned to slide 4 which showed a breakdown of the
changes to the FY 21 operating budget.
1:40:58 PM
Ms. Efird turned to slide 5 which reflected the FY 21 fund
source breakdown by funding source. She indicated the slide
also showed a breakdown of formula programs and non-formula
programs. The department's formula driven programs made up
75 percent of the state's DHSS budget.
Co-Chair Foster remarked that the grand total was $3.4
billion, and he assumed that the total was prior to the
duplicate removal
Ms. Efird responded in the affirmative. She explained that
it was meant to show that the Office of Management and
Budget (OMB) was attempting to show that some funds were
budgeted for various aspects, agencies, and departments in
the state.
Ms. Efird turned to slide 6 which showed the budget for the
Alaska Pioneer Homes Program. She explained the fund source
changes and budget changes:
? Add Authority for Alaska Pioneer Homes Payment
Assistance $5,000.0 UGF.
? Reduce Authority to Align with Anticipated Revenue
and Expenditures. ($2,592.2) DGF, ($7,407.8) Other.
1:44:38 PM
Representative Wool noted the addition of $5 million to the
Pioneer Homes in UGF. He wondered how there was also a net
reduction to the Pioneer homes of $4 million.
Ms. Efird replied that the previous year's Pioneer Homes
budget had a different component budget structure. She
noted that historically there was one component budgeted
with all the Pioneer Homes, and a smaller component for the
administrative cost. She remarked that OMB, in the year
prior, had inserted a new budget structure that accounted
for payment assistance. Therefore, all the money that was
collected was coming into the Pioneer Homes budget as
general funds in the "Payment Assistance Component." She
stated that the fund was only used as residents came into
the home with their income eligibility portion met. She
stated that once that resident was eligible for assistance,
the Payment Assistance Component was billed to meet the
needs monthly for each resident that needed help in making
their payments to stay in the home. She noted that in the
previous year there was some duplication of how the funding
source should show up in the Pioneer Homes component, so
the current budget was meant to ensure that there was an
exact payment assistance UGF number as it is billed as
interagency receipts or other funds. She restated that the
piece was a technical "shoring up" of how those sources
were coming in. She stressed that it was a true $5 million
increase to meet the needs of the Pioneer Homes residents.
1:47:21 PM
Representative Wool asked if the resident would experience
the effects of an increase or a decrease in the budget.
Ms. Efird replied that the budget was based on a projection
provided by the Pioneer Homes to meet the needs of the
residents. She noted that the reduction in "other funds"
referred to payment assistance amount. She noted that there
was also a request for a decrement in the DGF funds, and
those funds were private pay. She stressed that the Pioneer
Homes budget was always based on a projection, while not
knowing the exact number of patients that might need
payment assistance.
Representative Wool felt that there could be an accurate
expectation of additional fees paid privately, because of
the rate increase.
Ms. Efird would follow up with the committee. She noted
that the funding sources for the FY 20 budget was not
accurate, because of all of the attempts to make
adjustments and changes. She thought there were some
unintentionally double-counted items.
Vice-Chair Ortiz requested to see the information Ms. Efird
was going to provide. He wondered whether the $5 million
increase was a recalculation of how much would be needed
after the increase went into effect.
1:52:08 PM
Commissioner Crum believed the number of residents that
left the Pioneer Home as a result of the fee increase was
about 16 people. He remarked that there was an increase of
individual payments of almost $7 million, which was a new
aspect to the budget. He explained that the $5 million
would help provide the flexibility during the resident
turnover.
Vice-Chair Ortiz remarked that the year prior had a
presenter that made the projection that while the impact of
the proposed rate increase might show that the state would
save money, there would really cause a shift of the
population to see a higher percentage of the population
being unable to have the resources pay on their own, so
they would require state assistance to make up for the
change in population.
Commissioner Crum reported that the number of dollars
increased coming through the door in the year prior, but
noted the uniqueness of the turnover rate.
1:55:10 PM
Vice-Chair Ortiz asked for clarification in wording.
Commissioner Crum restated that there was a state saving
increase.
Vice-Chair Ortiz queried the exact amount of state savings.
