04/22/2003 03:27 PM House HES
| Audio | Topic |
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+ teleconferenced
= bill was previously heard/scheduled
ALASKA STATE LEGISLATURE
HOUSE HEALTH, EDUCATION AND SOCIAL SERVICES
STANDING COMMITTEE
April 22, 2003
3:27 p.m.
MEMBERS PRESENT
Representative Peggy Wilson, Chair
Representative Carl Gatto, Vice Chair
Representative John Coghill
Representative Paul Seaton
Representative Kelly Wolf
Representative Sharon Cissna
MEMBERS ABSENT
Representative Mary Kapsner
COMMITTEE CALENDAR
CS FOR SENATE BILL NO. 25(FIN)
"An Act relating to the acquisition of teachers' housing by
regional educational attendance areas and to teachers' housing
loan programs in the Alaska Housing Finance Corporation; and
providing for an effective date."
- MOVED HCS CSSB 25(HES) OUT OF COMMITTEE
CS FOR SENATE BILL NO. 105(HES) am(efd fld)
"An Act relating to eligibility requirements for medical
assistance for certain children, pregnant women, and persons in
a medical or intermediate care facility."
- MOVED HCS CSSB 105(HES) OUT OF COMMITTEE
SENATE BILL NO. 124(efd fld)
"An Act relating to grants for alcoholism and drug abuse
programs."
- MOVED HCS SB 124(HES) OUT OF COMMITTEE
PREVIOUS ACTION
BILL: SB 25
SHORT TITLE:TEACHERS' HOUSING/AHFC LOANS
SPONSOR(S): SENATOR(S) WILKEN
Jrn-Date Jrn-Page Action
01/21/03 0021 (S) PREFILE RELEASED 1/17/03
01/21/03 0021 (S) READ THE FIRST TIME -
REFERRALS
01/21/03 0021 (S) HES, FIN
02/12/03 (S) HES AT 1:30 PM BUTROVICH 205
02/12/03 (S) Heard & Held
02/12/03 (S) MINUTE(HES)
02/24/03 (S) HES AT 1:30 PM BUTROVICH 205
02/24/03 (S) Moved Out of Committee
02/24/03 (S) MINUTE(HES)
02/26/03 0272 (S) HES RPT CS 3DP 1NR 1AM SAME
TITLE
02/26/03 0272 (S) DP: DYSON, DAVIS, WILKEN;
02/26/03 0272 (S) NR: GUESS; AM: GREEN
02/26/03 0272 (S) FN1: ZERO(REV)
02/26/03 (S) MINUTE(HES)
03/06/03 (S) FIN AT 9:00 AM SENATE FINANCE
532
03/06/03 (S) Heard & Held
03/06/03 (S) MINUTE(FIN)
03/11/03 (S) FIN AT 9:00 AM SENATE FINANCE
532
03/11/03 (S) Scheduled But Not Heard
03/12/03 (S) FIN AT 9:00 AM SENATE FINANCE
532
03/12/03 (S) Moved CSSB 25(FIN) Out of
Committee
03/12/03 (S) MINUTE(FIN)
03/13/03 0489 (S) FIN RPT CS 5DP 1DNP 1NR NEW
TITLE
03/13/03 0489 (S) DP: WILKEN, TAYLOR, HOFFMAN,
OLSON,
03/13/03 0489 (S) STEVENS B; DNP: GREEN; NR:
BUNDE
03/13/03 0489 (S) FN1: ZERO(REV)
03/17/03 0522 (S) COSPONSOR(S): STEVENS G,
DYSON, SEEKINS
03/31/03 0641 (S) RULES TO CALENDAR 3/31/2003
03/31/03 0641 (S) READ THE SECOND TIME
03/31/03 0642 (S) FIN CS ADOPTED UNAN CONSENT
