Legislature(2001 - 2002)
04/17/2001 03:02 PM House HES
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* first hearing in first committee of referral
+ teleconferenced
= bill was previously heard/scheduled
+ teleconferenced
= bill was previously heard/scheduled
ALASKA STATE LEGISLATURE
HOUSE HEALTH, EDUCATION AND SOCIAL SERVICES
STANDING COMMITTEE
April 17, 2001
3:02 p.m.
MEMBERS PRESENT
Representative Fred Dyson, Chair
Representative Peggy Wilson, Vice Chair
Representative John Coghill
Representative Gary Stevens
Representative Vic Kohring
Representative Sharon Cissna
Representative Reggie Joule
MEMBERS ABSENT
All members present
COMMITTEE CALENDAR
HOUSE BILL NO. 197
"An Act relating to directives for personal health care services
and for medical treatment."
- HEARD AND HELD
CS FOR SENATE JOINT RESOLUTION NO. 21(HES)
Urging the United States Congress to extend the authorization
date for supplemental block grants to the State of Alaska under
the Federal Temporary Assistance to Needy Families Program.
- MOVED CSSJR 21(HES) OUT OF COMMITTEE
HOUSE BILL NO. 173
"An Act relating to establishing a screening, tracking, and
intervention program related to the hearing ability of newborns
and infants; providing an exemption to licensure as an
audiologist for certain persons performing hearing screening
tests; relating to insurance coverage for newborn and infant
hearing screening; and providing for an effective date."
- HEARD AND HELD
HOUSE BILL NO. 174
"An Act relating to mental health information and records; and
providing for an effective date."
- MOVED HB 174 OUT OF COMMITTEE
HOUSE BILL NO. 124
"An Act prohibiting nursing facilities and assisted living homes
from employing or allowing access by persons with certain
criminal backgrounds, with exceptions."
- MOVED CSHB 124(HES) OUT OF COMMITTEE
HOUSE JOINT RESOLUTION NO. 24
Urging the United States Congress to extend the authorization
date for supplemental block grants to the State of Alaska under
the Federal Temporary Assistance to Needy Families Program.
- SCHEDULED BUT NOT HEARD
HOUSE BILL NO. 209
"An Act directing the Department of Health and Social Services
to establish a foster care transition program; relating to that
program; and providing for an effective date."
- SCHEDULED BUT NOT HEARD
HOUSE BILL NO. 84
"An Act relating to civil liability for emergency aid."
- BILL HEARING POSTPONED TO 4/19/01
HOUSE BILL NO. 112
"An Act relating to information and services available to
pregnant women and other persons; and ensuring informed consent
before an abortion may be performed, except in cases of medical
emergency."
- BILL HEARING POSTPONED TO 4/19/01
PREVIOUS ACTION
BILL: HB 197
SHORT TITLE:HEALTH CARE SERVICES DIRECTIVES
SPONSOR(S): REPRESENTATIVE(S)HUDSON
Jrn-Date Jrn-Page Action
03/19/01 0649 (H) READ THE FIRST TIME -
REFERRALS
03/19/01 0649 (H) HES, JUD
03/28/01 0762 (H) COSPONSOR(S): KERTTULA
04/10/01 (H) HES AT 3:00 PM CAPITOL 106
04/10/01 (H) <Bill Postponed to 4/17>
04/17/01 (H) HES AT 3:00 PM CAPITOL 106
BILL: SJR 21
SHORT TITLE:EXTEND FEDERAL TANF GRANTS
SPONSOR(S): HEALTH, EDUCATION & SOCIAL SERVICES
Jrn-Date Jrn-Page Action
03/19/01 0717 (S) READ THE FIRST TIME -
REFERRALS
03/19/01 0717 (S) HES
03/28/01 (S) HES AT 1:30 PM BUTROVICH 205
03/28/01 (S) Moved CS(HES) Out of
Committee
MINUTE(HES)
03/29/01 0857 (S) HES RPT CS 4DP SAME TITLE
03/29/01 0857 (S) DP: GREEN, LEMAN, WILKEN,
DAVIS
03/29/01 0857 (S) FN1: ZERO(HSS)
04/11/01 1068 (S) RULES TO CALENDAR 4/11/01
04/11/01 1073 (S) READ THE SECOND TIME
04/11/01 1073 (S) HES CS ADOPTED UNAN CONSENT
04/11/01 1073 (S) ADVANCED TO THIRD READING
UNAN CONSENT
04/11/01 1073 (S) READ THE THIRD TIME CSSJR
21(HES)
04/11/01 1073 (S) PASSED Y18 N- E1 A1
04/11/01 1081 (S) TRANSMITTED TO (H)
04/11/01 1081 (S) VERSION: CSSJR 21(HES)
04/11/01 (S) RLS AT 10:30 AM FAHRENKAMP
203
04/12/01 0977 (H) READ THE FIRST TIME -
REFERRALS
04/12/01 0977 (H) HES, FIN
04/17/01 (H) HES AT 3:00 PM CAPITOL 106
BILL: HB 173
SHORT TITLE:SCREENING NEWBORNS FOR HEARING ABILITY
SPONSOR(S): REPRESENTATIVE(S)JOULE
Jrn-Date Jrn-Page Action
03/12/01 0542 (H) READ THE FIRST TIME -
REFERRALS
03/12/01 0542 (H) HES, FIN
03/13/01 0579 (H) COSPONSOR(S): SCALZI
03/30/01 0794 (H) COSPONSOR(S): KERTTULA
04/17/01 1021 (H) COSPONSOR(S): MORGAN
04/17/01 (H) HES AT 3:00 PM CAPITOL 106
BILL: HB 174
SHORT TITLE:MENTAL HEALTH INFORMATION AND RECORDS
SPONSOR(S): RLS BY REQUEST OF LEG BUDGET & AUDIT
Jrn-Date Jrn-Page Action
03/12/01 0543 (H) READ THE FIRST TIME -
REFERRALS
03/12/01 0543 (H) HES, JUD
04/17/01 (H) HES AT 3:00 PM CAPITOL 106
BILL: HB 124
SHORT TITLE:NURS.HOME/ASSISTED LIV. EMPLOYEES/VISITOR
SPONSOR(S): REPRESENTATIVE(S)HALCRO
Jrn-Date Jrn-Page Action
02/09/01 0282 (H) READ THE FIRST TIME -
REFERRALS
02/09/01 0282 (H) HES, JUD
03/07/01 0501 (H) COSPONSOR(S): DYSON
03/15/01 (H) HES AT 3:00 PM CAPITOL 106
03/15/01 (H) Heard & Held
03/15/01 (H) MINUTE(HES)
03/19/01 0656 (H) COSPONSOR(S): STEVENS
03/20/01 (H) HES AT 3:00 PM CAPITOL 106
03/20/01 (H) <Bill Canceled>
03/22/01 (H) HES AT 3:00 PM CAPITOL 106
03/22/01 (H) Heard & Held
03/22/01 (H) MINUTE(HES)
04/17/01 (H) HES AT 3:00 PM CAPITOL 106
WITNESS REGISTER
MELANIE LESH, Staff
to Representative Bill Hudson
Alaska State Legislature
Capitol Building, Room 502
Juneau, Alaska 99801
POSITION STATEMENT: Testified on behalf of the sponsor of HB
197.
