Legislature(1999 - 2000)
02/01/2000 03:44 PM House HES
| Audio | Topic |
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* first hearing in first committee of referral
+ teleconferenced
= bill was previously heard/scheduled
+ teleconferenced
= bill was previously heard/scheduled
HOUSE HEALTH, EDUCATION AND SOCIAL
SERVICES STANDING COMMITTEE
February 1, 2000
3:44 p.m.
MEMBERS PRESENT
Representative Fred Dyson, Chairman
Representative Jim Whitaker
Representative Joe Green
Representative Tom Brice
Representative Allen Kemplen
Representative John Coghill
MEMBERS ABSENT
Representative Carl Morgan
OTHER HOUSE MEMBERS PRESENT
Representative Lisa Murkowski
Representative Pete Kott
COMMITTEE CALENDAR
HOUSE BILL NO. 268
"An Act relating to the Alaska Higher Education Savings Trust;
and providing for an effective date."
- MOVED CSHB 268(HES) OUT OF COMMITTEE
HOUSE BILL NO. 288
"An Act relating to the creation of an aggravating factor for the
commission of domestic violence in the physical presence of a
child."
- MOVED HB 288 OUT OF COMMITTEE
HOUSE BILL NO. 258
"An Act relating to assisted living homes; and providing for an
effective date."
- MOVED CSHB 258(HES) OUT OF COMMITTEE
PREVIOUS ACTION
BILL: HB 268
SHORT TITLE: COLLEGE TUITION SAVINGS PLAN
Jrn-Date Jrn-Page Action
1/10/00 1889 (H) PREFILE RELEASED 12/30/99
1/10/00 1889 (H) READ THE FIRST TIME - REFERRALS
1/10/00 1889 (H) HES, FIN
1/10/00 1889 (H) REFERRED TO HES
1/27/00 (H) HES AT 3:00 PM CAPITOL 106
1/27/00 (H) Heard & Held
1/27/00 (H) MINUTE(HES)
1/28/00 2035 (H) COSPONSOR(S): KEMPLEN, MORGAN, DYSON
2/01/00 (H) HES AT 3:00 PM CAPITOL 106
BILL: HB 288
SHORT TITLE: CHILDREN WITNESSING DOMESTIC VIOLENCE
Jrn-Date Jrn-Page Action
1/14/00 1923 (H) READ THE FIRST TIME - REFERRALS
1/14/00 1923 (H) HES, JUD
1/14/00 1923 (H) REFERRED TO HES
2/01/00 (H) HES AT 3:00 PM CAPITOL 106
BILL: HB 258
SHORT TITLE: ASSISTED LIVING HOMES
Jrn-Date Jrn-Page Action
1/10/00 1887 (H) PREFILE RELEASED 12/30/99
1/10/00 1887 (H) READ THE FIRST TIME - REFERRALS
1/10/00 1887 (H) HES, FIN
1/10/00 1887 (H) REFERRED TO HES
2/01/00 (H) HES AT 3:00 PM CAPITOL 106
WITNESS REGISTER
CASEY SULLIVAN, Legislative Administrative Assistant
to Representative Lisa Murkowski
Alaska State Legislature
Capitol Building, Room 406
Juneau, Alaska 99801
POSITION STATEMENT: Presented amendment for CSHB 268.
DENISE HENDERSON, Legislative Secretary
for Representative Pete Kott
Alaska State Legislature
Capitol Building, Room 118
Juneau, Alaska 99801
POSITION STATEMENT: Presented sponsor statement for HB 288.
ANNE CARPENETI, Assistant Attorney General
Legal Services Section-Juneau
Criminal Division
Department of Law
P.O. Box 110300
Juneau, Alaska 99811
POSITION STATEMENT: Answered legal questions on HB 288.
MR. GEORGE HANSEN, Dentist
Alaska Dental Society
4860 Folker Street
Anchorage, Alaska 99507
POSITION STATEMENT: Testified in support of HB 288.
MONTA FAYE LANE, President
Alaska Caregivers Association
Owner, Assisted Living Home
109 East Fifth Avenue
North Pole, Alaska 99705
POSITION STATEMENT: Testified in support of HB 258.