Ms. Efird replied that the Pioneer Homes was still down
approximately $2 million in UGF, but agreed to go over the
specific numbers throughout the previous years.
Representative Josephson asked where to look for the
additional fees.
Ms. Efird clarified that there was a technical issue the
department was attempting to correct.
Ms. Efird continued to slide 7 reflecting the Alaska
Psychiatric Institute (API) budget. The change to the
budget was to attempt to fill all beds at API:
? Add Authority to Achieve Full Capacity at the Alaska
Psychiatric Institute. $2,529.2 UGF, $6,837.2 Other.
Representative Wool wondered whether the department was
receiving Medicaid payments prior to the waiver. He asked
whether residents of API were eligible for Medicaid.
Ms. Efird responded in the affirmative. She furthered that
it would now be covered under the 1115 waiver.
Representative Wool asked about the $2.6 million was for
expanding the number of beds. He asked if the department
still had the resources to increase the number of beds
without the 1115 waiver.
Ms. Efird replied that the increment was intended to
provide the resources to meet the staffing requirements
needed for the additional 80 beds. She stressed that the
slide reflected how the department would capture the
funding for the increment.
1:59:46 PM
Ms. Efird advanced to slide 8 showing the budget for the
Division of Behavioral Health. She pointed out the fund
source change from UGF to the MET fund:
? In FY2021 a Fund Change from UGF ($11,400.0) to MET
Fund (DGF) $11,400.0.
Co-Chair Johnston commented that there had been discussions
in the subcommittee about the sustainability, and was
interested in what was "really sustainable" year over year
for the Marijuana Fund.
Ms. Efird commented that the department would continue to
monitor the issue and would look more closely at the fund
to make sure sustainable dollars were available.
2:02:06 PM
Representative Josephson commented that the reduction in
the Behavioral Health portion of the budget still allowed
for providers to submit claims through the agency. He
wondered whether the 1115 waiver would show up in the
Supplemental Budget.
Ms. Efird did not completely understand Representative
Josephson's question.
Representative Josephson clarified that the need would be
comparable in FY 19. The legislature had recently
underfunded in anticipation of waiver approval for
services.
Ms. Efird clarified that the waiver services funding had
been approved.
Representative Josephson wondered whether have of the
waiver program was still "pending."
Ms. Efird responded, "That is correct." She deferred to Mr.
Wall.
2:04:46 PM
ALBERT WALL, DEPUTY COMMISSIONER, MEDICARE AND HEALTH CARE
POLICY, DEPARTMENT OF HEALTH AND SOCIAL SERVICES, shared
that the services provided under the 1115 waiver for the
substance use disorder services were already online. Those
services were being rolled out a little bit at a time. He
explained that the old way of billing under Medicaid was
still available, so there were two different forms to bill
under Medicaid. He explained that the reduction in grants
was the first phase, and the second phase was anticipated
for the following fiscal year.
2:06:09 PM
GENNIFER MOREAU-JOHNSON, ACTING DIRECTOR, DIVISION OF
BEHAVIORAL HEALTH, DEPARTMENT OF HEALTH AND SOCIAL
SERVICES, explained the sequence of milestones to help to
clarify the intent and process. She recalled that in FY 16,
there was a bill that allowed for the application of the
grant decrement. The decrement was implemented ahead of the
1115 waiver demonstration project. She furthered that in
November of 2018, the department received approval from the
federal government for the substance use disorder
component, which added twelve new services to be covered by
Medicaid. She remarked that it was in addition to regular
Medicaid.
Mr. Wall explained the reason why the 1115 waiver was
divided into the two portions.
2:10:38 PM
Representative Wool wondered whether the API residents
would be double billed for the resident fee and the
substance abuse assistance fee.
Mr. Wall responded that API was only doing the inpatient
psychiatric component, and not the substance abuse
component.
Representative Wool referred to an increase in the "other"
portion of the budget.
Mr. Wall further clarified that there was a shift in the
Medicaid expenditure in API in the coming years.
Commissioner Crum added that there was an anticipation of
receiving the IMB exclusion to bill against the behavioral
health portion, which would allow for the increase in
revenue for the incoming dollars.
Representative Wool asked that with the increase in
revenues, the state would be able to expand the number of
beds.
