Legislature(2001 - 2002)
04/23/2002 03:03 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
ALASKA STATE LEGISLATURE
HOUSE HEALTH, EDUCATION AND SOCIAL SERVICES
STANDING COMMITTEE
April 23, 2002
3:03 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
SENATE BILL NO. 345
"An Act relating to medical assistance for rehabilitative
services for certain children with disabilities; relating to
agreements to pay medical assistance for covered services paid
for or furnished to eligible children with disabilities by a
school district; and providing for an effective date."
- MOVED SB 345 OUT OF COMMITTEE
CS FOR SENATE BILL NO. 182(FIN)
"An Act requiring reductions in payments to individuals under
certain benefit programs if appropriations are not sufficient to
fully fund the statutorily established levels of payments."
- HEARD AND HELD
HOUSE BILL NO. 522
"An Act relating to medical services under the state Medicaid
program."
- HEARD AND HELD
PREVIOUS ACTION
BILL: SB 345
SHORT TITLE:EDUC. FUNDING/DISABLED/CORRESPONDENCE
SPONSOR(S): HEALTH, EDUCATION & SOCIAL SERVICES
Jrn-Date Jrn-Page Action
03/04/02 2365 (S) READ THE FIRST TIME -
REFERRALS
03/04/02 2366 (S) HES, FIN
03/15/02 (S) HES AT 1:30 PM BUTROVICH 205
03/15/02 (S) Moved Out of Committee
03/15/02 (S) MINUTE(HES)
03/18/02 2449 (S) HES RPT 4DP
03/18/02 2449 (S) DP: GREEN, LEMAN, WILKEN,
WARD
03/18/02 2449 (S) FN1: (HSS)
03/26/02 (S) FIN AT 9:00 AM SENATE FINANCE
532
03/26/02 (S) Moved Out of Committee
03/26/02 (S) MINUTE(FIN)
03/27/02 2536 (S) FIN RPT 6DP 2NR
03/27/02 2536 (S) DP: KELLY, GREEN, AUSTERMAN,
WILKEN,
03/27/02 2536 (S) LEMAN, WARD; NR: DONLEY,
OLSON
03/27/02 2537 (S) FN1: (HSS); FN2: (HSS)
04/10/02 (S) RLS AT 10:30 AM FAHRENKAMP
203
04/10/02 (S) MINUTE(RLS)
04/11/02 2732 (S) RULES TO CALENDAR 4/11/02
04/11/02 2733 (S) READ THE SECOND TIME
04/11/02 2733 (S) ADVANCED TO THIRD READING
UNAN CONSENT
04/11/02 2733 (S) READ THE THIRD TIME SB 345
04/11/02 2734 (S) PASSED Y20 N-
04/11/02 2734 (S) EFFECTIVE DATE(S) SAME AS
PASSAGE
04/11/02 2734 (S) TAYLOR NOTICE OF
RECONSIDERATION
04/12/02 2751 (S) RECONSIDERATION HELD TO
4/15/02
04/15/02 2776 (S) RECONSIDERATION HELD TO
4/16/02
04/16/02 2794 (S) RECONSIDERATION NOT TAKEN UP
04/16/02 2795 (S) TRANSMITTED TO (H)
04/16/02 2795 (S) VERSION: SB 345
04/17/02 2965 (H) READ THE FIRST TIME -
REFERRALS
04/17/02 2965 (H) HES, FIN
04/23/02 (H) HES AT 3:00 PM CAPITOL 106
BILL: SB 182
SHORT TITLE:PRO RATA REDUCTIONS IN BENEFIT PROGRAMS
SPONSOR(S): FINANCE
Jrn-Date Jrn-Page Action
04/09/01 1014 (S) READ THE FIRST TIME -
REFERRALS
04/09/01 1014 (S) FIN
03/01/02 (S) FIN AT 9:00 AM SENATE FINANCE
532
03/01/02 (S) Heard & Held
03/01/02 (S) MINUTE(FIN)
03/20/02 (S) FIN AT 9:30 AM SENATE FINANCE
532
03/20/02 (S) Moved CSSB 182(FIN) Out of
Committee
03/20/02 (S) MINUTE(FIN)
03/22/02 2490 (S) FIN RPT CS 4DP 3NR SAME TITLE
03/22/02 2490 (S) DP: DONLEY, GREEN, LEMAN,
WARD;
03/22/02 2490 (S) NR: KELLY, AUSTERMAN, WILKEN
03/27/02 2533 (S) FN1: INDETERMINATE(GOV/ALL
DEPTS)
03/27/02 2533 (S) FN2: INDETERMINATE(HSS)
03/27/02 2533 (S) FN3: INDETERMINATE(HSS)
03/27/02 2533 (S) FN4: INDETERMINATE(HSS)
03/27/02 2533 (S) FN5: INDETERMINATE(HSS)
03/27/02 2533 (S) FN6: INDETERMINATE(HSS)
03/27/02 2533 (S) FN7: INDETERMINATE(HSS)
03/27/02 2533 (S) FN8: INDETERMINATE(HSS)
03/28/02 (S) RLS AT 8:30 AM FAHRENKAMP 203