SIOUX PLUMMER
Juneau End of Life Task Force
2551 Vista Drive
Juneau, Alaska 99801
POSITION STATEMENT: Testified on behalf of the Juneau End of
Life Task Force and herself in favor of HB 197.
JANE DEMMERT, Executive Director
Alaska Commission on Aging
Department of Administration
PO Box 110209
Juneau, Alaska 99811
POSITION STATEMENT: Testified in support of HB 197.
MOLLY EIDEM
Long Term Care Ombudsman
3601 C Street
Anchorage, Alaska 99503
POSITION STATEMENT: Testified on behalf of Suzan Armstrong in
support of HB 197.
JOHN MANLY, Staff
to Representative John Harris
Alaska State Legislature
Capitol Building, Room 513
Juneau, Alaska 99801
POSITION STATEMENT: Testified on behalf of Representative
Harris, sponsor of HJR 24 (the companion bill), presented SJR 21
and explained the differences between the House and Senate
versions.
JIM NORDLUND, Director
Division of Public Assistance
Department of Health & Social Services
PO Box 110640
Juneau, Alaska 99811
POSITION STATEMENT: Answered questions on SJR 21.
CHRISTINE HESS, Staff
to Representative Reggie Joule
Alaska State Legislature
Capitol Building, Room
Juneau, Alaska 99801
POSITION STATEMENT: Answered questions on HB 173.
KAREN PEARSON, Director
Division of Public Health
Department of Health & Social Services
PO Box 110610
Juneau, Alaska 99811
POSITION STATEMENT: Answered question on HB 173.
HEATHER ALLIO, Parent
3961 Portage Boulevard
Juneau, Alaska 99801
POSITION STATEMENT: Testified on behalf of herself on HB 173.
LISA OWENS, Audiologist and Speech Pathologist
11935 Kristie Circle
Anchorage, Juneau 99503
POSITION STATEMENT: Testified on HB 173.
REPRESENTATIVE HUGH FATE
Alaska State Legislature
Capitol Building, Room 416
Juneau, Alaska 99801
POSITION STATEMENT: Testified as sponsor of HB 174.
ELMER LINDSTROM, Special Assistant
Office of the Commissioner
Department of Health & Social Services
PO Box 110601
Juneau, Alaska 99811
POSITION STATEMENT: Testified on HB 174 and HB 124.
ANNE HENRY, Special Projects Coordinator
Division of Mental Health & Developmental Disabilities
Department of Health & Social Services
PO Box 110620
Juneau, Alaska 99811
POSITION STATEMENT: Answered questions on HB 174.
PAT DAVIDSON, Legislative Auditor
Legislative Audit Division
Alaska State Legislature
PO Box 113300
Juneau, Alaska 99811
POSITION STATEMENT: Answered questions on HB 174.
KEVIN HAND, Staff
to Representative Andrew Halcro
Alaska State Legislature
Capitol Building, Room 414
Juneau, Alaska 99801
POSITION STATEMENT: Testified on behalf of the sponsor of HB
124.
ALISON ELGEE, Deputy Commissioner
Office of the Commissioner
Department of Administration
PO Box 110200
Juneau, Alaska 99811
POSITION STATEMENT: Testified on HB 124.
ACTION NARRATIVE
TAPE 01-44, SIDE A
Number 0001
CHAIR FRED DYSON called the House Health, Education and Social
Services Standing Committee meeting to order at 3:02 p.m.
Members present at the call to order were Representatives Dyson,
Coghill, Stevens, and Joule. Representatives Wilson, Kohring,
and Cissna joined the meeting as it was in progress.
HB 197-HEALTH CARE SERVICES DIRECTIVES
CHAIR DYSON announced that the first order of business would be
HOUSE BILL NO. 197, "An Act relating to directives for personal
health care services and for medical treatment."
Number 0019
MELANIE LESH, Staff to Representative Bill Hudson, Alaska State
Legislature, came forth on behalf of the sponsor of HB 197. She
read to the committee a statement written by Representative
Hudson:
I was asked to support this legislation by people I
respect and who have long proved worthy of
representing good causes. This cause I find to be
very civilized and humanitarian. You will hear
testimony from several persons in agencies that wish
to enable others to give a voice to others who can no
longer offer their own through the preparation of a
list of their wishes for their final days. This bill
expands the options for people who want to prepare
themselves for when they can no longer speak or act on
their own behalf. These expanded directives do not
interfere with the current statutes concerning living
wills and "do not resuscitate" orders. They simply
provide for a form to be circulated with which the
patient[s] can determine what they will need in
respect to their comforts - emotional, spiritual, and
physical. This bill will enable agencies that assist
terminally ill patients by providing a document
contained in the bill that spells out choices for them
to consider with their family and their loved ones.
It is hope that this document will continue to gain
attention, as it has in 37 other states, and broach a
subject that is uncomfortable for most of us, but
necessary for all of us.
CHAIR DYSON asked what keeps people from doing this now.
MS. LESH responded that she would rather somebody else spoke to
that. She said there are limited allowances in statutes now
that provide for living wills, but nothing sets forth a form
providing choices and options.
Number 0300
SIOUX PLUMMER, Juneau End of Life Task Force, came forth and
stated that [HB 197] is easily a piece of legislation that can
be supported by a variety of people in [Alaska]. She explained
that this enables the legislature to aid Alaskans in having more
clear and defined choices in how they want the end of their
lives to be. She said 35 other states have laws that have a
similar concept. This is based on the Five Wishes, a document
of a few pages of statements that talks about what a person
might want to think about and want the family or doctor to know
when he or she is terminally ill. She stated that Five Wishes
was created by an organization out of Florida called Aging With
Dignity. The gentleman who formed the Five Wishes worked with
Mother Theresa for several years. She added that the intent of
HB 197 is good public policy.
