Legislature(2017 - 2018)HOUSE FINANCE 519

02/07/2018 01:30 PM FINANCE

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* first hearing in first committee of referral
+ teleconferenced
= bill was previously heard/scheduled
-- Delayed to a Call of the Chair --
+ HB 236 EXTEND SENIOR BENEFITS PAYMENT PROGRAM TELECONFERENCED
Moved CSHB 236(FIN) Out of Committee
-- Public Testimony --
+= HB 215 DHSS: PUBLIC HEALTH FEES TELECONFERENCED
Moved CSHB 215(FIN) Out of Committee
+ Bills Previously Heard/Scheduled TELECONFERENCED
                  HOUSE FINANCE COMMITTEE                                                                                       
                     February 7, 2018                                                                                           
                         2:05 p.m.                                                                                              
                                                                                                                                
2:05:58 PM                                                                                                                    
                                                                                                                                
CALL TO ORDER                                                                                                                 
                                                                                                                                
Co-Chair Foster  called the House Finance  Committee meeting                                                                    
to order at 2:05 p.m.                                                                                                           
                                                                                                                                
MEMBERS PRESENT                                                                                                               
                                                                                                                                
Representative Neal Foster, Co-Chair                                                                                            
Representative Paul Seaton, Co-Chair                                                                                            
Representative Les Gara, Vice-Chair                                                                                             
Representative Jason Grenn                                                                                                      
Representative David Guttenberg                                                                                                 
Representative Scott Kawasaki                                                                                                   
Representative Dan Ortiz                                                                                                        
Representative Steve Thompson                                                                                                   
Representative Cathy Tilton                                                                                                     
Representative Tammie Wilson                                                                                                    
                                                                                                                                
MEMBERS ABSENT                                                                                                                
                                                                                                                                
Representative Lance Pruitt                                                                                                     
                                                                                                                                
ALSO PRESENT                                                                                                                  
                                                                                                                                
Elizabeth Diament,  Staff, Representative Paul  Seaton; Jill                                                                    
Lewis,   Deputy  Director,   Division   of  Public   Health,                                                                    
Department  of Health  and  Social  Services; Jane  Pierson,                                                                    
Staff,  Representative  Neal  Foster;  Representative  Scott                                                                    
Kawasaki, Sponsor;  Mercedes Colbert,  Staff, Representative                                                                    
Scott Kawasaki; Denise  Daniello, Executive Director, Alaska                                                                    
Commission  on  Aging,  Department   of  Health  and  Social                                                                    
Services;  David  Blacketer,  Chair,  Alaska  Commission  on                                                                    
Aging,  Department  of  Health and  Social  Services;  Jayne                                                                    
Andreen, AARP, Juneau.                                                                                                          
                                                                                                                                
SUMMARY                                                                                                                       
                                                                                                                                
HB 215    DHSS: PUBLIC HEALTH FEES                                                                                              
                                                                                                                                
          CSHB 215(FIN) was REPORTED out of committee with                                                                      
          a "do pass" recommendation and with one new                                                                           
          fiscal impact note from the Department of Health                                                                      
          and Social Services.                                                                                                  
                                                                                                                                
HB 236    EXTEND SENIOR BENEFITS PAYMENT PROGRAM                                                                                
                                                                                                                                
          CSHB 236(FIN)  was REPORTED out of  committee with                                                                    
          a  "do  pass"  recommendation  and  with  one  new                                                                    
          fiscal impact  note from the Department  of Health                                                                    
          and Social Services.                                                                                                  
                                                                                                                                
Co-Chair Foster reviewed the meeting agenda.                                                                                    
                                                                                                                                
HOUSE BILL NO. 215                                                                                                            
                                                                                                                                
     "An Act relating to program receipts; and relating to                                                                      
     fees for services provided by the Department of Health                                                                     
     and Social Services."                                                                                                      
                                                                                                                                
2:07:02 PM                                                                                                                    
                                                                                                                                
Co-Chair Foster noted  that the bill had last  been heard on                                                                    
February 2, 2018.                                                                                                               
                                                                                                                                
ELIZABETH  DIAMENT, STAFF,  REPRESENTATIVE PAUL  SEATON, had                                                                    
no additional information to share with the committee.                                                                          
                                                                                                                                