03/28/02 (S) -- Time Change --
03/28/02 (S) MINUTE(RLS)
04/02/02 2586 (S) RULES TO CALENDAR 1OR 4/2/02
04/02/02 2587 (S) READ THE SECOND TIME
04/02/02 2588 (S) FIN CS ADOPTED UNAN CONSENT
04/02/02 2588 (S) ADVANCE TO 3RD READING FLD
Y13 N4 E2 A1
04/02/02 2588 (S) ADVANCED TO THIRD READING 4/3
CALENDAR
04/03/02 2616 (S) READ THE THIRD TIME CSSB
182(FIN)
04/03/02 2616 (S) PASSED Y13 N6 E1
04/03/02 2616 (S) ELLIS NOTICE OF
RECONSIDERATION
04/04/02 2635 (S) RECONSIDERATION NOT TAKEN UP
04/04/02 2636 (S) TRANSMITTED TO (H)
04/04/02 2636 (S) VERSION: CSSB 182(FIN)
04/05/02 2813 (H) READ THE FIRST TIME -
REFERRALS
04/05/02 2813 (H) HES, FIN
04/05/02 2813 (H) REFERRED TO HES
04/23/02 (H) HES AT 3:00 PM CAPITOL 106
BILL: HB 522
SHORT TITLE:MEDICAID PAYMENTS FOR ABORTION
SPONSOR(S): HEALTH, EDUCATION & SOCIAL SERVICES
Jrn-Date Jrn-Page Action
04/18/02 3006 (H) READ THE FIRST TIME -
REFERRALS
04/18/02 3006 (H) HES, JUD, FIN
04/23/02 (H) HES AT 3:00 PM CAPITOL 106
WITNESS REGISTER
JERRY BURNETT, Staff
to Senator Lyda Green
Alaska State Legislature
Capitol Building, Room 125
Juneau, Alaska 99801
POSITION STATEMENT: Presented SB 345 on behalf of the Senate
Health, Education and Social Services Standing Committee,
sponsor.
BOB LABBE, Director
Division of Medical Assistance
Department of Health & Social Services
PO Box 110660
Juneau, Alaska 99811-0660
POSITION STATEMENT: Testified in support of SB 345 and answered
questions.
GREG MALONEY, Special Education
Teaching and Learning Support
Department of Education & Early Development
901 West Tenth Street, Suite 200
Juneau, Alaska 99801-1894
POSITION STATEMENT: Answered questions on SB 345.
MARILYN WILSON, Staff
to Senator Dave Donley
Alaska State Legislature
Capitol Building, Room 518
Juneau, Alaska 99801
POSITION STATEMENT: Presented SB 182 on behalf of the Senate
Finance Committee, sponsor.
ELLEN NORTHUP, State Food Coalition
PO Box 21123
Auke Bay, Alaska 99821
POSITION STATEMENT: Testified against SB 182.
PELTON GOUDEY
735 East 74th Avenue
Anchorage, Alaska 99518-2828
POSITION STATEMENT: Expressed concerns on how SB 182 would
affect foster care.
CORNELIA HUEBSCHER
National Alliance for the Mentally Ill (NAMI)
PO Box 1516
Sitka, Alaska 99835
POSITION STATEMENT: Testified against SB 182.
CHERYL JEBE, President
League of Women Voters of Alaska
6520 North Douglas Highway
Juneau, Alaska 99801
POSITION STATEMENT: Read a resolution passed by the League of
Women Voters of Alaska opposing SB 182.
DARYL NELSON
Access Alaska
(No address provided)
POSITION STATEMENT: Testified against SB 182.
JESSIE JOHNNIE, Elder
414 Hollywood Way, Apartment R
Sitka, Alaska 99835
POSITION STATEMENT: Testified against SB 182.
MARIE DARLIN
AARP
415 Willoughby Avenue
Juneau, Alaska 99801
POSITION STATEMENT: Testified against SB 182.
TONY LOMBARDO, Director of Advocacy
Covenant House
609 F Street
Anchorage, Alaska 99501
POSITION STATEMENT: Testified against SB 182.
LYN FREEMAN, Executive Director
Alaska Commission on Aging
Division of Senior Services
Department of Administration
PO Box 110209
Juneau, Alaska 99811-0209
POSITION STATEMENT: Testified against SB 182.
MARIE LAVIGNE, Executive Director
National Association of Social Workers (NASW)
Alaska Chapter
4220 Resurrection Drive
Anchorage, Alaska 99504
POSITION STATEMENT: Testified against SB 182.
