Legislature(2009 - 2010)HOUSE FINANCE 519
03/11/2009 01:30 PM House FINANCE
| Audio | Topic |
|---|---|
| Start | |
| HB116 | |
| HB26 | |
| Adjourn |
* first hearing in first committee of referral
+ teleconferenced
= bill was previously heard/scheduled
+ teleconferenced
= bill was previously heard/scheduled
| + | HB 116 | TELECONFERENCED | |
| + | HB 26 | TELECONFERENCED | |
| + | TELECONFERENCED |
HOUSE FINANCE COMMITTEE
March 11, 2009
1:35 p.m.
1:35:02 PM
CALL TO ORDER
Co-Chair Stoltze called the House Finance Committee meeting
to order at 1:35 p.m.
MEMBERS PRESENT
Representative Mike Hawker, Co-Chair
Representative Bill Stoltze, Co-Chair
Representative Bill Thomas, Jr., Vice-Chair
Representative Allan Austerman
Representative Harry Crawford
Representative Anna Fairclough
Representative Richard Foster
Representative Les Gara
Representative Reggie Joule
Representative Mike Kelly
Representative Woodie Salmon
MEMBERS ABSENT
None
ALSO PRESENT
James Ellis, Staff, Representative Mark Neuman; Co-Chair
Mike Hawker, Sponsor; Jon Sherwood, Director, Office of
Program Review, Department of Health and Social Services;
Brad Whistler, Division of Public Health, Department of
Health and Social Services; Jeff Jessee, Chief Executive
Officer, Alaska Mental Health Trust Authority; Severvine
Basham, Alaska Primary Care Association; Marie Darlin, AARP
PRESENT VIA TELECONFERENCE
Whitney Brewster, Director, Division of Motor Vehicles,
Department of Administration
SUMMARY
HB 116 "An Act relating to Iditarod finisher special
request license plates."
HB 116 was heard and HELD in Committee for further
consideration.
HB 26 "An Act repealing the repeal of preventative and
restorative adult dental services reimbursement
under Medicaid; providing for an effective date by
repealing the effective date of sec. 3, ch. 52,
SLA 2006; and providing for an effective date."
HB 26 was REPORTED out of Committee with a "do
pass" recommendation and with fiscal note #1 by
the Department of Health and Social Services.
1:35:27 PM
HOUSE BILL NO. 116
"An Act relating to Iditarod finisher special request
license plates."
JAMES ELLIS, STAFF, REPRESENTATIVE MARK NEUMAN, explained
that the bill authorizes the Department of Motor Vehicles
(DMV) to design and issue commemorative license plates to
honor the accomplishments of those who have completed the
Iditarod Sled Dog Race. It costs $50 per plate. The
process is that DMV will verify with the Iditarod Race
Committee that an individual has completed the race. There
is a zero fiscal note. All vehicles displaying the plates
must be registered in Alaska. Over 600 have completed the
race and some are currently completing it.
1:37:49 PM
Representative Fairclough asked if past Iditarod
participants would qualify for the special plates if they
are currently residing in Alaska and have a motor vehicle
registered in Alaska. Mr. Ellis said that was correct. He
said a person who resides outside of Alaska, but who
registers an Alaskan vehicle would also be eligible.
Representative Fairclough asked if the Iditarod Committee
would provide a list of qualified applicants to DMV. Mr.
Ellis did not know.
1:39:04 PM
WHITNEY BREWSTER, DIRECTOR, DIVISION OF MOTOR VEHICLES,
DEPARTMENT OF ADMINISTRATION, described how the process
would work. The bill indicates that the finisher would
provide DMV with written proof verified by the Iditarod
Trail Committee as to their eligibility.
Co-Chair Stoltze imagined that it would be a self-policing
situation. Communities would recognize an imposter. Mr.
Ellis agreed.
1:40:15 PM
Representative Austerman asked if only Alaskan-registered
vehicles would qualify. Mr. Ellis said that was correct.
Representative Fairclough shared her experience searching
the Iditarod website for data to determine who would
qualify. She suggested a standardized form to identify
qualifiers.
Co-Chair Stoltze commented that the Committee would be
hearing the bill one more time.