Mr. Wall noted that the problem did not have to do with
additional beds, rather it had to do with staffing
requirements.
Ms. Efird reviewed slide 9 having to do with the Office of
Children's Services:
? Staff Retention and Wellness Initiatives $1,500.0
Federal.
? Title IV-E Reimbursement for Legal Representation
for Parents $1,200.0 Federal.
2:14:47 PM
Vice-Chair Ortiz noted that the Office of Children's
Services Division generated the most questions from his
constituents. There were complaints that the division could
not meet the demands of services properly.
Commissioner Crum responded that a GAP analysis study would
be release in the following month. He hoped community
outreach would increase and allow for the department to
focus on the issue.
Ms. Efird advanced to the Health Care Services Division on
slide 10. The department felt the position should fall
within the Office of the Governor rather that the Health
Care Services Division:
? Transfer Office of Rate Review to Commissioner's
Office
Ms. Efird advanced to slide 11 and showed the budget
breakdown for the Division of Juvenile Justice.
Co-Chair Foster asked about the $2 million cut to the Nome
Youth Facility. He noted that the slide showed an increase
in funding for juvenile justice, and aske for further
information.
Ms. Efird replied that the reduction occurred from FY 19 to
FY 20. She noted that the major adjustments were salary and
technical adjustments in the budget.
Co-Chair Foster noted there had been cuts to travel. He
asked her to speak to transportation costs. He was
concerned that the cuts offset increments.
2:20:24 PM
Commissioner Crum responded that the staff had been
maintained at the Nome Facility for probation services, and
maintaining a facility for other kids until their transfer.
He stressed that many items, like Zoom, provided the
ability for distant access to keep some of the costs down.
He stressed that there were some discussions about the best
use for that facility for public use.
Co-Chair Foster asked if the commissioner had kept track of
the process. He wanted to know the detail on the Nome
Facility periodically.
Ms. Efird would provide the information to the committee.
Ms. Efird turned to slide 12 regarding the Division of
Public Assistance:
? Restore Adult Public Assistance Maintenance of
Effort Methodology $7,471.2 UGF.
? Transfer Parents as Teachers Program from the
Department of Education and Early Development for
Better Alignment $474.7 UGF.
Representative Knopp asked for a brief synopsis of the
Adult Public Assistance maintenance effort. He also
requested the eligibility requirements for some of the
public assistance programs.
Ms. Efird replied that the Adult Public Assistance Program
was required as a match for the Medicaid program. She
explained that the payments went to age-blind and disabled
people. The eligibility requirements included income
calculations related to who received the payments. She
furthered that there was a spending requirement called a
"maintenance of effort" on the program as a match for the
Medicaid program. The two ways the state calculated their
total maintenance of effort: 1) reverting to the payments
from 1983 with cost of living increases, which was proposed
in the original FY 20 budget; and 2) to maintain current
total expenditures of the process of payments. She
explained that the department estimated that the state
could save some funding in the current fiscal year, but was
more than the governor had in the original proposal,
therefore there was a reverting to the current proposal.
Commissioner Crum furthered that the Division of Public
Assistance administered eligibility and the intake for all
assistance programs.
Ms. Efird continued to slide 13, which compared the FY 20
and FY 21 budgets:
SB93 Increase SDPR for SHARP II
Vice-Chair Ortiz asked Ms. Efird to elaborate on the
motivation for the governor's particular change.
Commissioner Crum responded that the program had
historically been under the Department of Education and
Early Development. In the last couple of years the Division
of Public Health had been assigned that program.
Vice-Chair Ortiz would have more questions at the
subcommittee meeting.
2:29:28 PM
Ms. Efird discussed the Senior Disabilities Services
Budget. She expressed disappointment in the budget, because
the department had asked for an increase in the increment
of federal funds for the Preschool Development Grant, which
was phase 2. she stated that the Senior Disabilities
Services put in the application of the portion of the
grant.
Vice-Chair Ortiz returned to the topic of the $7 million
the state would not be receiving. He asked if the grant had
been in existence but would no longer be available.