Vice-Chair  Gara asked  why $600,000  in additional  revenue                                                                    
from the  fees only resulted  in a reduction of  $200,000 in                                                                    
undesignated general funds (UGF).                                                                                               
                                                                                                                                
JILL  LEWIS, DEPUTY  DIRECTOR,  DIVISION  OF PUBLIC  HEALTH,                                                                    
DEPARTMENT OF HEALTH AND SOCIAL  SERVICES, answered that the                                                                    
$200,000 reductions  to the general  fund (GF) was  based on                                                                    
the only  applicable program that  had existing  funding and                                                                    
was  used  to  craft  the   fiscal  note.  The  fiscal  note                                                                    
reflected that GF expenditures would be replaced by fees.                                                                       
                                                                                                                                
2:09:22 PM                                                                                                                    
                                                                                                                                
Representative   Kawasaki   noted  that   implementing   fee                                                                    
collection  was a  long  process. He  was  aware of  program                                                                    
receipt authority  placed in  the budget  and the  fees were                                                                    
never collected. He  asked for comments from  Ms. Lewis. Ms.                                                                    
Lewis  answered that  the issue  had been  addressed in  the                                                                    
fiscal note  by not  showing any  receipts collected  in the                                                                    
first year,  FY 2019. She  explained that in the  first year                                                                    
she expected  the division to  develop regulations  and hold                                                                    
meetings with  stakeholders. The  division hoped  to collect                                                                    
fees the following year. Representative  Kawasaki spoke to a                                                                    
provision related to waiving fees  in Section 2 of the bill.                                                                    
He  recounted  that  the  commissioner  can  waive  fees  if                                                                    
collection  was  deemed  not   feasible  or  in  the  public                                                                    
interest or if they  undermined the division's public health                                                                    
mission. He asked for more  detail about when in the process                                                                    
it was  determined a fee  undermined the mission.  Ms. Lewis                                                                    
replied that it  was a subjective analysis;  there were many                                                                    
things to weigh  in order to judge whether  something was in                                                                    
the  public's interest  or  would  undermine the  division's                                                                    
mission to  protect or promote  the health of  Alaskans. She                                                                    
explained that the  division would not pursue a  fee that it                                                                    
or stakeholders determined would  not achieve the division's                                                                    
goals. At some point a fee  could become a barrier to taking                                                                    
advantage  of services,  which would  negatively impact  the                                                                    
public's health.                                                                                                                
                                                                                                                                
2:12:00 PM                                                                                                                    
                                                                                                                                
Representative Guttenberg stated that  in a separate bill he                                                                    
was  working  on,  the administration  was  concerned  about                                                                    
raising fees  that would impact  state employees.  The state                                                                    
was anticipating  rising healthcare  costs. He asked  if the                                                                    
Department of  Administration (DOA) weighed in  on the issue                                                                    
regarding how the bill would  affect the cost of healthcare.                                                                    
Ms. Lewis  asked for clarification.  She wondered if  he was                                                                    
asking  that  by  filling  the   positions  there  would  be                                                                    
additional   healthcare  costs.   Representative  Guttenberg                                                                    
explained by  filling the position  and instituting  fees by                                                                    
the  department.  He asked  if  the  bill affected  employee                                                                    
healthcare  costs  in  anyway.  He  asked  whether  DOA  had                                                                    
expressed concerns.  Ms. Lewis replied in  the negative. She                                                                    
explained  that   the  positions  would  not   impact  state                                                                    
healthcare costs.                                                                                                               
                                                                                                                                
Representative Wilson asked for  verification the bill would                                                                    
charge patients. She asked whether  the charge was a sliding                                                                    
fee. Ms.  Lewis answered  that the department  currently had                                                                    
the  authority to  collect fees  for clinical  services like                                                                    
lab  fees, specialty  clinics, and  public  nurse fees.  She                                                                    
listed services  the department could  not charge  fees for;                                                                    
professional services,  consultations, technical assistance,                                                                    
specialized  data   analysis,  and   certain  administrative                                                                    
services.  The  costs  would generally  be  charged  to  the                                                                    
entity  that utilized  the services  but  not to  individual                                                                    
members of the public.                                                                                                          
                                                                                                                                