ALISON ELGEE, Deputy Commissioner
Department of Administration
PO Box 110200
Juneau, Alaska 99811-0200
POSITION STATEMENT: Testified against SB 182.
ELMER LINDSTROM, Deputy Commissioner
Department of Health and Social Services
PO Box 110601
Juneau, Alaska 99811-0601
POSITION STATEMENT: Testified against SB 182.
THERESA TANOURY, Director
Central Office
Division of Family & Youth Services
Department of Health & Social Services
PO Box 110630
Juneau, Alaska 99811-0630
POSITION STATEMENT: Testified how SB 182 would affect foster
care.
KATHLEEN WARWICK
895 West Twelfth Street, Number 104
Juneau, Alaska 99801
POSITION STATEMENT: Expressed concern about living on APA
benefits if they are cut due to SB 182.
PAULETTE ALDEN
895 West Twelfth Street, Number 212
Juneau, Alaska 99801
POSITION STATEMENT: Expressed concern about living on APA
benefits if they are cut due to SB 182.
EUGENE WARWICK
895 West Twelfth Street, Number 104
Juneau, Alaska 99801
POSITION STATEMENT: Testified on SB 182.
ACTION NARRATIVE
TAPE 02-35, SIDE A
Number 0001
CHAIR FRED DYSON called the House Health, Education and Social
Services Standing Committee meeting to order at 3:03 p.m.
Representatives Dyson, Wilson, Coghill, Stevens, Kohring, and
Cissna were present at the call to order. Representative Joule
arrived as the meeting was in progress.
SB 345 - EDUC. FUNDING/DISABLED/CORRESPONDENCE
CHAIR DYSON announced that the first order of business would be
SENATE BILL NO. 345, "An Act relating to medical assistance for
rehabilitative services for certain children with disabilities;
relating to agreements to pay medical assistance for covered
services paid for or furnished to eligible children with
disabilities by a school district; and providing for an
effective date."
Number 0105
JERRY BURNETT, Staff to Senator Lyda Green, Alaska State
Legislature, presented SB 345 on behalf of the Senate Health,
Education and Social Services Standing Committee, sponsor. He
explained that SB 345 allows schools to become Medicaid
providers for certain special education students who qualify
under the Medicaid program. Under this bill, schools which are
currently required to provide these same services, such as
physical or speech therapy, under the IDEA [Individuals
Disabilities Education Act], receive about 16 percent of the
money for special education services that Congress should be
providing. This bill allows school districts to provide the
services and then bill Medicaid for those services. The school
districts would pay the state match, so there is no additional
cost to the state. It allows the school districts in Alaska to
generate about $7 million in additional funding for special
programs, with no additional cost to the state other than the
small administrative fiscal note. He said 42 other states do
this.
Number 0245
REPRESENTATIVE WILSON asked if this is just transferring the
responsibility from the state to the school district or if the
districts actually gain some money.
Number 0275
MR. BURNETT answered that right now the schools provide these
services with the general fund money received under the school
foundation formula. If this bill passes, the school districts
can seek reimbursement from the Medicaid program for those
services that are eligible. Currently, no one can seek the
Medicaid reimbursement. If the federal match rate for Medicaid
is 60:40, that means for a dollar that the districts put at a
state match, they get back $1.50 from the federal government.
He told Representative Wilson that it doesn't transfer any state
responsibility to the schools.
REPRESENTATIVE WILSON asked if the state would provide forms for
the schools or if this will be complicated.
MR. BURNETT agreed it may require some complicated forms to be
filled out. There is a small administrative fiscal note that's
with the bill to help with training and setting up the program.
He noted that the school districts would not be required to do
this for any student.
Number 0475
REPRESENTATIVE KOHRING asked if there was any concern as far as
this encouraging more spending in Medicare than was necessary.
MR. BURNETT replied that he didn't think it would, but that has
been discussed. He explained that the students have to have an
IEP [individual education plan] to qualify for this, and those
students are getting those services now. There could be some
legitimate concern that a school district could decide to
provide more services for students who are Medicaid eligible
than for students that aren't. But, the school district would
be under pressure not to do that, and he said he can't imagine
that the educators would do that.
Number 0535
REPRESENTATIVE STEVENS asked what the districts would be
required to do that they are not now doing.
MR. BURNETT suggested that the department could answer that
better, but basically the difference between what is being done
now and what will be done is billing Medicaid. The difference
would be paperwork, he noted.
Number 0575
REPRESENTATIVE COGHILL commented that he thinks IDEA has been
characterized as an unfunded mandate. He wondered if this bill
would change that a little bit.
MR. BURNETT replied yes, that was most of the point for doing
this.
Number 0616
BOB LABBE, Director, Division of Medical Assistance, Department
of Health & Social Services, expressed support of SB 345. He
noted that the schools will participate voluntarily, and each of
the districts will have to assess the cost benefit of entering
into this, because it does require some build up of
administrative structure. The intent is to have something
streamlined to the extent possible under a Medicaid program, and
to do it in a way that is less burdensome, but there are
requirements that will need to be met.