Representative Joule asked if a handout in members' packets
was a sample of the license plate. Mr. Ellis remarked that
it was only a proposal. Representative Joule wondered if
the dog depicted was an actual Iditarod finisher. Mr. Ellis
said it was.
HB 116 was heard and HELD in Committee for further
consideration.
1:43:19 PM
HOUSE BILL NO. 26
"An Act repealing the repeal of preventative and
restorative adult dental services reimbursement under
Medicaid; providing for an effective date by repealing
the effective date of sec. 3, ch. 52, SLA 2006; and
providing for an effective date."
CO-CHAIR MIKE HAWKER, SPONSOR, explained the purpose of HB
26. He described the bill as continuing the authorization
established in 2006 for the Adult Dental program. The bill
is an Act repealing the repeal of preventative and
restorative adult dental services reimbursed under Medicaid.
It would create open-ended authority for the Department of
Health and Social Services to continue to provide
preventative adult dental services.
Co-Chair Hawker related how the program existed prior to
2006. At that time, adults on Medicaid could only receive
emergency care to relieve pain and fight infection. Due to
budget constraints, there were concerns that expanding
Medicaid services would lead to overspending. Limitations
were set as to how much could be spent on one patient
annually. It would have taken two years to obtain a set of
dentures under those limitations. In order to control
costs, the amount was kept in a separate allocation in the
budget so money could not be moved in or out. It was
estimated to cost about $10 million a year. In reality, it
turned out to be around $6 to $7 million per year.
Co-Chair Hawker pointed out in the fiscal note that there is
very moderate growth going forward. He saw it as a
component of Medicaid in which spending has been brought
under control.
Co-Chair Hawker noted that passing HB 26 would remove the
sunset provision and make the Adult Dental program a
permanent part of the state Medicaid program.
1:48:29 PM
Vice-Chair Thomas inquired if there is a residency
requirement. Co-Chair Hawker observed that the requirements
are those of the Medicaid program. He thought that
residency was a requirement.
Representative Kelly asked if the Mental Health Trust was
still involved. Co-Chair Hawker replied that the agreement
with the Mental Health Trust was that they would support the
program through its pilot phase and, if it became
successful, it would become part of the Medicaid program.
Representative Kelly asked how success was defined. Co-
Chair Hawker replied that success was determined by if the
program was operated within the intended parameters. Two
hundred providers have been developed, providing service to
about 6,000 patients annually. Dental prevention has proven
to be much more successful than the previous barbaric
standard.
Representative Kelly asked if federal funds are
undiminished. Co-Chair Hawker explained that the FMAP
percentage rate is in play. The program will include FMAP
no matter if the rate is up or down.
1:51:03 PM
Representative Gara asked what the income limitations are in
order to qualify for Medicaid services. Co-Chair Hawker
deferred to the Department of Health and Social Services to
answer.
Representative Gara inquired about the relationship between
Medicaid coverage and Denali KidCare. Co-Chair Hawker
deferred to the Department of Health and Social Services.
1:52:37 PM
JON SHERWOOD, DIRECTOR, OFFICE OF PROGRAM REVIEW, DEPARTMENT
OF HEALTH AND SOCIAL SERVICES, spoke in support of extending
the Medicaid Adult Dental program, which has been very
successful. There is also an Administrative proposal to
extend the program another five years in order to better
prove cost savings claims. He spoke in support of the
program.
Mr. Sherwood observed that there is a residency requirement
to qualify for Medicaid. He discussed the income
requirements to qualify for this program. These services
apply to adults. The income limits for the disabled and the
aged are approximately about 110 percent of the federal
poverty level. For parents of dependant children in low
income families, the income limit is closer to 75 percent of
the federal poverty level. Comprehensive dental coverage is
already included the Medicaid program for children so the
Denali KidCare population would not be directly affected.
Co-Chair Stoltze asked about the developmentally disabled
community as it relates to the program. Co-Chair Hawker
replied that the disabled community, such as ARC of
Anchorage and the Key Coalition, benefits from the program.
Co-Chair Stoltze pointed out that Hope Community Resources
recognized Co-Chair Hawker as Legislator of the Year.
1:56:42 PM
BRAD WHISTLER, DIVISION OF PUBLIC HEALTH, DEPARTMENT OF
HEALTH AND SOCIAL SERVICES, described the programs provided
by the program: preventive and routine dental exams, routine
restorative, root canal therapy, and denture services. He
maintained that good oral health is a quality-of-life issue.