2:14:57 PM                                                                                                                    
                                                                                                                                
Vice-Chair Gara  thanked Ms. Lewis,  Ms. Diament  and others                                                                    
for their  work. He shared  that the previous year  the DHSS                                                                    
finance subcommittee recommended  the department charge fees                                                                    
for  certain  services  that were  not  thoroughly  "fleshed                                                                    
out." He appreciated the  department's and Co-Chair Seaton's                                                                    
follow up.                                                                                                                      
                                                                                                                                
Vice-Chair  Gara reviewed  the new  fiscal impact  note from                                                                    
the Department  of Health and  Social Services  allocated to                                                                    
Public  Health  Administrative  Services.  The  fiscal  note                                                                    
reflected a  $200,000 expected reduction  in UGF in  FY 2020                                                                    
and  anticipated  raising  $600,000  in revenue  for  a  net                                                                    
positive of $400,000.                                                                                                           
                                                                                                                                
Representative Wilson asked what  data was used to determine                                                                    
the  numbers. Ms.  Lewis admitted  that a  certain level  of                                                                    
uncertainty existed  because the  proposed type of  fees had                                                                    
never  been   collected  before.   She  analyzed   each  fee                                                                    
individually  to  determine the  volume  and  guessed at  an                                                                    
amount for a  reasonable fee. The fee could be  no more than                                                                    
cost. The division had made  the best attempt at identifying                                                                    
what was necessary to support  the program and an amount for                                                                    
a fee that was possible to collect.                                                                                             
                                                                                                                                
2:17:34 PM                                                                                                                    
                                                                                                                                
Co-Chair  Seaton  MOVED  to  REPORT  CSHB  215(FIN)  out  of                                                                    
committee   with   individual    recommendations   and   the                                                                    
accompanying fiscal  note. There being NO  OBJECTION, it was                                                                    
so ordered.                                                                                                                     
                                                                                                                                
CSHB  215(FIN) was  REPORTED  out of  committee  with a  "do                                                                    
pass"  recommendation and  with one  new fiscal  impact note                                                                    
from the Department of Health and Social Services.                                                                              
                                                                                                                                
2:18:14 PM                                                                                                                    
AT EASE                                                                                                                         
                                                                                                                                
2:22:39 PM                                                                                                                    
RECONVENED                                                                                                                      
                                                                                                                                
                                                                                                                                
HOUSE BILL NO. 236                                                                                                            
                                                                                                                                
     "An Act  extending the  Alaska senior  benefits payment                                                                    
     program."                                                                                                                  
                                                                                                                                
2:22:55 PM                                                                                                                    
                                                                                                                                
Co-Chair  Seaton  MOVED  to  ADOPT  the  proposed  committee                                                                    
substitute  for  HB  236, Work  Draft  30-LS0754\D  (Glover,                                                                    
2/2/18).                                                                                                                        
                                                                                                                                
Co-Chair Foster OBJECTED for discussion.                                                                                        
                                                                                                                                
JANE PIERSON,  STAFF, REPRESENTATIVE NEAL  FOSTER, explained                                                                    
the  changes in  the  Work Draft.  The  change extended  the                                                                    
program  from  four years  to  six  years at  the  sponsor's                                                                    
request.                                                                                                                        
                                                                                                                                
Co-Chair  Foster  WITHDREW  his OBJECTION.  There  being  NO                                                                    
further OBJECTION, it was so ordered.                                                                                           
                                                                                                                                
2:24:21 PM                                                                                                                    
AT EASE                                                                                                                         
                                                                                                                                
2:24:47 PM                                                                                                                    
RECONVENED                                                                                                                      
                                                                                                                                
REPRESENTATIVE SCOTT  KAWASAKI, SPONSOR,  briefly introduced                                                                    
the  legislation. He  shared that  the bill  was simple  and                                                                    
kept "grandparents  in the state"  by enabling  some seniors                                                                    
to  continue to  live in  Alaska. He  read from  the sponsor                                                                    
statement:                                                                                                                      
                                                                                                                                