Number 0738
MR. LABBE expressed concern about the provider complying with
the regulations to avoid potential pitfalls of recoupment or
other types of activity that could occur if people weren't
diligent. He noted that there is some ability to tailor the
requirements and the services. Most of the states participating
in this have generated some revenue, but they've also had to
jump through some hoops. It isn't necessarily an easy thing to
do, but this legislation will get the discussion started on
policy and the best way to do it.
Number 0790
CHAIR DYSON asked what part of the fiscal note is general fund
dollars that will be used to prepare the forms and the
administrative procedures.
MR. LABBE answered that it amounts to about $52,000 in 2003,
$40,000 in 2004, $54,000 in 2005, and then drop back to $51,000
for on going. He explained that the costs to modify the
computer system is generally matched at 75 percent; but the
staff effort is generally matched at 50 percent.
REPRESENTATIVE STEVENS asked about the funding.
Number 0937
GREG MALONEY, Special Education, Teaching and Learning Support,
Department of Education & Early Development, replied that the
funds used now are a mixture of local, state, and federal funds
to provide the services. This bill would be another "catchment
of services" that is allowed under the IDEA to help pay for
those services. He replied to an earlier question and told the
committee that the services covered are speech and language
therapy, occupational therapy, physical therapy; those types of
services which have a licensed provider providing those services
within the school. Another set of services are medical services
that are now being required to be provided in the schools.
Since the conclusion of several court cases, schools now have a
larger responsibility for providing medical services in the
school setting. This bill then allows the federal funds to
offset some more of those costs without significant cost to the
state, he noted.
REPRESENTATIVE STEVENS asked for clarification on the funding.
Number 1073
MR. MALONEY explained that the expectation is that approximately
$7 million in costs, once the system is fully ramped up, would
be able to be billed as Medicaid. After the match was taken
out, it would create about $4 million in new revenue for the
districts, and that could be a conservative estimate. There
would be new revenue that districts would be able to use to
provide the services. He indicated that there plans to be a
group of stakeholders to look at what will be the most feasible
system for reimbursement. He noted that it's a voluntary
system.
MR. MALONEY explained that the match would not require up-front
funds but would come after the Medicaid reimbursement. The
district would never be required to put funds up front. He
commented that electronic billing is being looked at to ease the
burden on the districts. He said, hopefully, the impact on
districts would be limited. Also taken into account has been
rural districts versus urban districts and making sure that
everyone has an equal opportunity to participate, and there will
be benefits for all. In some of the smaller districts, the
benefits are going to be smaller, but he reiterated that there
would be new revenue coming in.
Number 1146
CHAIR DYSON asked if the schools are not providing all these
services now, will they be required to provide more services.
MR. MALONEY replied that that is not expected. Under federal
law and state law, the districts are providing the services
developed by the IEP team. With additional funds, it is hoped
there will be improved services. He said that extra services
wouldn't be expected, because the incentive to provide
additional services coming from Medicaid alone is not strong
enough, because the paperwork or the challenge of providing the
services, even with this additional revenue, is going to
outweigh the incentive.
Number 1253
REPRESENTATIVE WILSON asked for an explanation on the fiscal
note where it says, "Districts would reimburse the Department of
Health and Social Services for the state match required."
MR. MALONEY answered that while there is no process attached to
this legislation that says how it exactly would happen, the
expectation is that once a district bills its Medicaid-eligible
cost, it would receive 100 percent reimbursement; from that
allotment, it would return a check back to the state that covers
the match requirement. It may sound like duplicative efforts,
but this makes sure that the audit trail is clean. It shows
that the matching requirements are met, there is no additional
burden on the districts, and the funds are able to be cleanly
disbursed.
Number 1320
MR. LABBE said one of the concerns was to make sure that there
was no additional cost to the state program for putting this in.
Normally if a new service is added to Medicaid, there would be a
new state general fund cost to draw down the federal funds. In
this case, the district will be providing the match, but instead
of getting 100 percent of the payment, they're getting the
federal share of the payment because they are responsible for
the match. Instead of the districts sending the state funding
for the match, the state will forward fund it and get the match
back from the districts. He agreed it was a bit circular, but
that makes the audit trail for the federal government easier to
find, so it doesn't have to audit all the school districts to
see if there were actually matching funds available for payment
claimed.
Number 1483
REPRESENTATIVE WILSON asked Mr. Labbe to track the trail of the
money.
MR. LABBE answered the school sends the state a bill for the
services; the state pays the district for that service; the
state collects back from the district the amount for the state
match for the federal funds; the state bills the federal
government and the federal government pays the state.
Number 1595
REPRESENTATIVE STEVENS asked what happens to the districts who
choose not to enter the program.
MR. MALONEY answered that no change would be expected.