03/31/03 0642 (S) ADVANCED TO THIRD READING
UNAN CONSENT
03/31/03 0642 (S) READ THE THIRD TIME CSSB
25(FIN)
03/31/03 0642 (S) COSPONSOR(S): LINCOLN
03/31/03 0642 (S) PASSED Y16 N1 E3
03/31/03 0643 (S) EFFECTIVE DATE(S) SAME AS
PASSAGE
03/31/03 0648 (S) TRANSMITTED TO (H)
03/31/03 0648 (S) VERSION: CSSB 25(FIN)
04/02/03 0729 (H) READ THE FIRST TIME -
REFERRALS
04/02/03 0729 (H) HES, FIN
04/02/03 0751 (H) CROSS SPONSOR(S): LYNN
04/11/03 0947 (H) CROSS SPONSOR(S): ROKEBERG
04/15/03 (H) HES AT 3:00 PM CAPITOL 106
04/15/03 (H) Heard & Held
MINUTE(HES)
04/22/03 (H) HES AT 3:00 PM CAPITOL 106
BILL: SB 105
SHORT TITLE:MEDICAID:CHILDREN/PREGNANT WOMEN/FACILITY
SPONSOR(S): RLS BY REQUEST OF THE GOVERNOR
Jrn-Date Jrn-Page Action
03/06/03 0389 (S) READ THE FIRST TIME -
REFERRALS
03/06/03 0389 (S) HES, FIN
03/06/03 0389 (S) FN1: (HSS)
03/06/03 0389 (S) GOVERNOR'S TRANSMITTAL LETTER
03/26/03 (S) HES AT 1:30 PM BUTROVICH 205
03/26/03 (S) Heard & Held
03/26/03 (S) MINUTE(HES)
03/26/03 (S) MINUTE(HES)
03/26/03 (S) MINUTE(HES)
04/03/03 (S) HES AT 5:00 PM BELTZ 211
04/03/03 (S) Scheduled But Not Heard --
Time and Location Change --
04/07/03 (S) FIN AT 10:00 AM SENATE
FINANCE 532
04/07/03 (S) <Pending Referral> -- Meeting
Canceled --
04/07/03 (S) HES AT 1:30 PM BUTROVICH 205
04/07/03 (S) Moved CSSB 105(HES) Out of
Committee
MINUTE(HES)
04/08/03 0746 (S) HES RPT CS 3DP 2DNP SAME
TITLE
04/08/03 0747 (S) DP: DYSON, GREEN, WILKEN;
04/08/03 0747 (S) DNP: GUESS, DAVIS
04/08/03 0747 (S) FN1: (HSS)
04/09/03 0763 (S) FIN RPT CS(HES) 4DP 2DNP
04/09/03 0763 (S) DP: GREEN, WILKEN, BUNDE,
STEVENS B;
04/09/03 0763 (S) DNP: HOFFMAN, OLSON
04/09/03 0763 (S) FN2: (HSS)
04/09/03 0763 (S) RULES TO CALENDAR 4/9/2003
04/09/03 0765 (S) READ THE SECOND TIME
04/09/03 0765 (S) HES CS ADOPTED Y11 N8 E1
04/09/03 0765 (S) ADVANCED TO THIRD READING
4/10 CALENDAR
04/09/03 (S) FIN AT 9:00 AM SENATE FINANCE
532
04/09/03 (S) Moved Out of Committee
04/09/03 (S) MINUTE(FIN)
04/10/03 0787 (S) READ THE THIRD TIME CSSB
105(HES)
04/10/03 0787 (S) RETURN TO SECOND FOR AM 1
UNAN CONSENT
04/10/03 0787 (S) AM NO 1 ADOPTED Y12 N7 E1
04/10/03 0788 (S) AUTOMATICALLY IN THIRD
READING
04/10/03 0789 (S) PASSED Y12 N7 E1
04/10/03 0789 (S) EFFECTIVE DATE(S) FAILED Y12
N7 E1
04/10/03 0789 (S) ELLIS NOTICE OF
RECONSIDERATION
04/11/03 0814 (S) RECONSIDERATION NOT TAKEN UP
04/11/03 0815 (S) TRANSMITTED TO (H)
04/11/03 0815 (S) VERSION: CSSB 105(HES) AM(EFD
FLD)
04/14/03 0957 (H) READ THE FIRST TIME -
REFERRALS
04/14/03 0957 (H) FIN
04/16/03 1017 (H) HES REFERRAL ADDED BEFORE FIN