     House  Bill  236  would   extend  the  Senior  Benefits                                                                    
     Program  to  2022,  ensuring   another  four  years  of                                                                    
     support for  low income seniors across  Alaska. Without                                                                    
     action, the program would end in 2018.                                                                                     
                                                                                                                                
     The   Senior  Benefits   Program  protects   low-income                                                                    
     seniors by  providing them with modest  cash assistance                                                                    
     to pay  for expenses  like food,  heating, electricity,                                                                    
     transportation and prescription medication.                                                                                
                                                                                                                                
     The  program  was  established in  2007  and  currently                                                                    
     provides assistance  to nearly 11,500 Alaskans  ages 65                                                                    
     and older with incomes at  75 percent, 100 percent, and                                                                    
     175 percent  of the  federal poverty  level. Assistance                                                                    
     ranges from $76  to $250 a month  for eligible seniors,                                                                    
     depending on  income and the size  of the appropriation                                                                    
     from the Alaska State  Legislature. The Senior Benefits                                                                    
     Program is  a successor to the  Longevity Bonus created                                                                    
     in 1972.                                                                                                                   
                                                                                                                                
     This  program   protects  seniors  who  have   spent  a                                                                    
     lifetime building this  state. It lends a  hand to low-                                                                    
     income seniors  who need assistance  to help  make ends                                                                    
     meet. Terminating  this program would put  thousands of                                                                    
     seniors  at  risk for  losing  means  to buy  essential                                                                    
     items  necessary for  maintaining a  healthy lifestyle,                                                                    
     such  as  groceries, medication,  transportation,  rent                                                                    
     and utilities.                                                                                                             
                                                                                                                                
2:28:31 PM                                                                                                                    
                                                                                                                                
Representative  Kawasaki elaborated  that the  bill received                                                                    
extensive vetting  and was placed  in a subcommittee  in the                                                                    
House Health  and Social Services  Committee. He  listed the                                                                    
members  of  the  subcommittee; Representative  Fansler  and                                                                    
Representative Sullivan-Leonard.  He relayed that he  held a                                                                    
statewide  listening session  in September  2017 to  gain as                                                                    
much public input as possible on the bill.                                                                                      
                                                                                                                                
MERCEDES  COLBERT,  STAFF,  REPRESENTATIVE  SCOTT  KAWASAKI,                                                                    
offered to review program requirements.                                                                                         
                                                                                                                                
Co-Chair Foster  requested that the invited  testifier share                                                                    
her testimony.                                                                                                                  
                                                                                                                                
DENISE  DANIELLO, EXECUTIVE  DIRECTOR, ALASKA  COMMISSION ON                                                                    
AGING, DEPARTMENT  OF HEALTH  AND SOCIAL  SERVICES, provided                                                                    
information  about the  commission. She  explained that  the                                                                    
commission  existed  within  the Department  of  Health  and                                                                    
Social  Services  (DHSS) and  worked  to  plan services  for                                                                    
seniors,  educate  Alaskans  regarding  senior  issues,  and                                                                    
provided recommendations  regarding budget and  policy items                                                                    
that  affected   senior  citizens.  She  relayed   that  the                                                                    
commission strongly supported the  bill and extension of the                                                                    
Senior  Benefits Program,  which benefitted  the quality  of                                                                    
life  for  over  11,000 seniors.  She  identified  financial                                                                    
security  as  a  pressing  issue  confronting  seniors.  She                                                                    
shared that  over the  years the  program's growth  had been                                                                    
modest.    The   state's    senior   population    increased                                                                    
approximately  4   percent  annually  and   120,908  seniors                                                                    
resided  in  the  state.  The  program  increased  only  1.7                                                                    
percent  statewide. She  elaborated that  the Commission  on                                                                    
Aging  held  a joint  senior  advocacy  meeting recently  in                                                                    
Juneau  with H  NET, The  Pioneer Home  Advisory Board,  and                                                                    
AARP  Alaska.  She  related  that all  were  in  support  of                                                                    
passage of  the bill. She  characterized the bill as  a hand                                                                    
up to seniors, not a handout.                                                                                                   
                                                                                                                                