Districts are currently receiving a portion of Medicaid funds
under the "admin capturement." It's based on a time survey
that's done; it's not a direct billing reimbursement system, and
that would stay in place. These additional funds would be for
direct reimbursement. So if a district chose to participate in
that system, it would get those funds. If it chose not to, then
the system would just be the same. The real purpose of this
funding is to give districts a better shot at providing the
services they are required to provide. There are some very
expensive programs that districts are not able to get additional
support for. This bill will help provide some significant
support for on-going costs. It may be complicated in
description, but the actual process for application does not
have to be that complicated. He indicated that the stakeholders
group would discuss how best to get that process in place.
REPRESENTATIVE STEVENS asked if there would be any penalties to
those districts who chose not to enter the program. He said he
assumes that most districts would voluntarily enter the program.
Number 1659
MR. LABBE said each district would have to make an assessment.
There might be a district that had only one child with expensive
service, but it still might be worthwhile to participate even
for one child on Medicaid. On the other hand, it may not be
worth it if the cost of the services is less than the cost of
complying. The bigger districts will certainly see a benefit;
the smaller ones may see a benefit depending upon their
caseload. The state will work with them on the assessment.
Number 1715
REPRESENTATIVE COGHILL commented that the federal government is
going through a revamp of IDEA and wondered how that would
interface with this.
MR. MALONEY answered that the reauthorization of IDEA is
expected to move forward, and this is one of the topics being
discussed around the country, because there are conflicts in
federal law regarding special education and Medicaid. He told
the members that there has been discussion with the Medicaid
folks in Washington, D.C., and there has been no indication of
any interference or conflict.
Number 1765
REPRESENTATIVE COGHILL moved to report SB 345 out of committee
with individual recommendations and the accompanying fiscal
notes. There being no objection, SB 345 was reported out of the
House Health, Education and Social Services Standing Committee.
SB 182 - PRO RATA REDUCTIONS IN BENEFIT PROGRAMS
CHAIR DYSON announced that the next order of business would be
CS FOR SENATE BILL NO. 182(FIN), "An Act requiring reductions in
payments to individuals under certain benefit programs if
appropriations are not sufficient to fully fund the statutorily
established levels of payments."
Number 1791
MARILYN WILSON, Staff to Senator Dave Donley, Alaska State
Legislature, presented SB 182 on behalf of the Senate Finance
Committee, sponsor. She read the following:
Committee Substitute for SB 182 recognizes the reality
that funds may not always be available to fund
individual benefit payments at the statutorily
suggested level. If this should occur, individuals
who rely on these programs would only receive benefits
until the money runs out for that fiscal year. This
legislation provides a contingency in the event that a
funding shortage occurs in the future.
Senate Bill 182 would allow program directors to
reduce benefit payments on a pro rata basis should
funding for that program be insufficient. It would
require proration irregardless of possible
supplemental funding when so directed by legislative
intent in the budget.
While this would reduce each payment, it would extend
payments over the full 12-month period, thus allowing
the legislature and administration to respond to
reductions in revenue and increases in program
recipients in a simple and practical manner. This
proposed bill specifically excludes loan programs,
subsidies for hard-to-place children, fishermen's
fund, workers' compensation fund, second injury fund,
retirement programs, and programs for which other
provisions of law address underfunding.
Number 1855
CHAIR DYSON asked what things would be included.
MS. WILSON replied that the list includes the longevity bonus
program, medical assistance, catastrophic and chronic illness
assistance, foster care, general relief assistance, and adult
public assistance. She suggested that the administration may be
able to add to the list.
Number 1985
ELLEN NORTHUP, State Food Coalition, testified on behalf of the
food coalition and herself. She noted that this bill does not
affect her, but it could if circumstances changed in her life.
She said she does have many elderly friends who would be
affected by this bill. She told the committee that many elderly
people count totally on the longevity bonus to make their rent
payments, and it would be problematic if that fluctuates. She
indicated that this bill would cause havoc among the very poor.
She mentioned that she is really worried about the foster care
people, because it is so difficult to get decent people to be
foster parents, and there is never enough money to pay for the
real support of the child. She encouraged the legislature to
appropriate enough money for foster care. She urged the
committee not to pass this bill.
CHAIR DYSON asked Ms. Northup what she would choose when there
isn't enough money to fund all the things, and it comes down to
two choices: either get a little less each month or get cut off
at the end of the last month or two.
MS. NORTHUP answered that she believes there is a third choice
of a supplemental appropriation.
Number 2160
PELTON GOUDEY, Foster Care Association, testified via
teleconference. He expressed concern on how this would affect
foster parents, and he acknowledged how difficult it is to
recruit new foster parents. He urged the State of Alaska to get
additional money for these programs through sales taxes or
income taxes.