LESLEE OREBAUGH, Owner
Parkside and Rosewood Assisted Living Homes
Executive Secretary
Alaska Caregivers Association
309 East 24th Avenue
Anchorage, Alaska 99503
POSITION STATEMENT: Testified in support of HB 258.
ALISON ELGEE, Deputy Commissioner
Department of Administration
P.O. Box 110200
Juneau, Alaska 99811
POSITION STATEMENT: Testified in support of HB 258.
ELMER LINDSTROM, Special Assistant
Office of the Commissioner
Department of Health & Social Services
P.O. Box 110601
Juneau, Alaska 99811
POSITION STATEMENT: Testified in support of HB 258.
JANE DEMMERT, Executive Director
Alaska Commission on Aging
Division of Senior Services
Department of Administration
P.O. Box 110209
Juneau, Alaska 99811
POSITION STATEMENT: Testified in support of HB 258.
ACTION NARRATIVE
TAPE 00-7, SIDE A
Number 0001
[The minutes for the State Independent Living Council are found
in the 3:00 p.m. cover sheet for the same date.]
CHAIRMAN FRED DYSON reconvened the House Health, Education and
Social Services Standing Committee meeting at 3:44 p.m. Members
present were Representatives Dyson, Whitaker, Green, Brice,
Kemplen and Coghill.
HB 268 - COLLEGE TUITION SAVINGS PLAN
Number 0051
CHAIRMAN DYSON announced the next order of business as House Bill
No. 268, "An Act relating to the Alaska Higher Education Savings
Trust; and providing for an effective date." [Before the
committee was version 1-LS1235\H, Ford, 1/24/00, which was
adopted as a work draft on 1/27/00.]
Number 0075
CASEY SULLIVAN, Legislative Administrative Assistant to
Representative Lisa Murkowski, Alaska State Legislature, came
forward to present an amendment.
REPRESENTATIVE COGHILL made a motion to adopt Amendment 1, 1-
LS1235\H.1, Ford, 1/31/00, which read:
Page 4, line 16:
Delete "An"
Insert "Except as provided under AS 34.40.110, an"
CHAIRMAN DYSON asked whether there was any objection. There
being none, Amendment 1 was adopted.
Number 0240
REPRESENTATIVE COGHILL made a motion that CSHB 268, version 1-
LS1235\H, Ford, 1/24/00, as amended, move out of committee with
individual recommendations. There being no objection, CSHB
268(HES) moved from the House Health, Education and Social
Services Standing Committee.
HB 288 - CHILDREN WITNESSING DOMESTIC VIOLENCE
CHAIRMAN DYSON announced the next order of business as House Bill
No. 288, "An Act relating to the creation of an aggravating
factor for the commission of domestic violence in the physical
presence of a child."
Number 0295
DENISE HENDERSON, Legislative Secretary for Representative Pete
Kott, Alaska State Legislature, came forward to testify. She
explained this bill would add a new section to Statute
12.33.144(c)(18). At the present time, committing domestic
violence in the presence of a child is not included as a
determining factor in the sentencing of the perpetrator.
Currently there is nothing in the Alaska Statutes that would
allow judges to factor the egregiousness of the crime into the
sentencing. This should be an aggravating factor in determining
sentence for the crime of domestic violence. This bill would
expand the list to include the special vulnerability to children.
It would become a major factor in determining the severity of the
crime and the resulting sentence thereof. House Bill 288 would
allow the courts to consider these factors to mitigate or
aggravate the severity of domestic violence when committed in the
presence of children. It is Representative Kott's belief and her
own that this is valid criteria for the court in rendering
sentence.
MS. HENDERSON went on to say the public policy that the committee
is being asked to consider today is that the commission of the
crime of domestic violence be included on this list of factors.
She shares an interest in the welfare of children. She has seen
the devastating and long-term effects that domestic violence can
have on the children. She worked for the Juvenile Division of
the District Attorney's Office in Albuquerque, New Mexico and
unfortunately the one underlying factor that seemed to play a
role in the lives of the kids that came through the system was
domestic violence. Since moving to Anchorage, she had the
opportunity to work with Abused Women's Aid in Crisis where she
witnessed once again the devastation that domestic violence can
play on children. She is also a Court Appointed Special Advocate
(CASA) with the Office of Public Advocacy in Anchorage. This
bill would give the court system a new tool to further the fight
against domestic violence and child abuse. This bill would not
only bring awareness to the trauma that children bear in
witnessing domestic violence in the home, but it would be
instrumental in breaking the cycle of domestic violence.