Ms. Efird explained that the grant was developed by the
federal government to address preschool development. She
explained that states were asked to apply, so the state
applied through the Department of Education and Early
Development (DEED). The stated received that portion of the
grant.
Vice-Chair Ortiz interjected a question. He wondered what
happened to that portion of the grant.
Commissioner Crum responded that the grant was identified
by the Alaska Early Development Coordinating Council. He
explained that the initial phase of the grant was for
strategy, and did a very good job with all the
stakeholders.
Ms. Efird added that only the states that received the
first piece were asked to request the second phase request.
Ms. Efird reviewed slide 14 showing the Senior Disabilities
Services:
? Children and Families Preschool Development Grant
(Grant was not awarded to division and authority will
be adjusted.) $7,000.0 Federal.
? Electronic Visit Verification System Maintenance and
Operation $412.5 Federal and $137.5 UGF.
2:34:38 PM
Vice-Chair Ortiz asked about slide 14, and wondered about
day rehab services within the Senior and Disability
Services.
Commissioner Crum replied in the affirmative.
Vice-Chair Ortiz noted concern about the adjustment to the
program over several years, particularly in rural
communities that did not have alternatives. He asked for
more information on that issue.
Commissioner Crum admitted it was an ongoing issue. He was
aware of a definition rewrite. There had been a significant
amount of input from the community. He suggested the
conversation was constant.
Vice-Chair Ortiz asked if it was safe to say over the last
several years there had been a significant reduction in
services.
Commissioner Crum could follow-up with more information.
Vice-Chair Ortiz would like to further address the area of
concern.
Ms. Efird continued to the last budgeted appropriation was
the Medicaid Services Appropriation. She reported an
increased request.
Representative Josephson commented in the prior March and
April he became knowledgeable enough to be dangerous. He
noted a hearing with Mr. Teal at which time he declared
that the governor could put any plan forward . He wondered
about the administration's reform, and asked Ms. Efird to
provide a sense of the administration's position.
Commissioner Crum indicated the question would get
addressed the following Medicaid presentation.
Co-Chair Johnston asked the commissioner to provide further
detail about the 4 additional staff positions as noted on
slide 15.
Commissioner Crum explained that he had asked for feedback
from division directors who all provided feedback that
Medicaid typically overshadowed the divisions. He noted a
new position included a tribal liaison.
Co-Chair Johnston noted the department was adding a deputy
commissioner position, and wondered what other positions
would be added.
Ms. Efird responded that department would be adding a
deputy commissioner, a special assistant, and two project
coordinators.
Representative Wool wondered whether the four positions
would require the two records of funding be a total of
$630,000.
Ms. Efird replied in the affirmative. She explained that it
was based on the public assistance cost allocation plan,
where there was a cost-out of the federal portion.
^MEDICAID BUDGET UPDATE
2:44:50 PM
RENEE GAYHART, HEALTH CARE SERVICES DIRECTOR, DEPARTMENT OF
HEALTH AND SOCIAL SERVICES, introduced herself.
2:45:39 PM
ADAM CRUM, COMMISSIONER, DEPARTMENT OF HEALTH AND SOCIAL
SERVICES, began the Medicaid budget overview with slide 20:
5 percent Provider Rate Reduction for Medicaid
services
Representative Josephson wondered whether the commissioner
was saying that the cuts from FY 20 was a restoration of
the cuts from FY 20.
Commissioner Crum responded replied that a portion of the
cuts had been restored from FY 20.
Representative Sullivan-Leonard referred back to slide 16
and asked if the supplemental funding was included in that
request. She also asked for explanation of the increase of
the $127 million for the difference between FY 20 and FY
21.
Commissioner Crum responded that the likely supplemental
request of the $120 million range would be read the
following day.
Co-Chair Foster thought the supplemental would be out in
the current day.
2:49:01 PM
Commissioner Crum explained that the system was shocked in
the year prior. He stated that there was an increment
request to bring stability to the system, so there was not
a large supplemental request. He explained that it was an
item was meant to move forward with a larger increment for
stability to the Medicaid program.
Representative Sullivan-Leonard clarified that $127 million
for the governor's increase, and there would be a separate
increase for the supplemental.