CHAIR DYSON asked why this needs to be in law.
MS. PLUMMER responded that to her understanding this improves
and expands existing state statutes so it is clearer as to what
the choices are. This aids someone in thinking about these
things and legally enables him or her to do it.
CHAIR DYSON stated that the value of law is not to aid people in
thinking. He asked who would go to jail if someone were to fill
this out and it was not followed through.
MS. PLUMMER answered that she does not know of any language in
this law or the new proposed law that would say that if it
weren't followed, somebody would go to [jail].
CHAIR DYSON asked why this should be put in law, then.
MS. PLUMMER replied that she thinks the Department of Health &
Social Services or the Department of Administration might have
some suggestions that it merely be in regulation.
CHAIR DYSON asked why the state needs to be involved in this.
MS. PLUMMER remarked that she was hoping someone from Aging With
Dignity could talk about what other states have done and why
this was put it into law. She added that she wants to urge [the
legislature] to understand and support the concept and the
intent of [HB 197].
Number 0573
REPRESENTATIVE STEVENS stated that he thinks Chair Dyson is
getting at a good point. He said he had just received from his
mother a power of attorney and a living will and would like to
know what [the proposed legislation] would do that the power of
attorney and the living will do not do.
MS. PLUMMER stated that she believes this language just expands
on what already exists and gives a greater clarity to what a
living will could include.
REPRESENTATIVE STEVENS asked if there is a contradiction among
the living will, the power of attorney, and this [proposed]
form. He asked what legally would take precedence.
Number 0671
JANE DEMMERT, Executive Director, Alaska Commission on Aging,
Department of Administration, came forth and stated, in response
to Representative Stevens' questions, that it might be helpful
to take a look at some of the statements that begin on page 13
of the bill. She said:
I'll just speak for myself as an individual.
Acknowledging that I will die is a hard thing to come
to grips with; it's even harder to think about how -
to the extent that it could happen - I would like to
be cared for and treated when I can no longer, through
a discussion like this, tell people what I'm seeking.
One of the steps that this takes is to - based on the
experience of people in many different settings now -
pose some statements here that would help me ... to
anticipate the kinds of circumstances that I would
experience. And then to, based on that, say, "And
here's how I'd like you to support me as I'm going
through these last stages of my life."
CHAIR DYSON asked what would take precedence and if this has any
legal standing.
MS. DEMMERT explained that there is a reference on page 17 about
how this would phase in. It states:
... a person who, by a statutory form power of
attorney executed under AS 13.26.332 before the
effective date of this Act, has been given powers to
make health care decisions under and consistent with
authority set out in the repealed provisions, may
continue to exercise those powers under and consistent
with the authority set out in the repealed provisions
until the appointment made by the statutory form power
of attorney with respect to health care services
terminates or is revoked.
MS. DEMMERT stated that she thinks this speaks to one of the
considerations in terms of how this would articulate with
current statutes.
Number 0880
CHAIR DYSON remarked that there is no "or else." He asked if
there is anything that binds the caregiver to obey it, besides
helping people think this through. He asked what the penalty
would be for disobedience.
MS. DEMMERT responded that she does not know. She asked,
"Philosophically, do you think there should be, if there's not?"
CHAIR DYSON answered absolutely, if it is going to be put into
law.
MS. DEMMERT remarked that this is very interesting because it
brings together a number of provisions as well as charts some
new ground. She said she believes everyone is thinking about
this in a more comprehensive fashion.
Number 0981
REPRESENTATIVE CISSNA asked if this is a general power of
attorney. She said that would mean the person who has been
designated as having the power of attorney can do the things
that are listed here; therefore, there would be some statutory
strength. She also asked if there are additional things in [the
proposed form] beyond a normal power of attorney
MS. DEMMERT answered yes.
REPRESENTATIVE CISSNA remarked that she personally thinks this
is useful. She shared that her late husband had a power of
attorney and a living will, and one of the horrendous things she
went through was trying to figure out what he meant. She said
she can see a real need for trying to make that very end
decision a clear one.
CHAIR DYSON stated that it certainly is a power of attorney and
covers a lot of things. He said that he suspects [the
committee] will pass the bill and let [the House Judiciary
Standing Committee] wrestle with whether or not there should be
a form in state law.
MS. LESH commented that Representative Hudson has acknowledged
that the directive could be maintained in the bill and that the
form could be brought about through a regulatory direction
through the legislature. She said Representative Hudson was
willing to work with the national Dying with Dignity group
because there is some legislation in other states that enables
the state agency to create the form with the direction of the
legislature. She added that Representative Hudson has also
wrestled with the idea that the form's being in the statute may
not be the best method.
Number 1245
CHAIR DYSON stated that he appreciates that. He remarked that
he is particularly interested in how the [medical] industry
feels when somebody says, "I don't want pain killers," and yet
the whole tradition has been to make the patient comfortable.
He asked if [the industry] will be afraid of liabilities.
MS. PLUMMER stated that the Juneau End of Life Task Force is a
group of people that began talking with Representative Hudson
about this legislation. She said she also serves on the Hospice
Foundation Board for Juneau, which endorses HB 197. She read
from a document from the Hospice Foundation Board:
The meaning of HB 197 is really a gift to one's family
members and friends so they won't have to guess what
you want. The Hospice and Homecare of Juneau's board
of directors urges approval of HB 197.
CHAIR DYSON remarked that the two times he has been involved in
cases like this, there weren't elderly people involved. He
noted that nothing has been put in [the bill] that refers to
children.
MS. PLUMMER responded that those are the kinds of things that
people often include in their durable powers of attorney or
their wills. She said this is only addressing the very intimate
end of life decisions a person makes.
CHAIR DYSON stated that he is confused because page 2 [of the
bill] lists a lot of important things such as banking
transactions, real estate, claims, and litigation.
MS. LESH responded that those provisions stay in statute just as
they are. [House Bill 197] creates a new section that deals
with health care directives.
REPRESENTATIVE CISSNA stated that she is assuming the line here
is between the [the person the] power of attorney that is in
place while the person in question is alive and the executor of
the will who is there after that transition.
MS. PLUMMER responded that sometimes it is the same person [who
is named in the durable power of attorney], but that is up to
each individual.