REPRESENTATIVE GREEN asked if what the children are witnessing
would be a felony if charged under AS 11.41.
Number 0587
ANNE CARPENETI, Assistant Attorney General, Legal Services
Section-Juneau, Criminal Division, Department of Law, came
forward to answer questions. She explained that AS 11.41
addresses person crimes. The fact that this is an aggravating
factor means it gives the court the discretion to raise the
sentence in a particular case. It only applies to felonies to
which presumptive sentencing applies, which isn't even all
felonies.
REPRESENTATIVE COGHILL asked if there is some significance to the
age 16 and not age 18.
Number 0629
MS. CARPENETI answered that age 16 is the age of consent. Many
statutes dealing with children draw a line at the age of 16. The
statutes address different ages for different statutory purposes.
REPRESENTATIVE COGHILL asked if this proposed statute would apply
if children who are 17 or 18 years old witness domestic violence.
MS. CARPENETI answered the way it is written now would only apply
to domestic violence in front of a child under 16.
REPRESENTATIVE COGHILL asked if this could be used to put a block
between parents if a youngster witnessed something and gets
caught between two parents in an argument. The charge of felony
is there but he wondered if the youngster could find himself in a
very hard position of tipping this into a definite felony
conviction.
MS. CARPENETI answered that wouldn't happen because this only
applies to felony offenses to which presumptive sentencing
applies. It is an aggravating factor for sentencing after a
person has been convicted of a crime.
Number 0743
MR. GEORGE HANSEN, Dentist, Alaska Dental Society, testified via
teleconference from Anchorage in favor of HB 288. The organized
dentists in Alaska are interested in this bill because they are
often called upon to treat the injuries to the face and/or mouth
which have been caused by physical abuse. For this reason the
American Dental Association (ADA) has a policy and commitment to
recognize and prevent domestic abuse. It has been postulated
that children witnessing abuse are prone to commit that same
abuse when they are adults. It is desirable that the cycle be
stopped. This bill is intended to assist only in the sentencing
phase following a conviction for domestic abuse by adding to the
list of aggravating factors. He knows of no opposition to this
bill. He referred to the age issue and mentioned he has read
material which says by the time a child is ten or twelve, his/her
adult habits and thoughts are reasonably formed. He would not
encourage lowering the age but would not oppose it if the age
were raised to 18.
CHAIRMAN DYSON told Mr. Hansen that he was impressed that the
dentists' organization takes a stand on this issue.
The committee took an at-ease from 3:55 p.m. to 3:56 p.m.
REPRESENTATIVE COGHILL wondered if the age were not changed to 18
would the judge not have a legal precedent to put that in as an
aggravator.
MS. CARPENETI agreed if the child witnessing the crime is 17 or
18, the judge won't be able to apply this specific aggravating
factor. A judge usually does have other aggravating factors to
consider in domestic violence cases.
REPRESENTATIVE KEMPLEN asked if this factor would still be
applied if the child were too young to experience the impact of
domestic violence.
MS. HENDERSON stated the age of the child should not matter nor
play a factor because the child is in danger anytime violence is
present in the home.
REPRESENTATIVE KEMPLEN asked if during an argument someone throws
a skillet across the room would that be considered domestic
violence.
Number 1095
MS. CARPENETI replied it always depends on the circumstances. An
aggravating factor at sentencing is something the judge can
consider. It doesn't necessarily mean that the sentence will be
raised because he/she finds that aggravating factor. There may
be other aggravating factors; there may be mitigating factors.
This legislation just gives the court more leeway in terms of
fashioning a sentence appropriate to the case, and it only
applies to felonies.
CHAIRMAN DYSON explained when there is physical violence, not
only is there danger to the child of getting hit, there is
tremendous emotional impact on the child. Newborns can tell if
there is anger and tension in the home, and they can tell things
aren't right between their parents. There is evidence that
prenatally, children are affected by the tension and/or
insecurities of what goes on around them. Aside from the
physical danger, there is emotional danger. That damage
occurring to an infant perseveres for a significant part of
his/her life.