Number 2296
CORNELIA HUEBSCHER, National Alliance for the Mentally Ill
(NAMI), Sitka, testified via teleconference on behalf of NAMI
and as a consumer of these services. She read from the analysis
on fiscal note number 4:
Many of the individuals who rely on this monthly cash
assistance lead very frugal lives and have limited
resources, reductions in any amount will leave these
clients with having to choose between such things as
paying the electric bill or buying food. Adult Public
Assistance payments have been held steady since 1993
without cost-of-living adjustments. These blind,
disabled, and elderly clients have already had to cut
costs just because of the higher cost-of-living in the
last ten years.
MS. HUEBSCHER told the committee that she receives Adult Public
Assistance because she is disabled. She said she may have to
choose between food and electricity. Many clients on disability
due to mental health are productive community members through
volunteering when they can. If this bill passes, many people
will be forced into group homes or be out on the street or be in
nursing homes for the elderly. She urged the committee not to
pass SB 182.
TAPE 02-35, SIDE B
Number 2364
CHERYL JEBE, President, League of Women Voters of Alaska, read
the following resolution passed by the League of Women Voters of
Alaska on April 7, 2002: [Original punctuation provided]
Whereas, the laws of the State of Alaska provide for
assistance with basic support for low-income families,
the elderly and disabled; and
Whereas, basic support programs promote self-
sufficiency for low-income families, and
Whereas, basic support programs also allow the elderly
and disabled to live with dignity in their own
communities; and
Whereas, SB 182 allows the legislature to disregard
actual need for a benefit program, and instead under
fund basic support programs; and
Whereas, the state agency determining the benefit
program would then be required to prorate the benefit,
reducing the amount of the benefit to all recipients,
and
Whereas, a fluctuating benefit will cause instability
in the lives of Alaska's most vulnerable citizens; and
Whereas, the League of Women Voters position on
meeting basic human needs calls for benefit levels to
be sufficient to provide decent, adequate standards
for food, clothing and shelter and to be uniform based
on needs,
Now, therefore, be it resolved that the League of
Women Voters of Alaska opposes passage of SB 182.
Number 2250
DARYL NELSON, Access Alaska, testified via teleconference. He
stated that he was appalled at this bill and told the committee
that people on public assistance are going to be hurt by this.
Number 2218
JESSIE JOHNNIE, Elder, testified via teleconference. She told
the committee that the Elders passed a resolution, and she faxed
it to Representative Wilson and the other committee members.
She told the committee that her Social Security check is $400 a
month, and she cannot survive on that. She expressed opposition
to SB 182. She reported that some of the other residents who
live in the same apartments for the elderly that she does also
oppose this bill.
Number 2110
MARIE DARLIN, AARP, testified in opposition to SB 182. She
referred to a letter from AARP that states the concerns about
several of the programs that would be cut. In looking at this
as a method of reducing the costs of government and budget, she
indicated that there is concern about his method because many of
these benefit programs are preventive measures that keep people
out of more expensive programs, which can cost the state more in
the long run.
Number 2045
TONY LOMBARDO, Covenant House, testified via teleconference on
behalf of Covenant House, a privately funded, nonprofit charity.
He read the following testimony:
In addition to our emergency shelter, we have a
program in Anchorage called Passage House, which helps
teen moms transition off public assistance and into
self-sufficiency. I speak to you today on their
behalf.
Most Passage House moms come to us barely surviving on
ATAP [Alaska Temporary Assistance Program] and WIC
[Special Supplemental Nutrition Program for Women,
Infants, and Children]. We help [them] stabilize
their lives, find affordable day care, learn life
skills like money management, find a job and over the
course of about 18 months, [and] transition off of
public assistance.
They come to us because they know that they are barely
making it, and often fear that one false step will
result in life on the street and possibly [the] loss
of their children or child to the state's protective
custody.
The uncertainty that this bill would create in the
meager budgets of young moms, like those coming to
Passage House, is too great. Those teen moms who
could otherwise come to us for help might lose their
children to state services before they ever get to
Passage House. We need less babies in state custody,
not more. We need more programs transitioning poor
moms and babies into self-sufficiency and off public
assistance, but these moms do not need any more
financial crisis or uncertainty.
In addition, if this bill passes, foster parents would
not necessarily know from month to month how much
income to factor into their budget. The added
difficulties could discourage foster parents from
participating in the program. We already have a
shortage of foster care homes in this state. If we
wreck the fragile homes maintained by moms like those
at Passage House, the state will need somewhere to
place those children.
In short, Covenant House is opposed to the apparent
intent of this bill. It would be unreasonable to
introduce our state budgetary uncertainty into the
health, safety and welfare of our poorest families.
Thank you.
Number 1964
LYN FREEMAN, Executive Director, Alaska Commission on Aging,
Division of Senior Services, Department of Administration,
testified that the commission passed a resolution opposing
SB 182, and she reviewed the resolution for the committee.