Number 1444
MOLLY EIDEM, Long Term Care Ombudsman, testified via
teleconference on behalf of Suzan Armstrong. She read to the
committee:
The Office of the Long Term Care Ombudsman (OLTCO)
supports HB 197, "An Act relating to directives for
personal health care services and for medical
treatment." Long Term Care Ombudsmen from around the
country have been extolling the benefits of Five
Wishes for some time now. Our clients, the elderly of
Alaska, need clear tools, written in specific
language, that [direct] our health care providers and
others on how to administer to our clients' final
needs. Too often, the OLTCO has attempted to help
family and friends struggling to determine what their
loved one would want and not want, and having little,
if any, input from the elder. Sadly, acute conditions
that inhibit worthwhile communication or chronic
conditions such as dementia prevent our clients from
expressing their wishes and desires during their final
days and hours. The Five Wishes format would be a
priceless gift to all of our Alaska families and would
greatly enhance our capabilities to administer to our
dying Alaskans' final wishes and to plan for our own.
Number 1529
CHAIR DYSON called for an at-ease at 3:28 p.m. The meeting was
called back to order at 3:40 p.m.
[HB 197 was held over.]
SJR 21-EXTEND FEDERAL TANF GRANTS
[Contains discussion of HJR 24, the companion bill.]
CHAIR DYSON announced that the next order of business would be
CS FOR SENATE JOINT RESOLUTION NO. 21(HES), Urging the United
States Congress to extend the authorization date for
supplemental block grants to the State of Alaska under the
Federal Temporary Assistance to Needy Families Program.
Number 1650
JOHN MANLY, Staff to Representative John Harris, Alaska State
Legislature, came forth on behalf of Representative Harris,
sponsor of HJR 21, to explain SJR 21. He stated that [SJR 21]
asks the federal government to continue the supplemental funding
for the TANF (Temporary Assistance to Needy Families) program,
which is about $6.9 million or about 30 percent of [Alaska's]
block grant. He remarked that a number of states that were
either poor or growing faster than the national rate were
allowed this. He noted that according to the census figures,
[Alaska] has grown by 14 percent since 1990. [The supplemental
funding] is scheduled to expire the next federal fiscal year,
and the whole TANF authorization program expires a year after
that. He explained that this resolution asks for a one-year
extension so that when the program is reconsidered, [Alaska]
will be funded up to that point.
MR. MANLY explained that there are a few changes in the Senate
version from the House version of the resolution. The House
version had included the Head Start program in the list of
programs and services that TANF funds cover. However, in the
Senate version, on page 2, line 10, that has been taken out.
The Senate version also added the President and the U.S.
Secretary to be the designated recipients of the resolution.
CHAIR DYSON asked why the legislature needs to be involved with
this.
Number 1753
JIM NORDLUND, Director, Division of Public Assistance,
Department of Health & Social Services (DHSS), came forth and
stated that this is a resolution to Congress encouraging them to
continue the funding. This is using the "finesse" and the
authority of the legislature to deliver that message.
REPRESENTATIVE JOULE asked, if the legislature did not pass a
resolution, whether congress would [continue the funding].
MR. NORDLUND answered that this is a formal way of bringing
attention to the issue. He noted that [the resolution] will be
fairly well received by Congress. There have already been 14
[U.S.] Senators who have written letters to the President asking
for this extended funding, including Alaska's Senator Stevens.
It is supported by resolutions from the National Governor's
Association, and from the American Public Human Services
Association. He stated that there is broad support for this,
but lending the voice of [Alaska's] legislature would be
helpful.
Number 1816
CHAIR DYSON stated that he thinks Representative Joule was
asking if this is the only way to make this happen and that Mr.
Nordlund's response was, "No, but it would be useful." He asked
if the Knowles Administration has any other way of notifying the
U.S. government of the desire to have this funding continue.
MR. NORDLUND responded that [DHSS] has been working through the
Governor's office and the congressional delegation to get this
[resolution] through. He said it certainly would be helpful if
the legislature would lend its voice as well. He added that
this could happen without the passage [of the resolution].
MR. NORDLUND, in reply to a further question, explained that the
resolution states that "we" have committed this funding for
various programs. If [Alaska] receives that $7 million cut to
the block grant, then "we" will have to reach out to some of
those agencies and figure out who can no longer be funded. He
added that [Alaska] is facing a $14 million deficit with TANF
funds for FY 2003. He said getting the supplemental funding
continued would plug a big hole in that deficit.
CHAIR DYSON asked Mr. Nordlund what the Senate's thinking was in
taking out Head Start.
MR. NORDLUND answered that it was [DHSS's] request. He stated
that [DHSS] is funding Head Start right now; however, it doesn't
seem proper. [DHSS] is presently under an audit, and the
legislature should not have extended TANF funding to the Head
Start program because it is not an allowable use under the
federal rights.
Number 1959
REPRESENTATIVE CISSNA stated that it would seem to her that as
money policy makers [legislators] should be weighing the costs
of all of these things, making resolutions on federal funds, and
knowing what they are.
REPRESENTATIVE COGHILL remarked that block grants are based on
the rolls of the temporary assistance [programs]. He asked Mr.
Nordlund if, since [Alaska] has gone down in the [number of
people on temporary assistance, [this resolution] is asking to
be held harmless for the amount [Alaska] has gone down.
MR. NORDLUND responded that with the way the block grant was
structured when welfare reform passed, the deal in Congress was
that the entitlement status for welfare would end, and states
would be given a set amount of money. The states would have to
live with that amount of money if the welfare caseloads go up;
if the caseloads go down, the states get to keep the money,
regardless of the size of the caseload. He stated that there
was one provision whereby states with high populations and the
poorer states would get a 2.5 percent bump every year. [Alaska]
has been getting that "bump" every year, regardless of what has
been happening with the caseload. Since the caseload has been
going down, the state has been able to keep that difference and
use that funding for other purposes. He explained that in
[Alaska] the child care program used to have about $10 million
in general fund (GF) money. The federal TANF dollars that have
been saved have supplemented the GF, thereby helping to close
the fiscal gap.
Number 2078
REPRESENTATIVE COGHILL asked if the grant itself will be based
on the reauthorization of what [Alaska's] caseload is.
MR. NORDLUND answered that "we" don't know that yet. He stated
that this is a huge debate in Congress right now. There is a
lot of pressure within Congress to say, "Well, since the
caseload has dropped in half, you obviously don't need as much
money as we guaranteed you in '94." But states are saying,
"Well, but we are using those funds for very legitimate other
purposes and are actually running programs with it. ... Pulling
back that funding level would mean defunding certain programs."
REPRESENTATIVE COGHILL remarked that this is probably why he
won't support the resolution, because he thinks it is the
state's responsibility and not the federal government's [to fund
these other programs].