REPRESENTATIVE BRICE also commented that the level of research
and understanding of emotional impact on children, newborns,
infants and the unborn is becoming more and more documented, and
the environment in which a child is brought up does impact the
way that child acts and reacts throughout life. He would be
concerned about trying to establish a minimum age. They may want
to increase the age from 16 to 18.
REPRESENTATIVE COGHILL indicated since most children can be
emancipated at 16, he is willing to let this bill pass without
amending the age.
Number 1286
REPRESENTATIVE COGHILL made a motion to move HB 288 from the
committee with individual recommendations. There being no
objection, HB 288 moved from the House Health, Education and
Social Services Committee.
HB 258 - ASSISTED LIVING HOMES
Number 1348
CHAIRMAN DYSON announced the next order of business as House Bill
No. 258, "An Act relating to assisted living homes; and providing
for an effective date."
Number 1374
REPRESENTATIVE COGHILL, co-sponsor with Representative Jeannette
James, presented HB 258. He noted he has dealt with this subject
on the Long-Term Care Task Force. Assisted living homes have
been well defended today, and the cost of institutional care is
way beyond the state's ability to handle. The average age is
growing rapidly, and the need for assisted care, long-term care,
respite care and institutional care is rising. To plan for this,
they have to figure out how to take care of people in the best,
most dignified and least expensive way possible. A community-
based effort is the best way to do that. The proposed CS deals
with indigent people who are not able to take care of themselves
and are under general relief and the caregivers who are being
reimbursed only $35 per day. Since this bill has a Finance
committee referral, he suggested this committee focus on the
policy itself. Representative James and he feel strongly that
this issue is a priority for this legislature because the
alternative is costly institutional care.
Number 1500
REPRESENTATIVE COGHILL made a motion to adopt the proposed
committee substitute (CS) for HB 258, version 1-LS1076\D,
Lauterbach, 1/29/00, as a work draft. There being no objection,
proposed CSHB 258 was before the committee.
REPRESENTATIVE COGHILL explained the difference in the bill
versions was on page 2, Sec. 5 where there was a tiered approach
in three different years. Representative James and he felt they
should start at this basic level.
REPRESENTATIVE KEMPLEN asked Representative Coghill why he is
interested in raising the rate for assisted living services and
facilities when there are other alternatives that have been
suggested, in particular with faith organizations assisting with
these people. It seems that expanding the size of the budget
goes contrary to that way of thinking, and he wondered how that
is reconciled.
REPRESENTATIVE COGHILL indicated this is not to diminish faith-
based work. Most of the people working in assisted living homes
do not do it for the money. This bill would take care of an
indigent population that the State of Alaska has agreed to care
for. It should be done with dignity or not done at all. This is
a statement saying let's do it so that there is a real
reimbursement rate for this. He is a fan of getting faith-based
organizations involved so that these costs do not have to be
there. They need to work hand in hand. The cost of the rate in
the proposed CS was brought from the Mental Health Trust
Authority. The Department of Administration has suggested
another model that brings the rate up to $100, but he did not
suggest that rate but agreed the Finance Committee should discuss
it. This bill goes to the $75 limit. The cost definitely needs
to be shifted; there is a need here.
Number 1712
MONTA FAYE LANE, President, Alaska Caregivers Association, Owner,
Assisted Living Home, testified via teleconference from
Fairbanks. She represents about 45 assisted living homes in that
association which provide indigent care. She described a
situation where she was asked by Denali Center to take a 525
pound man who needed three showers a day and wound care on his
stomach three times a day for $34.50 per day. She felt she had
to turn this down because of the potential damage this man could
cause on the pipes in her home and on her bathroom. Because the
state has no reimbursement rates for damage control, it would be
impossible for her to take this man in. It would be a poor
business judgment on her part to have done so; therefore, she had
to refuse this person. One year later Denali Center called her
again and said the same man now only weighs 425 pounds. He lost
100 pounds, but that is still not enough to walk on her floors
with pipes to her furnace.
MS. LANE said there has been a long battle with the state for
general relief rates in Alaska. She came into this business ten
years ago, and the state told her at that time that she should
have another job in order to pay the mortgage and pay for food
and utilities for her home. Now Alaska's population is getting
older and living longer and getting sicker. Back then the state
said the care providers could not take anyone in their homes who
was in a wheelchair who could not transfer himself/herself to the
bathroom or to and from the bed or chair. Now she gets calls
from Denali Center saying a patient is out of money now and on
Medicaid, and Denali Center can no longer keep him/her in their
facility, but they could move the patient to her facility for
$34.50 a day. She noted that Denali Center gets $345 a day and
she gives personal one-on-one attention for $34.50 a day. The
difference is she gets 10 percent of what Denali Center makes.