Essentially the primary role of these basic supports is to allow
a consistent way for individuals to pay for the most basic
expenses of living, food, shelter, clothing, medical, and
transportation. It would allow Alaskans to live independently
and in communities of their choice. She stressed that that is
very important to the commission. She noted that these basic
supports also avert problems such as homelessness and prevent
the higher costs that often come in hospitals and nursing homes.
She summarized that the Alaska Commission on Aging opposes
efforts to prorate these most essential programs. She urged the
committee to oppose SB 182.
Number 1910
MARIE LAVIGNE, Executive Director, National Association of
Social Workers (NASW), Alaska Chapter, testified via
teleconference. She said NASW represents over 500 social
workers in Alaska. This professional social worker organization
serves Alaska's most vulnerable citizens: the poor, the
elderly, the disabled, those in foster care, and working
families on assistance; those very citizens who will be impacted
if SB 182 passes. She declared that the NASW strongly opposes
this bill.
MS. LAVIGNE expressed three main concerns on SB 182: It erodes
the safety net for those who are the most vulnerable; it
unfairly targets those living on fixed incomes; and it
circumvents the budget process. For the blind, the disabled,
the elderly, the poor, and children in foster care who receive
benefits, such programs are their safety net. The vulnerable
Alaskans are able to meet their basic needs and work towards
self-sufficiency through the benefits they receive. Yet SB 182,
if passed, will unfairly target those on fixed incomes. It's
heralded as a cost saving, but SB 182 will pass the budget
shortfalls back onto the most vulnerable Alaskans by reducing
monthly payments to all beneficiaries.
Number 1830
MS. LAVIGNE asked the committee to imagine living on a fixed
income and having it fluctuate without warning because of budget
shortfalls. This bill directly impacts those on limited
incomes, but it also impacts landlords, utility companies, and
small businesses. This is a step backwards in welfare reform,
she commented. She pointed out that NASW is also concerned that
this bill circumvents the budget process. Its passage would
mean that the level of assistance provided by these programs
could plummet from one month to the next without warning,
without public debate, and without legislative change in the
statutory formula that now governs benefits. The bottom line is
there needs to be a long-term fiscal plan and not more budget
cuts. She urged the committee to stop this bill from going
forward.
Number 1776
ALISON ELGEE, Deputy Commissioner, Department of Administration,
agreed that SB 182 would affect the Longevity Bonus Program if
the legislature chose to prorate benefits by making a budgetary
decision. She pointed out that the committee has heard all the
social reasons why this is a very bad idea. She indicated that
it impacts the poorest seniors the most dramatically, and those
same seniors could be impacted at the same time by a cut to
Adult Public Assistance. People on fixed incomes would be very
vulnerable to the ability to pay bills if the assistance
payments fluctuate. More than that, the department opposes the
process by which those decisions would be made. The idea that a
decision could be made to amend the Longevity Bonus Program by a
budget committee operating in a conference committee environment
at the end of session and not have any public debate about the
consequences of those actions is wrong. She commented that if
the legislature wants to change the level of benefits, it should
be done through the regular statutory review process.
Number 1680
ELMER LINDSTROM, Deputy Commissioner, Department Health and
Social Services, testified that the department believes the
following programs will be impacted: Foster Care Program,
Alaska Temporary Assistance Program (ATAP), Longevity Bonus
Program, and Adult Public Assistance Program (APA), which is the
cash assistance to the blind, disabled, and elderly. He
suggested that there may be some unintended consequences as
well.
MR. LINDSTROM pointed out that ATAP and APA are not extravagant
benefit programs. He referred to the handouts that show the
Alaska Poverty Level for ATAP and APA. He told the committee
that neither of these programs is adjusted for inflation in any
way. The value of those benefits has eroded over time by virtue
of inflation. Someone receiving ATAP benefits in 2002 as the
only source of income is at the 59 percent poverty level. The
APA has eroded from 110 percent of the federal poverty level
back in 1992 to 99 percent of the federal poverty level in 2002.
He commented that is not an extravagant lifestyle.
MR. LINDSTROM expressed concern about these benefits getting
reduced at the end of session with no public input. He
suggested making any changes to the programs through the normal
statutory process, not simply as a budget adjustment by the
conference committee.
Number 1444
REPRESENTATIVE JOULE noted that these programs had already been
reduced a small percentage in the budget and wondered if SB 182
passed, what additional reduction might there be.
MR. LINDSTROM replied that he couldn't predict that at this
point; there are too many uncertainties. Even if the
legislature intended to fully fund a program, things can happen
during the year, and the state could be short funded. A number
of these programs are dependent on federal funding sources,
which are somewhat stable, but things could come up to change
that. He reiterated that there is a lot of potential for
unintended consequences.
Number 1177
REPRESENTATIVE STEVENS asked Mr. Lindstrom to comment on the
testimony about people being forced out of their homes into
state-supported long-term care.