2:32:03 PM                                                                                                                    
                                                                                                                                
DAVID   BLACKETER,  CHAIR,   ALASKA  COMMISSION   ON  AGING,                                                                    
DEPARTMENT OF  HEALTH AND SOCIAL SERVICES,  spoke in support                                                                    
of the  legislation. He appreciated  the program  and shared                                                                    
that he  benefitted from the  program. He conveyed  that his                                                                    
only other income was from  social security. He outlined the                                                                    
various timing of income received  during the month and when                                                                    
his bills  were due.  He and  his wife  received a  total of                                                                    
$152  from the  program, which  helped him  pay his  rent on                                                                    
time.  He noted  that if  he did  not pay  the rent  on time                                                                    
there was a penalty. He  noted that around 1,200 people were                                                                    
receiving senior benefits from the program in Alaska.                                                                           
                                                                                                                                
2:34:26 PM                                                                                                                    
                                                                                                                                
JAYNE  ANDREEN,  AARP,  JUNEAU,  spoke  in  support  of  the                                                                    
legislation. She  shared that AARP  had over  95,000 members                                                                    
in Alaska.  She shared a  personal story about  visiting her                                                                    
elderly  parents and  discussing  with them  how they  could                                                                    
remain  in their  home and  sustain a  quality of  life. She                                                                    
elucidated that  one group who  would most benefit  from the                                                                    
program  was older  women. She  communicated that  women had                                                                    
lower earning power  and outlived men. As  the husband faced                                                                    
declining health,  resources were  used on him  leaving less                                                                    
for  the woman  when she  is widowed.  The organization  was                                                                    
also concerned about low income  Alaskans who had worked all                                                                    
their lives  at low paying jobs  and were not able  to build                                                                    
retirement  income. In  addition, rural  Alaskans, living  a                                                                    
subsistence  lifestyle benefitted  from  senior benefits  as                                                                    
well  as  the oldest  living  individuals;  people in  their                                                                    
80's,  90's, and  100  or older.  She  shared another  story                                                                    
about a family member who was  able to live at home until he                                                                    
was 99 years  of age, but his resources  had been completely                                                                    
used up.  She concluded that the  classifications of seniors                                                                    
she listed benefitted  the most from senior  benefits due to                                                                    
increasing health  costs and needs for  services without the                                                                    
increasing income to meet the needs.                                                                                            
                                                                                                                                
2:37:34 PM                                                                                                                    
                                                                                                                                
Co-Chair Foster CLOSED public testimony.                                                                                        
                                                                                                                                
Representative Wilson was supportive of moving the bill.                                                                        
                                                                                                                                
Co-Chair  Foster believed  the  bill  had strong  bipartisan                                                                    
support.                                                                                                                        
                                                                                                                                
Representative  Grenn  had  a  comment  about  amending  the                                                                    
fiscal note to reflect the extension to six years.                                                                              
                                                                                                                                
2:38:54 PM                                                                                                                    
AT EASE                                                                                                                         
                                                                                                                                
2:39:54 PM                                                                                                                    
RECONVENED                                                                                                                      
                                                                                                                                
Vice-Chair  Gara addressed  the previously  published fiscal                                                                    
impact  note  from  the  Department  of  Health  and  Social                                                                    
Services  (FN  1 (DHS))  allocated  to  the Senior  Benefits                                                                    
Payment  Program.   He  shared   that  the  note   showed  a                                                                    
consistent program  cost of $19,986,100 through  FY 2024. He                                                                    
reported that an  amended fiscal note to  extend the program                                                                    
to 2024 was forthcoming.                                                                                                        
                                                                                                                                
Co-Chair  Seaton  MOVED  to  REPORT  CSHB  236(FIN)  out  of                                                                    
committee   with   individual    recommendations   and   the                                                                    
accompanying fiscal note.                                                                                                       
                                                                                                                                
CSHB  236(FIN) was  REPORTED  out of  committee  with a  "do                                                                    
pass"  recommendation and  with one  new fiscal  impact note                                                                    
from the Department of Health and Social Services.                                                                              
                                                                                                                                
Co-Chair  Foster reviewed  the  schedule  for the  following                                                                    
day.                                                                                                                            
                                                                                                                                
ADJOURNMENT                                                                                                                   
                                                                                                                                
2:42:23 PM                                                                                                                    
                                                                                                                                
The meeting was adjourned at 2:42 p.m.