MS. LANE pointed out that the legislature supports the pioneer
homes for between $30-38 million a year. The public doesn't
understand that the person going into the pioneer home pays $2000
a month to be there. With 600 people in the pioneer homes, that
equals $12 million a year which can put back into the general
fund.
MS. LANE wanted the committee to know that the caregivers are
there for the people and will remain for the people, but they
cannot do it at $34.50 a day. Last year the caregivers said they
would not take any new people at $34.50 a day and then reneged on
that because they didn't have the heart to put the patients out.
This year will be a whole different story. She urged the
committee to find a solution for this.
Number 1977
REPRESENTATIVE KEMPLEN asked Ms. Lane if money was the only thing
she would be satisfied with or would other means of compensation
be appropriate. He suggested education credit at the university
or a housing voucher or a percentage rate reduction for a loan or
other in-kind benefits.
MS. LANE replied she has some education which has trained her for
this and is game for education. As to other subsidies, she is a
for-profit entity, and the legislature does not provide money for
that. She is a business but does not get paid for any of the
administrative costs.
Number 2136
LESLEE OREBAUGH, Owner, Parkside and Rosewood Assisted Living
Homes, Executive Secretary, Alaska Caregivers Association,
testified via teleconference from Anchorage. She has 32 beds in
her homes. She is also representing approximately 45 homes
across the state. She reminded the committee the state
reimbursement rate is 17.5 years old and economically, no one is
living with a 17.5 year old budget right now. In 1995 the state
made them a business, with business licenses and business
insurances. She emphasized that they can't take anything but
money. Her staff does not and will not take education units or
anything else as a form of compensation for their work. There is
a problem in Anchorage right now because the owners get paid so
little that they cannot pass on good wages to their staff. They
have to have this raise. There is a staffing crisis now.
MS. OREBAUGH has received numerous calls in the past two or three
weeks asking her if she had people or knew of people available
for staffing. Owners and administrators have told her they can
no longer afford to take a straight indigent person without a
Medicaid waiver or CHOICE [the Community and Home Options to
Institutional Care for the Elderly and Disabled] waiver. The
state is the largest consumer even though there are private
clients. The number of state beds and homes that will take
indigents are decreasing. The daily rate increase is desperately
needed. The care givers can't do without it and continue in
their business. The state will be looking at culpable liability
at having indigent clients placed in inappropriate housing, on
the street or other places; they are looking at illnesses and
death that they don't want to face. She urged the committee to
take a hard look at this issue.
ALISON ELGEE, Deputy Commissioner, Department of Administration,
came forward to testify. Through the Division of Senior Services
the department deals with the assisted living industry in the
state for services provided to seniors. It is a foundation of
their home and community-based care delivery system. She
referred to the testimony from two assisted living providers and
the economic straits they find themselves as a result of the
current general relief rates. A study was done about 18 months
ago under the auspices of the Mental Health Trust Authority to
look at the economics of the assisted living industry in Alaska,
and that study supports the $75 rate that is suggested in CSHB
258. In the provision of home and community-based care services,
and in the assisted living environment in particular, they are
often dealing with the most vulnerable adults who, as a result of
some crisis, need protective housing arrangements. Assisted
living is a very appropriate environment for them, and there
needs to be the economic resources to supplement the income of
these individuals when they don't have the resources themselves.
She offered support for the bill on behalf of the seniors.
Number 2324
ELMER LINDSTROM, Special Assistant, Office of the Commissioner,
Department of Health & Social Services (DHSS), came forward to
testify. He noted that his department and the Department of
Administration (DOA) are companion agencies. The DOA tends to
fund the senior population through the Division of Senior
Services and DHSS funds persons with developmental disabilities
or mental health consumers through the Division of Mental Health
and Developmental Disabilities. He mentioned there are fiscal
notes from both departments.