He provided examples. He spoke of how dental problems
relate to job opportunities and food choices. He shared the
advantages of preventative care. He described the
relationship between good dental care and disease
prevention. He shared information about children's oral
health.
1:59:42 PM
Co-Chair Stoltze wondered how the issue of missed dental
visits resulting in lost fees could be addressed. Mr.
Whistler shared that the Department's positions is that a
missed appointment is not a Medicaid service. Dentists may
charge for missed appointments. He added that the
Department tries to educate patients in the importance of
keeping appointments. He suggested a potential fix for the
problem by tracking missed appointments in order to identify
the extent of the problem.
2:01:36 PM
JEFF JESSEE, CHIEF EXECUTIVE OFFICER, ALASKA MENTAL HEALTH
TRUST AUTHORITY, spoke in support of the bill. He spoke of
the successes of the program and the attempt to reduce the
legislature's risk by implementing cost containment and
efficiency into the programs. He thought that the
Department had done an excellent job with the program.
Mr. Jessee responded to a question by Representative Kelly.
Although the Mental Health Trust is no longer a financial
partner, the mini-grant program continues to spend
considerable money to supplement Medicaid dental services.
Co-Chair Stoltze commented that the Mental Health Trust's
involvement was clearly defined as a short-term commitment.
2:03:27 PM
SEVERVINE BASHAM, ALASKA PRIMARY CARE ASSOCIATION, testified
in favor of HB 26. She reported that there are currently 26
community health centers and 141 sites serving about 80,000
persons. Primary care includes behavioral health, basic
medical, and basic dental. Early intervention and
prevention are the keys to good dental health. She spoke of
the importance of the bill.
Representative Gara asked what would not be covered if the
bill does not pass. Ms. Basham thought that preventive
medicine was covered by the bill.
2:05:23 PM
MARIE DARLIN, AARP, spoke in favor of HB 26. She referred
to a letter included in the members' packets. She
paraphrased from the letter. Dental care is essential to
quality health care. Funding for dental care should be
considered sensible prevention with the long term
possibility of saving Medicaid funds. Of the 7,600 adults
who benefited from this program, about 1,800 are older
Alaskans, including 900 who received dentures. The average
cost of care provided to a senior Alaskan was $855.
Ms. Darlin voiced a concern about the annual cap of $1,150.
The fee for an upper or lower set of dentures is now between
$1,700 and $1,800, and some of the Medicaid beneficiaries
have more significant oral health problems that may go
considerably beyond the cap. She suggested raising the cap.
2:08:27 PM
Co-Chair Hawker pointed out that the fiscal note from
2/20/09 contains anticipated steady growth. The amount for
FY10 is already in the budget and is for about $6 million.
He maintained that the expense was reasonable. He
acknowledged the federal match, noting that there would be
FMAP rate changes.
Representative Gara noted that the state match is about $2.5
million a year. He suggested that there are many needs of
equal import to be funded.
2:10:56 PM
Representative Austerman MOVED to REPORT HB 26 out of
committee with individual recommendations and the
accompanying fiscal note.
HB 26 was REPORTED out of Committee with a "do pass"
recommendation and with fiscal note #1 by the Department of
Health and Social Services.
ADJOURNMENT
The meeting was adjourned at 2:12 PM.
| Document Name | Date/Time | Subjects |
|---|---|---|
| 02 HB116 Sponsor Statement.pdf |
HFIN 3/11/2009 1:30:00 PM |
HB 116 |
| 03 HB116 Sectional.pdf |
HFIN 3/11/2009 1:30:00 PM |
HB 116 |
| HB026 Background Materials.pdf |
HFIN 3/11/2009 1:30:00 PM |
HB 26 |
| HB026 Sectional Analysis.pdf |
HFIN 3/11/2009 1:30:00 PM |
HB 26 |
| HB026 Sponsor Statement.pdf |
HFIN 3/11/2009 1:30:00 PM |
HB 26 |
| HB026 Testimony.pdf |
HFIN 3/11/2009 1:30:00 PM |
HB 26 |
| Testimony HB81.pdf |
HFIN 3/11/2009 1:30:00 PM |
HB 81 |