Number 2152
REPRESENTATIVE JOULE made a motion to move SJR 21 [CSSJR
21(HES)] from committee with individual recommendations and the
attached zero fiscal note.
REPRESENTATIVE COGHILL objected.
A roll call vote was taken. Representative Stevens, Cissna,
Joule, Wilson, and Dyson voted in favor of moving the
resolution. Representative Coghill voted against it.
[Representative Kohring was absent.] Therefore, CSSJR 21(HES)
moved from the House Health, Education and Social Services
Standing Committee by a vote of 5-1.
HB 173-SCREENING NEWBORNS FOR HEARING ABILITY
CHAIR DYSON announced that the next order of business would be
HOUSE BILL NO. 173, "An Act relating to establishing a
screening, tracking, and intervention program related to the
hearing ability of newborns and infants; providing an exemption
to licensure as an audiologist for certain persons performing
hearing screening tests; relating to insurance coverage for
newborn and infant hearing screening; and providing for an
effective date." [Before the committee was the original bill;
although there was a proposed committee substitute (CS) in the
packets; version 22-LS0003\B, Lauterbach, 4/11/01, it was never
adopted.
Number 2199
CHAIR DYSON called for an at-ease at 3:55 p.m. The meeting was
called back to order at 3:56 p.m.
REPRESENTATIVE JOULE stated, as sponsor of the bill, that each
year in Alaska approximately 10,000 babies are born. Around 30
to 40 of these children will have some sort of congenital
hearing loss. Hearing loss, he said, is more prevalent than any
other congenital abnormality for which newborns are routinely
screened. Without newborn screening, the average age at which
children in the United States are identified with hearing loss
is 12 to 25 months - after critical windows of learning have
passed. If left undetected, hearing loss can result in lifelong
delays in language, cognitive, socio-emotional, and academic
development.
REPRESENTATIVE JOULE explained that [HB 173] does three things.
It requires testing of infants before release from a hospital or
within 30 days, except if hospitals have less than 50 births a
year or birthing centers refer for screening within 30 days; the
development of a reporting and tracking system for newborn and
infants; and intervention by providing parents with information
through which they could get services if their child has a
hearing loss, as well as providing general information about
hearing testing of infants.
REPRESENTATIVE JOULE explained that in the last several years 32
states have passed legislation requiring newborn hearing
screening. Three or more states test on a voluntary basis, and
four states are considering legislation this year. He added
that there is a new fiscal note for [the bill], which is $90,000
a year, whereas the old fiscal note, was over $500,000.
REPRESENTATIVE JOULE offered Amendment 1, which read:
Page 5, subsection (g), lines 14-18
DELETE
TAPE 01-44, SIDE B
CHAIR DYSON asked, if [the committee] were to accept
Representative Joule's amendment, whether the fiscal note would
go away.
REPRESENTATIVE JOULE responded that the change in the fiscal
note is the result of deleting the one section [referred to in
the amendment].
CHAIR DYSON asked how much the old fiscal note was.
Number 2275
CHRISTINE HESS, Staff to Representative Reggie Joule, Alaska
State Legislature, answered that it was almost $600,000.
REPRESENTATIVE JOULE explained that if newborns who are
otherwise covered by some form of insurance, such as IHS (Indian
Health Service) or Denali KidCare, are born in a hospital where
there are 50 or more births, they automatically get screened
within the first 30 days. The cost that goes away is for those
children who were not covered by one form or another of
insurance, which is about four to six children yearly.
CHAIR DYSON asked if Denali KidCare covers hearing screenings
for newborns.
MS. HESS answered yes.
CHAIR DYSON asked if most of the health care policies that
families have in Alaska cover it.
MS. HESS responded that several hospitals are screening right
now and have reported that they haven't had any problems with
the insurance covering it. It has been part of a newborn
hearing-screening package. The hearing screening is included
with everything that is done now with the newborn. Eventually,
she said, it will get its own medical code. However, the bill
provides that in certain circumstances the insurance is going to
have to provide that as part of the insurance coverage.
CHAIR DYSON asked what those circumstances would be.
MS. HESS responded that on page 3, lines 9 through 14, it states
that if the plan covers services provided to women during
pregnancy and childbirth and the dependents of a covered
individual, it should include the hearing screening and a
follow-up if required. She added that the test is relatively
inexpensive, ranging from $45 to $100, and takes about five
minutes.
CHAIR DYSON asked about the deletion Representative Joule wants
to make on page 5.
REPRESENTATIVE JOULE stated that the deletion of subsection (g)
eliminates a large part of the fiscal note for a relatively
small group of children. He said he felt it was more important
at this point to get the larger number of kids taken care of and
to get the bill moving. In discussing the bill with [committee]
members, he said, there is a huge concern about a large fiscal
note.
CHAIR DYSON asked if most hospitals are already doing this.
REPRESENTATIVE JOULE answered no.
CHAIR DYSON asked if by deleting [subsection] (g), coverage for
the people who fall through that crack would be eliminated.
REPRESENTATIVE JOULE said he was correct.
MS. HESS stated that from discussions the Department of Health &
Social Services (DHSS), a couple of things would happen. She
said [DHSS] is not actually sure of the statistical data
regarding how many kids are uninsured with Denali KidCare. She
said "we're" hoping it's only two to four kids and that some
nonprofit groups such as the Lion's Club and Rotary will help.
The hospitals will help with the hearing screenings. The other
good news, she said, is that ILP (Infant Learning Program) is
currently funded for $700,000; therefore, those kids would go on
to the ILP waitlist and hopefully get services through that.
Number 2028
REPRESENTATIVE WILSON said she is thinking about her area,
Wrangell, and asked how much the machines that do the tests
cost; she noted that right now Wrangell's hospital does not have
anything like that. She also said she is concerned that since
the hospital doesn't [have the machine] but has 30 days to make
sure the patient gets referred, the patient would have to spend
money to fly someplace else.
MS. HESS responded that the testing equipment costs anywhere
from $9,000 to $15,000. There is a program with the National
Hearing Association whereby hospitals can [lease] the equipment
while they get started, for free. There is also, she said, a
portable device, which can be easily transported. Therefore, a
couple of hospitals could get together and share a hearing-
screening device. Some rural states are actually doing this,
and other states use volunteers to do the testing, which reduces
the cost. She added that there is a lot of federal grant money
available now.
REPRESENTATIVE STEVENS asked, since the old fiscal plan was
$600,000 and this fiscal plan is $95,000 and the only difference
is two to four children who will not be tested, whether that
means it costs $500,000 for two to four children.
MS. HESS responded yes, but it is not only for the testing; it
is for the intervention, all follow ups, and any hearing
devices.