REPRESENTATIVE KEMPLEN asked Ms. Elgee about the study she
mentioned. He mentioned another option in Scandinavia called
"co-housing" which is a living arrangement where individuals come
together in a mutually supportive arrangement. It is small
groups that live together.
TAPE 00-7, SIDE B
Number 2385
REPRESENTATIVE KEMPLEN noted that option is not a for-profit
business, however the needs of the participants are met. He
wonders if the study done by the department considered the option
of that alternative support system, and if they evaluated co-
housing as a viable alternative to the system currently in place.
MS. ELGEE answered they did not evaluate that option. The study
was specifically to look at the economics of the assisted living
industry here in the state of Alaska to determine what was
necessary as an underlying rate to make it a viable industry.
The environment he described is not one in most of the examples
she is familiar with that incorporates the actual services that
are available in an assisted living environment. In an assisted
living environment those services are provided to individuals who
are no longer capable of performing those functions without
assistance which includes bathing, dressing, eating,
transferring, and others.
REPRESENTATIVE KEMPLEN clarified that the person running an
assisted living home or their staff are tasked with the
responsibility of providing the physical assistance to the elder
in terms of physically carrying them to the bathroom or
physically washing them or whatever type of service or activity
that needs to be provided.
MS. ELGEE explained there are individual care plans developed for
each person in an assisted living home on a CHOICE waiver or
Medicaid waiver. The services are tailored to the individual's
needs. Not every individual needs assistance with all services.
There will be quite a spectrum.
CHAIRMAN DYSON asked if the $2.4 million fiscal note was in the
Governor's budget this year.
MR. LINDSTROM said it is not currently in the Governor's budget
which is why it is seen as a fiscal note.
MS. ELGEE referred to a spread sheet for both Senior Services and
Health and Social Services so that the committee can see the
total cost anticipated of $4,738.3 million.
MR. LINDSTROM pointed out the funding source is split between
general funds and the Mental Health Trust Authority which has
been supportive of the program. There is $850,000 from the
Mental Health Trust Authority.
CHAIRMAN DYSON asked if the administration supports the bill and
this fiscal note.
MS. ELGEE answered yes. She said the department sees assisted
living as an alternative to nursing home care. The cost for this
program is considerably less than the cost would be if many of
these individuals were admitted to a nursing home which would be
the only alternative available to them for long-term care.
REPRESENTATIVE BRICE asked how the original $30 a day standard
set.
MS. ELGEE answered the rate is set in regulations.
REPRESENTATIVE BRICE asked why they couldn't just do it through
the regulatory process.
MS. ELGEE answered that certainly could be done, but it wouldn't
work without funding to cover the rate.
MR. LINDSTROM noted this was one of the recommendations from the
Long-Term Care Task Force last year, and Senator Miller did
introduce legislation that was supported by the task force and by
the administration. It is keeping faith with that approach from
last year.
REPRESENTATIVE COGHILL agreed with Ms. Elgee that the trouble
with these figures is the real costs are not seen. In the day of
missions and measures, the cost of institutional care is going to
drive the state into the ground. Those are costs that are not
only are formula-driven but are needs-driven. He anticipates
solving a problem before a real serious problem exists. A $4
million problem is nothing compared to what is going to be
happening over the next eight years.
REPRESENTATIVE COGHILL mentioned a fiscal note put together by
Community Mental Health and said it was different from what came
from the Department of Administration and DHSS. Because there
are some differences and Representative James was working on
getting some agreements, he would like to see this go to the
Finance Committee for that kind of work. Since there are some
wide differences in the fiscal notes, those things should be
discussed at the Finance Committee.
REPRESENTATIVE KEMPLEN asked if all assisted living homes are
operated as businesses.
MS. ELGEE answered that assisted living homes are licensed where
they have occupancy of three or more residents. To that degree,
anybody interested in public funding has to be licensed even if
they are only taking one person.
REPRESENTATIVE KEMPLEN asked if a license turns them into a
business.
MS. ELGEE answered there are very specific requirements set out
in statute and expanded upon in regulation that look very
business like. One of the providers told the committee that they
are required to have insurance. There are financial accounting
responsibilities as well as the responsibilities of an employer,
there is staff in the larger homes hired to help provide
services. People are not providing assisted living for a little
extra pocket change. They do it as a livelihood.
REPRESENTATIVE KEMPLEN asked about nonprofit organizations.