Ms. Efird responded that the FY 20 numbers did not include
a supplemental, but there would be a request coming out
soon.
Co-Chair Foster noted that the base would increase after
the supplemental was released.
Ms. Efird noted the supplemental amounts were not included.
2:51:46 PM
Co-Chair Johnston could see the confusion because in the
previous year there was a promise that there would not be a
supplemental. She also asked about a date for the
supplemental.
Ms. Efird responded that the department was working on the
numbers and the timing for additional funds.
Co-Chair Johnston stressed that there were some concerns
because private sector businesses had incurred costs.
Commissioner Crum continued to discuss slide 20. He
reported that the previous year had drastic measures and
cuts, and some were successful and some were not.
Commissioner Crum moved on to discuss the hospital
diagnostic related groups as seen on slide 21:
Hospital Diagnostic Related Groups (DRGs)
Commissioner Crum moved to slide 22 regarding the long-term
care rate reduction. The department could only provide a
rate reduction of 3 percent.
2:56:12 PM
Representative Josephson asked how the flat rate versus
actual cost rate affected providers.
Ms. Gayhart responded that no providers had disenrolled,
but many years had a flat rate.
Representative Josephson suggested the previous system was
generous.
Commissioner Crum agreed, and explained that the Medicare
program also paid for the service.
Representative Wool asked whether a flat rate would be more
in line with a fee per service.
Commissioner Crum replied that it was a flat rate basis.
Commissioner Crum spoke about the pharmacy adjustment
listed on slide 24. He mentioned that the department was
working closely with the Department of Corrections (DOC).
He indicated it was an internal alignment.
Co-Chair Johnston asked if there was an alignment with the
Department of Administration (DOA).
Commissioner Crum responded in the affirmative, and there
were discussions with the Division of Retirement and
Benefits; and discussions with the Division of Insurance.
He explained that Washington was able to receive a waiver
for the pharmaceutical purchasing, which allowed for some
larger purchasing and bulk power. He stressed that the
department was able to achieve a long list of items to
pursue.
Ms. Gayhart spoke to slide 25 dealing with the limited
physical therapy, occupational therapy, and speech therapy.
3:01:12 PM
Ms. Gayhart explained that the Expanded Care Management
Program was the attempt to be the "friendlier face of
Medicaid." She explained that there was a desire to assist
Medicaid recipients by being more thoughtful in their use
of services. She explained that the program tied the
recipient to one primary care provider and one pharmacy for
all of their needs. She stated that regulations took longer
than anticipated for the program, so they did not meet the
number of desired recipients.
Commissioner Crum moved to slide 27 having to do with
implementing a nurse hotline.
Commissioner Crum explained that the timely filling
allowance reduction, shown on slide 28, would not save
money.
Ms. Gayhart continued to slide 29 to discuss streamlining
costs of care collections. A savings would be seen in
FY 21.
Commissioner Crum moved to slide 30. He stated that it was
more affordable for the department to pay the premium to
keep a person on Medicaid, than it was for the department
to lose that person due to the high cost of the premium.
3:05:19 PM
Ms. Gayhart reported that the state was on target for a
savings of $20 million. She scrolled through slides 32-34
and noted that after FY 17 and FY 18 there was a $20
million savings. They were fairly aggressive targets.
Representative Josephson asked about tribal reclaiming. He
wondered if the issue was simply that formerly Alaska
Natives were having some of their services billed through
Medicaid at 50 to 60 percent, but were now billed at 100
percent and saving through the general fund.
Ms. Gayhart responded that they were prior period
adjustments. She explained that the claims were paid at
whatever percentage they would be paid. She stated that
currently a Native Alaskan who received services at a
tribal health organization would receive 100 percent. She
explained that if they received the service at a non-tribal
site, the payment would be a match of the eligibility of
that individual.
Commissioner Crum discussed transportation efficiencies on
slide 36. She reported that the dollars had been absorbed
in reclaiming efforts by tribal organizations.
3:10:45 PM
Co-Chair Johnston warned of the 'One-Liners." She thought
adjustments had been made to the transportation. She
thought the Tribal Health Organizations deserved kudos.
Commissioner Crum spoke of the electronic visit
verification program as noted on slide 37.