Number 1931
KAREN PEARSON, Director of Public Health, Department of Health &
Social Services, came forth and explained that the title of the
initial bill states that it provides for screening tests and
intervention. The three to four children would have been the
ones without insurance who needed the full-blown intervention.
There is an unknown number of kids, represented by about
$200,000 in the original fiscal note, who don't have a payment
source for their screening. The remainder for the fiscal note
was for the intervention as well as travel for kids who live in
a place where screening or intervention is not available. She
stated that the current fiscal note is what is needed to put the
data system together to do the tracking. Then, she explained,
in 2005 the grant for the staff goes away so there is a request
for half a staff person to keep the project going.
REPRESENTATIVE COGHILL asked how many screenings would be
mandated to Alaska right now under this bill.
MS. Pearson responded that she does not have that information.
REPRESENTATIVE COGHILL stated that he is concerned that places
like Wrangell, Kotzebue, or Barrow, where they have health care
facilities, will be mandated a $9,000 to $12,000 machine, which
seems like a pretty heavy load. He added that this is not going
to have a small impact on health care facilities.
MS. PEARSON stated that the technology is changing quite rapidly
and she thinks the costs will be coming down. She added that
there is a lot of interest in this area at the federal level
because they understand the impact on the education system and
justice system of children not being able to hear.
REPRESENTATIVE STEVENS asked what would be accomplished with
this equipment that a good family doctor would not be able to
tell when examining a baby.
Number 1787
HEATHER ALLIO, Parent, came forth and stated that to test for
[hearing loss, doctors] originally put a sound into a baby's ear
and then measured the amount of sound that came back out. That
can tell whether or not a child has a hearing loss, but it can't
tell the degree of the hearing loss. A second test can then be
performed, which is called an ABR (auditory brainstem response)
test or a BAER (brainstem auditory evoked response) test, during
which electrodes are put on the head. Sound is admitted into
the ear and the brain's response to the sound is tested.
CHAIR DYSON asked how that has gone for her family.
MS. ALLIO shared her story with the committee:
My first son was diagnosed at six months. In fact,
[apart from] a family dog that barked and barked and
barked and my son never responded, he was not tested
at birth. He was then fitted with the hearing aids.
Since then - he's three - he [knows] well over 1,500
signs [of sign language]; he's got sounds that he can
make that represent words. Had he not had those
hearing aids at six months, he would have missed an
awful lot of that. My second son, Brady (ph) was
tested at one week old, here at the audiologist, and
found that he had a loss of some sorts. So we went to
Seattle and had the second test done.
CHAIR DYSON asked if this is hereditary in her family.
MS. ALLIO answered no. She continued stating that most kids are
not caught at six months like her son was. Most are not caught
until age two; therefore, they have missed out on that two-year
window of the ability to hear and the ability to learn sign
language.
Number 1675
CHAIR DYSON asked Ms. Pearson what [Alaska's] situation would be
if parents were unwilling to have their kids tested and if that
would be considered a child-in-need-of-aid case.
MS. PEARSON responded that there is the potential of being asked
what the impact on the child is if there is no religious basis
for the choice of medical care.
CHAIR DYSON asked if it would be the same situation if it were
diagnosed and [the parents] refused to do anything remedial.
MS. PEARSON stated that she thinks so.
MS. HESS responded that the bill provides for an exemption if
the parent objects, for example, due to religious practices.
She added that DFYS (Division of Family and Youth Services)
could step in if a parent refuses to take appropriate medical
procedures.
Number 1574
LISA OWENS, Audiologist and Speech Pathologist, testified via
teleconference. She explained that there is audiology coverage
for almost every area of the state right now, and almost every
audiologist has one of the types of systems being used, that can
travel. She said she thinks there are three areas right now
that have the equipment available; however, they are working on
getting grants to cover the costs through state task forces.
The second point is that for 50 percent of children there is no
known cause for hearing loss. The average age of identification
right now, in states that do not have newborn hearing screening,
is 18 months to 2 years. In states such as Colorado, Rhode
Island, and Hawaii that have been doing newborn hearing
screenings for the past six or seven years, the average age of
identification is lowered to 3 months of age. She said there
are many studies showing that children who are identified by 3
months of age and given hearing aids and early intervention are
developing language and communication skills at age-appropriate
levels, versus children who are identified at 18 months to 2
years who end up having a reading level of third grade.
MS. OWENS explained that a child being identified at 18 months
to 2 years hears virtually nothing for those first 18 months or
2 years of life. Information on brain research shows that there
is a critical time for brain development, and if children miss
that window it is hard for them to ever fully develop those
skills. In states that have been doing these programs, kids are
going on to preschool and kindergarten and are not requiring the
special assistance that they would need if they were identified
later in life, which is a huge cost savings.
CHAIR DYSON asked, if this passes, whether Ms. Owens would get
more business.
MS. OWENS answered probably not; she said [her practice] is
pretty full as it is. She stated that this would protect kids
who are missing out on hearing.
CHAIR DYSON asked what percentage of the newborns in [Alaska]
are not getting screened now.
MS. OWENS responded that right now Providence Hospital is the
primary birthing center and is screening all babies, as are
Columbia National Regional and the Native hospitals. She said
Nome is now screening and Kotzebue is going to start screening
within the next month. She said the problem in some of the
rural areas is not necessarily the equipment but the training of
the hospital staff. Therefore, most of the audiologists are
trying to get to those areas to provide appropriate training and
help them to get the funding for equipment.
CHAIR DYSON asked who pays [the audiologists] to do that.
MS. OWENS stated that nobody does; she is doing it on a
volunteer basis.
Number 1320
REPRESENTATIVE COGHILL asked how the follow-up works now.
MS. OWENS explained that typically babies are screened during
their first day of life in a hospital. If they fail the
screening, the hospital will try to rescreen before they are
discharged or they are screened within the first week of life
when the parents bring them back to the hospital. Children who
fail both screenings, are referred to an audiologist for a full
diagnostic test, who would then confirm the [hospital's]
diagnostic testing. From that point, they would be referred to
the ILP and to the Alaska Early Intervention Hearing Resource
Program, which provides parents with sign language and
educational support.
[HB 173 was held over.]
HB 174-MENTAL HEALTH INFORMATION AND RECORDS
CHAIR DYSON announced that the next order of business would be
HOUSE BILL NO. 174, "An Act relating to mental health
information and records; and providing for an effective date."
CHAIR DYSON called for an at-ease at 4:29 p.m. The meeting was
called back to order at 4:31 p.m.