MR. LINDSTROM agreed there are a number of nonprofit
organizations that are in this business, particularly for the
developmentally disabled (DD) population. He guessed that most,
if not all, of the assisted living homes for the DD population
are under the umbrella of a nonprofit organization. Assisted
living used to be called adult foster care. He guessed that some
caregivers come to the business with the basic outlook of someone
who has a foster care sort of mentality. Assisted living covers
the spectrum from someone at home with one to three persons all
the way to the larger facilities which house 30-50 people.
Motivation, expectations and business ability are going to cover
a wide spectrum of assisted living.
REPRESENTATIVE KEMPLEN asked how many of the provider
organizations are faith organizations.
MS. ELGEE said she doesn't have an answer to that but could
develop that information.
REPRESENTATIVE KEMPLEN said he would be interested in that
information.
JANE DEMMERT, Executive Director, Alaska Commission on Aging,
Division of Senior Services, Department of Administration, came
forward to testify. She referred to previous discussion and
added the need for an increase in the rate is something that will
affect and does affect Alaskans of all ages. She emphasized that
the commission focuses on responding to critical issues as they
affect everyone as they age as well as the effect on children and
grandchildren. Assisted living is a form of small business for
the most part. It is a young industry around the country and
even younger in Alaska. "There are businessmen amongst us and
you cannot go into a business and expect to survive if you don't
have a way to at least begin to meet your expenses." The
situation heard about this afternoon is one in which people who
are in a business are being asked to provide a service that they
are taking a very real loss in. For those people who intend to
spend their lives in Alaska, assisted living is one of the very
critical pieces. If they can't see that these businesses are
able to make a go of it by providing a service that the state is
asking them to provide, then that is a disservice to the business
community as well as to all those involved from a perspective of
public policy.
MS. DEMMERT referred to Ms. Lane's testimony. There are people
who have difficult circumstances, so this is not the kind of work
that can be done casually; it requires professionalism. She
pointed out again that these rates have been in place since 1983,
so there has not been any ability to keep up with inflation.
Because assisted living is a new concept and questions have been
asked about it, she invited the committee to visit a small
assisted living home in Juneau.
Number 1788
REPRESENTATIVE KEMPLEN asked Ms. Demmert what exactly the
expenses are in assisted living homes.
MS. DEMMERT answered there are basic expenses for operating and
maintaining these businesses which include the facility,
staffing, pieces of equipment needed for particular individuals
and the on-going operating support in terms of providing meals,
transportation and any other particular services needed and
insurance, which a very significant item.
REPRESENTATIVE KEMPLEN asked how much of the rate increase will
go to personnel.
MS. DEMMERT answered that should be asked of the providers
because the pay ranges do vary slightly across businesses. There
would be an individual answer for each facility. There is great
difficulty in this area now in being able to offer any kind of a
wage that recognizes the quality of work provided by the
employee. It is work that is physically and mentally
challenging.
REPRESENTATIVE KEMPLEN said he is trying to figure out whether
the business model is the best model to implement in the state to
provide assistance to the elders. It seems to him there are
other viable models to consider. He could envision nonprofit
organizations like AmeriCorps or faith organizations providing
these professional services, but other personnel could
participate as a part of community service. He sees two
competing models available to them: profit-motivated and
community-service-motivated. He would be interested in hearing
about the community service model.
CHAIRMAN DYSON stated that what Representative Kemplen is
bringing up is valid, but he is not sure this is the best forum
for that discussion. He suggested that the Long-Term Care Task
Force would be interested in a presentation on some other models
that have worked, or this committee could have a discussion on
some of the other models. He chose not to pursue that issue
further at this time.
REPRESENTATIVE COGHILL added that faith-based modeling is part of
the mix. It does not compete with this; it works hand in hand
with it, but it is sporadic. The rate is undergirding a cost for
service.
REPRESENTATIVE COGHILL made a motion to move CSHB 258, version 1-
LS1076\D, Lauterbach, 1/29/00, as amended, from committee with
individual recommendations and attached fiscal notes. There
being no objection, CSHB 258(HES) moved from the House Health,
Education and Social Services Committee.
ADJOURNMENT
Number 1500
There being no further business before the committee, the House
Health, Education and Social Services Committee meeting was
adjourned at 4:47 p.m.
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