Commissioner Crum moved to slide 38 which discussed the
transitional services to 1915(k).
Commissioner Crum reviewed slide 39, to discuss the Adult
Preventative Dental costs.
Co-Chair Johnston had concerns about how the Adult
Preventative Dental program would roll out. She wondered
whether there would be a "bump" in the supplemental,
because of the removal of the program in the year prior.
Commissioner Crum responded in the affirmative.
Co-Chair Johnston asked if it cost the state more money.
Commissioner Crum replied in the affirmative.
Commissioner Crum turned to slide 40, which discussed
Transitional Behavioral Health Grants.
Commissioner Crum looked at slide 41, which discussed the
1115 Behavioral Health Waiver:
? Substance Misuse Disorder Treatment Component
? Approved in November 2018
? Became effective January 1, 2019
? Behavioral Health Component
Approved September 2019
? Will be implemented by June 30, 2020
? Administrative Services Organization
? Contracted with Optum Health in November 2019
? Goes live on February 1, 2020
Commissioner Crum continued to the bar chart on slide 42
showing Medicaid enrollment and spending in Alaska.
3:16:23 PM
Co-Chair Johnston asked if she was seeing that Alaska was
spending less for more people.
Commissioner Crum moved to slide 43 to answer Co-Chair
Johnston's question.
Co-Chair Johnston wondered whether there were projections
noting the formula change.
Commissioner Crum replied in the affirmative. He stressed
that the formula change provided a long-term forecast. He
stressed that the curve was bent slightly from the year
prior.
Co-Chair Johnston thought all members had received the MESA
Report.
Representative Josephson asked about the growth in the
green bar. He wondered if it represented the increasing
percent over 90 percent.
Commissioner Crum responded that it was the actual
expansion group.
Representative Josephson wondered about a cost to the
state.
Ms. Efird responded that she could provide the information
to the committee.
Representative Josephson asked for a dollar figure.
Ms. Efird replied that she would provide the exact numbers.
Representative Josephson asked the administration's
position on the amendments.
3:20:15 PM
Commissioner Crum responded that some of the items were put
forward due to regulation change.
Representative Wool referred to the chart on slide 43
regarding the Medicaid expansion numbers.
Commissioner Crum referred back to slide 42 that reflected
population and dollar amounts.
Representative Wool surmised that the two graphs were
tracking exactly proportionately. He stated that the
increase in the total Medicaid spending, including
expansion, was many times less than the federal total
dollars.
Commissioner Crum replied in the affirmative.
3:23:55 PM
Co-Chair Johnston wondered whether the department was aware
of the projected dates in which the state would run out of
Medicaid funding.
Commissioner Crum turned to the final slide which address
the 3-year vision of DHSS:
DHSS Mission To promote and protect the health and
well-being of Alaskans.
Health and Social Services
? Systems Alignment and Change
? Focus on IT Systems
? Emergency Readiness and Response
? Behavioral Health Continuum of Care
HB 205 was HEARD and HELD in committee for further
consideration.
HB 206 was HEARD and HELD in committee for further
consideration.
Co-Chair Foster reviewed the agenda for the following day.
ADJOURNMENT
3:32:59 PM
The meeting was adjourned at 3:32 p.m.
| Document Name | Date/Time | Subjects |
|---|---|---|
| Handout of DHSS Organizational Charts - Current and Proposed 2-1-20.pdf |
HFIN 2/3/2020 1:30:00 PM |
DHSS - HFIN |
| DHSS and Medicaid Overview HFIN 2-3-20.pdf |
HFIN 2/3/2020 1:30:00 PM |
|
| DHSS HFIN Response Rep Foster NYF Closure Savings.pdf |
HFIN 2/3/2020 1:30:00 PM |
|
| DHSS HFIN Response AKPH FY21 Decrement and Revenues.pdf |
HFIN 2/3/2020 1:30:00 PM |
|
| DPA Programs.pdf |
HFIN 2/3/2020 1:30:00 PM |
DHSS HFIN Response |
| LegLog 8102 HFIN DHSS Dept Overview 2-3-2020.pdf |
HFIN 2/3/2020 1:30:00 PM |
DHSS HFIN Response |