MR. LINDSTROM answered that he didn't have any data to support
that, but intuitively, it seems apparent that that is a likely
outcome in some cases. People are trying to remain in their
homes independently, and yet they are on a fixed income. If
their income is reduced, at some point they are going to have no
other choice but to seek assistance, which would likely be more
expensive to the state.
CHAIR DYSON commented that the budget is the best estimate, but
often the legislature passes a supplemental budget to make up
any shortfalls. He wondered if the legislature has ever not
funded a supplemental budget for these programs.
MR. LINDSTROM replied that he had no recollection of a situation
such as that.
CHAIR DYSON asked what would happen if the legislature did not
fund the shortfall in the supplemental.
MR. LINDSTROM answered that these programs are entitlements. He
used foster care as an example, and said he assumes if they have
children to place in foster families, at the end of the day,
there would be a legal obligation to reimburse those foster
families.
Number 0854
MS. ELGEE responded to the question by Representative Stevens on
long-term care. She explained that the CHOICE [The Community
and Home Options to Institutional Care for the Elderly and
Disabled] waiver for the elderly program administered through
the Division of Senior Services is for people who qualify for
nursing home care. They could be in a nursing home, but they
choose to remain in their own homes. Medicaid only pays for
services; it does not pay for the cost of living, whether its
room and board in an assisted living environment or the room and
board at home. She reported that there are approximately 1,500
people on the CHOICE program, and two-thirds of those people
live in their own homes. Those are the people at risk if the
underlying support is cut.
Number 0795
THERESA TANOURY, Director, Central Office, Division of Family &
Youth Services, Department of Health & Social Services,
testified about the impacts of SB 182 on the Foster Care
Program. She confirmed that the foster parent stipend is very
low, and people don't become foster parents to get rich.
Currently, the foster care payment is set at the 1993 poverty
levels. Alaska is well below where it needs to be in paying
foster parents for the care they provide. Foster parents going
in to this know that they're not going to get rich or make money
on this. The average payment is $22.34 a day.
MS. TANOURY expressed concern about telling foster parents that
the payment may be reduced, and that could cause uncertainty in
a child's life if he/she can't remain in that home. Many foster
parents have told her that they can't afford to lose money on
this. There is a struggle today to recruit and retain foster
parents, and she said she thought that SB 182 would hurt those
efforts even more. She indicated that some of the foster kids
will have to be put in care that will cost more. She encouraged
the committee to think about the impacts of this bill on the
Foster Care Program.
Number 0599
KATHLEEN WARWICK testified on her own behalf as a resident of
Mountain View Apartments. She wondered how she would be able
live on APA if the benefits were cut.
Number 0540
PAULETTE ALDEN testified on her own behalf as a resident of
Mountain View Apartments. She is on APA, and if it is cut, she
told the members that it will hurt her and everyone who is on
APA. She said it wasn't fair.
Number 0470
EUGENE WARWICK expressed concern about living on $10 worth of
food stamps a month.
CHAIR DYSON closed the public hearing on SB 182. He announced
that SB 182 would be held over.
The committee took an at-ease from 4:34 p.m. to 4:35 p.m.
TAPE 02-36, SIDE A
Number 0001
HB 522 - MEDICAID PAYMENTS FOR ABORTION
CHAIR DYSON announced that the final order of business would be
HOUSE BILL NO. 522, "An Act relating to medical services under
the state Medicaid program."
Number 0063
CHAIR DYSON presented HB 522. He explained that it is an
attempt for the legislature to define which class of abortions
will and will not be paid for with public funds and set some
limits on what is classified as medical necessity. There have
been several efforts by the legislature to set the elective
abortion funding policy in the appropriation process and one or
two court challenges in the six years that he's been here. He
explained that this bill and its companion bill in the Senate
tries to meet the criteria that were set forth in the court
cases and to follow the guidelines set out in the federal
legislation, in the Hyde Amendment, in which public money will
be used for funding abortions if the pregnancy is a result of
rape and incest, and if the life of the mother is at stake. In
his view, the "life of the mother" has been expanded to the
"life and health of the mother," and the question has become:
What are medically necessary abortions in order to protect the
health of the mother?
CHAIR DYSON said he thinks the whole subject of abortion is
painful. No matter which side people take, he said that he
knows of no one who wants there to be abortions. His
understanding of the issue is: If it is an elective abortion
and the life of the mother is not in question, should public
funds be used to pay for the abortion; and Should people who
have an absolute moral repugnance to taking the life of an
unborn child be forced to participate with their money in
something that is not necessary to protect the life of the
mother? He concluded that this legislation tries to define what
abortions will be paid for that are on that edge.
CHAIR DYSON announced that due to technical difficulties with
the teleconference, HB 522 would be held over.
ADJOURNMENT
Number 0416
There being no further business before the committee, the House
Health, Education and Social Services Standing Committee meeting
was adjourned at 4:42 p.m.
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