Number 1070
REPRESENTATIVE HUGH FATE, Alaska State Legislature, came forth
as sponsor on HB 174. He stated that this bill is a result of
the Legislative Budget & Audit Committee's recommendation to the
state auditor and the Department of Health & Social Services.
House Bill 174 allows the state to better track direct grant
money given to a community mental health provider. He stated
that the bill does two things: it complies with the auditor's
report for reporting actual consumer data, and it holds agencies
harmless for being sued by the consumer for breach of
confidentiality if that should ever occur. He added that this
is about accountability for state grant funds.
CHAIR DYSON asked whether somebody who breaks that
confidentiality would not be liable for it.
REPRESENTATIVE FATE responded yes, that this holds harmless an
agency if a suit should occur by a consumer for a breach of
confidentiality.
Number 0974
ELMER LINDSTROM, Special Assistant, Office of the Commissioner,
Department of Health & Social Services [DHSS], came forth and
stated that there has been a requirement in regulation for a
number of years for providers and community mental health
centers to provide client information. Generally, they have not
complied. He explained that one of the reasons they have not
done so is because of a fear that without clear, explicit
authority for them to share this information with the [DHSS],
they would be subject to suit by a consumer. This bill gives
immunity to the community mental health center that would be
required to provide [DHSS] the data under this bill.
CHAIR DYSON asked if there is very limited scope in this bill,
which gives [the community mental health centers] immunity if
they are providing this confidential information.
MR. LINDSTROM replied that this is specifically for providing
the information to [DHSS].
CHAIR DYSON asked if [DHSS] will treat [the information] well.
MR. LINDSTROM answered that there is a lot of confidential
information in his department. He stated that in his ten years
working for the department he doesn't recall ever being called
"on the carpet" by the legislature for disclosing confidential
information. On the other hand, he said, he gets questions
about why [the department] won't release confidential
information. He added that this is a normal bit of his
business.
CHAIR DYSON asked if the information are held in electronic or
paper files.
MR. LINDSTROM responded that files exist in both formats. The
goal in this program ultimately would be an electronic exchange
of information that is encrypted.
CHAIR DYSON asked if anyone has every "hacked" into [the files].
MR. LINDSTROM answered not to his knowledge.
Number 0808
REPRESENTATIVE STEVENS asked whether the information being
collected about people with mental health problems is by name or
just includes data.
MR. LINDSTROM answered that it would be client-specific. A
unique identifier would be used for an individual, but it would
be encrypted so [the person] would not be readily identifiable.
He clarified for the committee that [DHSS] funds community
mental health centers in two ways. One is the grant aid
process, whereby general fund grant dollars are given to
community mental health centers to provide mental health
services to clients. He stated that this was the only thing
that existed as recently as eight or nine years ago. In 1992
[DHSS] began allowing them to bill through Medicaid, and the
costs of mental health services billed through Medicaid went
from $0 to $5 million to $10 million to $20 million and are now
in excess of $50 million. The Finance Committee requested the
original audit, and in noting this growth in the Medicaid
budget, wondered how the funding through Medicaid related to the
funding of the general fund grants. The conclusion of the
audit, he stated, is that they really cannot [relate the
funding], because while [DHSS] gets that client-specific data
very well in the Medicaid system, it has not been historically
captured for persons served through those grant dollars that go
to the community mental health centers. He added that this
would give [DHSS] that same level of detail for those grant
dollars that have been customarily received through the Medicaid
program.
Number 0684
REPRESENTATIVE STEVENS asked why [DHSS] would need the name.
MR. LINDSTROM answered that he believes it gets to the issue of
outcomes of individual clients' treatment. He stated that it is
not unusual and that it is the same data received on Medicaid
clients as a matter of course.
REPRESENTATIVE CISSNA asked if it is possible to have numbers
rather than names [in the data].
MR. LINDSTROM responded that that is the goal. [The
information] would be electronically transmitted and encrypted.
Number 0578
ANNE HENRY, Special Projects Coordinator, Division of Mental
Health & Developmental Disabilities, Department of Health &
Social Services, came forth and stated that the unique
identifier used on the data that are collected from providers
include the person's initials, date of birth, and the last four
digits of the social security number. She added that for the
grant work, [DHSS] does not collect any names. When [DHSS]
receives the information from providers, it is in encrypted
form, which is then decrypted [by DHSS] and stored back in an
encrypted form.
CHAIR DYSON asked if [DHSS] has been unable to figure out how
the public money was being spent or the desired outcomes that
were happening because they couldn't track individual clients.
PAT DAVIDSON, Legislative Auditor, Legislative Audit Division,
Alaska State Legislature, answered that he was correct. She
stated that the auditors could show what the trends were in
Medicaid, what services were being provided, and what clients in
terms of age or location services were being provided for.
After discussing it with [DHSS] they could see where the growth
was. As a result of the audit, she said, one of the things that
changed was the rate. There was a leveling off and, in some
cases, decreased costs in certain activities. However, she
said, the auditors hit a blank wall when it came to the state
grants because they did not know who was being served, what
services were being provided, or if some of the clients were
also being billed under Medicaid or private insurance. This,
she explained, comes down to the unique identifier. From an
accountability standpoint it is necessary to know that the same
person isn't billing insurance, Medicaid, and the state grant.
She remarked that [the auditors'] conclusion was that a fee for
service and a grant program are inherently incompatible, and
that one way around that is to get the same data for state-
funded clients as for Medicaid clients.
CHAIR DYSON asked Representative Fate if he or anyone in his
office has talked with any of the mental health consumers to see
if they would take exception to this bill.
Number 0300
REPRESENTATIVE FATE answered that they haven't. He noted that
there is an ongoing lawsuit that involves a Fairbanks community
mental health center. That lawsuit was brought because of the
mere fact that [the mental health center] was liable because of
its requirement for submissions of certain confidential client
information. He stated that if this bill were to pass, this
lawsuit would be dropped.
CHAIR DYSON remarked that it is his sense that this is more of a
legal issue than a health issue and perhaps it should be sent on
to the consideration of the House Judiciary Standing Committee.
He added that if that occurs then he will write a note to the
chairman of the House Judiciary Standing Committee that [DHSS]
should give notice to and an opportunity for any of the
representatives of the mental health consumer community to weigh
in on it.
Number 0223
REPRESENTATIVE CISSNA made a motion to move HB 174 from
committee with individual recommendations and the attached zero
fiscal note. There being no objection, HB 174 moved from the
House Health, Education and Social Services Standing Committee.
HB 124-NURS.HOME/ASSISTED LIV. EMPLOYEES/VISITOR
CHAIR DYSON announced that the last item of business would be
HOUSE BILL NO. 124, "An Act prohibiting nursing facilities and
assisted living homes from employing or allowing access by
persons with certain criminal backgrounds, with exceptions."
KEVIN HAND, Staff to Representative Andrew Halcro, Alaska State
Legislature, came forth on behalf of the sponsor of HB 124. He
noted that the most current committee substitute (CS) draft is
Version P. He explained that HB 124 is a barrier-crime piece of
legislation that was brought about in part because of a
legislative audit, which mentioned that the Pioneers' Home
employs several sex offenders. Version P removes a number of
contentious points that were raised by various parties. For
example, contract workers, non-employees, and volunteers would
be removed from being subject to a background check. It also
removes crimes in which the victim was a resident [of a nursing
home] from the background check requirement
TAPE 01-45, SIDE A
MR. HAND continued, stating that [Version P] adds Section 2 on
page 3, line 11, which reads, "(d) A nursing facility
administrator shall provide safeguards to ensure that
contractors, volunteers, and other persons entering the nursing
facility do not abuse, neglect, or exploit a resident of the
facility." He added that this has a mirror section for assisted
living facilities later in the bill.
Number 0101
REPRESENTATIVE WILSON asked if the concern about facilities
where the owner lives in the same household was taken care of.
MR. HAND answered that it has been addressed by a slight change;
however, there is not a total agreement on it. Part of it is
because it is under a receivership clause in the latter part of
the bill. From the standpoint of the administration, it
wouldn't be people taking physical possession of the home; it
would just be administration of the services of those residents.
The other option would be that those people are just kicked out
in the street because the government would be forced to either
shut it down or take it over, the alternative being that someone
would come in on a daily basis and run the home.
CHAIR DYSON stated that in the last hearing of this bill he had
a question concerning what should be done with a new hire that
just "got off the boat," since there would be no instantaneous
criminal check. He asked if this was addressed in the current
revisions.
MR. HAND responded that it was point that was discussed at
length regarding how in-state workers would have some background
information available with nursing home administrators in
assisted living home facilities. [The administrators] were all
in agreement that that point would make it completely
unworkable, and they would all voice opposition if that portion
were included.
Number 0317
REPRESENTATIVE CISSNA remarked that she has recently learned
that personnel in a few of the nursing homes in her area
[Anchorage] make trips to foreign countries to get staff,
because there is such a shortage. She asked what is done in
situations like that and if there is any kind of reciprocal
information exchange with foreign countries.
MR. HAND replied that as for the person's background and
criminal history, that question may be better suited for
licensing. He added that these people are subject to the same
background checks; however, the availability of that information
would seemingly be difficult, although it is ascertainable.
CHAIR DYSON asked where the bill is going next.
MR.HAND stated that it is going to [the House Finance
Committee]. He explained that it is actually referred to [the
House Judiciary Standing Committee] next; however, the chairman
has waived it in lieu of a new House finance Committee referral.
CHAIR DYSON asked Mr. Hand how he would feel about adding on
page 3, line 13, after "volunteers," "new hires from out of
state or out of country,". He stated that this establishes the
duty of the administrator to take care of it.
MR. HAND responded that he sees no [problem with adding that
language].
REPRESENTATIVE CISSNA remarked that she thinks this is worth
investigating. She stated that she has heard some folks who
have relatives in nursing homes say that when they looked for
nursing homes they discovered that the people who appeared to be
most concerned about the elderly were in fact from other
countries.
ELMER LINDSTROM, Special Assistant, Office of the Commissioner,
Department of Health & Social Services, remarked that there is
parallel language relative to assisted living [homes] beginning
on page 5, line 31. He stated that he does not think that this
would be a meaningless amendment. The licensing agency would go
into a nursing home or an assisted living home and will want to
see concrete evidence of policy procedures that have been put in
place to implement that section.
Number 0740
REPRESENTATIVE CISSNA made a motion to adopt Conceptual
Amendment 1, adding, after "volunteers," on page 3, line 13, and
on page 6, line 1, "new hires from out of state and out of
country,".
REPRESENTATIVE COGHILL made a motion to adopt the proposed CS
for HB 124, version 22-LS008\P, Lauterbach, 4/5/01. There being
no objection, Version P was before the committee.
REPRESENTATIVE CISSNA repeated her motion to adopt Conceptual
Amendment 1. There being no objection, Conceptual Amendment 1
was adopted.
Number 0890
REPRESENTATIVE COGHILL referred to the emergency involuntary
termination of contract on page 8, which states, "with less than
30 days' notice". He asked if the less than 30 days could mean
immediately, for example, if somebody becomes violent.
MR. HAND responded that it is not necessarily immediate. He
stated that this deals with the termination of a contract. If
someone were to grow violent in a home, he or she could be
removed immediately. The home could then move forward with
terminating the person's contract, which could take [as little
as] 72 hours.
REPRESENTATIVE COGHILL asked if the receivership of the assisted
living home, referenced on page 12, Section 15, has been run by
the assisted living home organization.
MR. HAND answered that it has been a point of extensive
discussion; however, not everyone agrees with how it has been
written.
Number 1049
ALISON ELGEE, Deputy Commissioner, Office of the Commissioner,
Department of Administration, came forth and stated that the
receivership provision is a very last recourse and would only be
used if there were no other alternatives. One of the things
heard from some of the assisted living administrators is that
maybe it could be limited from a size standpoint. However, this
is a situation in which there is not any other capacity in the
community to deal with a long-term care situation. She stated
that the first choice, if there were problems with the home,
would be to relocate the residents from the home into another
environment and not to take over the operation of the home
itself. She added that if there is a small home in a community
where that is the only home, this may take a little longer than
if it were a home in a community with a variety of alternatives.
She remarked that this provides some protection to the
administrators of these assisted living homes, because it brings
a neutral third party into it. The licensing agency would have
to go to court to demonstrate that it has exhausted every other
possibility in terms of remedying the problems of the assisted
living home operations.
Number 1138
REPRESENTATIVE COGHILL made a motion to move the CS for HB 124,
22-LS0087\P, Lauterbach, 4/5/01, as amended, from committee with
individual recommendations and the attached zero fiscal note.
There being no objection, CSHB 124(HES) moved from the House
Health, Education and Social Services Standing Committee.
ADJOURNMENT
There being no further business before the committee, the House
Health, Education and Social Services Standing Committee meeting
was adjourned at 5:09 p.m.
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