04/22/03 (H) HES AT 3:00 PM CAPITOL 106
BILL: SB 124
SHORT TITLE:ALCOHOLISM AND DRUG ABUSE GRANTS
SPONSOR(S): RLS BY REQUEST OF THE GOVERNOR
Jrn-Date Jrn-Page Action
03/06/03 0414 (S) READ THE FIRST TIME -
REFERRALS
03/06/03 0414 (S) HES, FIN
03/06/03 0414 (S) FN1: (HSS); FN2: (HSS)
03/06/03 0415 (S) FN3: (HSS); FN4: (HSS)
03/06/03 0415 (S) GOVERNOR'S TRANSMITTAL LETTER
03/10/03 (S) HES AT 1:30 PM BUTROVICH 205
03/10/03 (S) Moved Out of Committee
03/10/03 (S) MINUTE(HES)
03/12/03 0468 (S) HES RPT 2DP 1NR 1AM
03/12/03 0468 (S) DP: DYSON, GREEN;
03/12/03 0468 (S) NR: GUESS; AM: DAVIS
03/12/03 0468 (S) FN1: (HSS); FN2: (HSS)
03/12/03 0468 (S) FN3: (HSS); FN4: (HSS)
04/02/03 (S) FIN AT 9:00 AM SENATE FINANCE
532
04/02/03 (S) Heard & Held
04/04/03 0688 (S) FIN RPT 4DP 2NR
04/04/03 0688 (S) DP: GREEN, WILKEN, STEVENS B,
BUNDE;
04/04/03 0688 (S) NR: TAYLOR, OLSON
04/04/03 0688 (S) FN1: (HSS); FN2: (HSS)
04/04/03 0688 (S) FN3: (HSS): FN4: (HSS)
04/04/03 (S) FIN AT 9:00 AM SENATE FINANCE
532
04/04/03 (S) Moved Out of Committee
04/04/03 (S) MINUTE(FIN)
04/09/03 0768 (S) RULES TO CALENDAR 4/9/2003
04/09/03 0768 (S) READ THE SECOND TIME
04/09/03 0768 (S) ADVANCED TO THIRD READING
4/10 CALENDAR
04/10/03 0792 (S) READ THE THIRD TIME SB 124
04/10/03 0792 (S) PASSED Y11 N8 E1
04/10/03 0793 (S) EFFECTIVE DATE(S) FAILED Y12
N7 E1
04/10/03 0793 (S) ELLIS NOTICE OF
RECONSIDERATION
04/11/03 0815 (S) RECONSIDERATION NOT TAKEN UP
04/11/03 0816 (S) TRANSMITTED TO (H)
04/11/03 0816 (S) VERSION: SB 124(EFD FLD)
04/14/03 0958 (H) READ THE FIRST TIME -
REFERRALS
04/14/03 0958 (H) HES, FIN
04/22/03 (H) HES AT 3:00 PM CAPITOL 106
WITNESS REGISTER
LARAINE DERR, President
Alaska State Hospital and Nursing Home Association (ASHNHA)
Juneau, Alaska
POSITION STATEMENT: During hearing on SB 25, offered statistics
and answered questions.
SHEILA PETERSON, Staff
to Senator Gary Wilken
Alaska State Legislature
Juneau, Alaska
POSITION STATEMENT: Spoke on behalf of the sponsor of SB 25.
PAUL KAPANSKY, Mortgage Operations Director
Alaska Housing Finance Corporation (AHFC)
Department of Revenue
Anchorage, Alaska
POSITION STATEMENT: Answered questions related to the HCS for
CSSB 25, Version U.
DANIEL R. FAUSKE, Chief Executive Officer/Executive Director
Alaska Housing Finance Corporation (AHFC)
Department of Revenue
Anchorage, Alaska
POSITION STATEMENT: Answered questions related to the HCS for
CSSB 25, Version U.
LAURIE HOLTE, Residential Loan Officer
Chief Underwriting Supervisor
Alaska Housing Finance Corporation (AHFC)
Department of Revenue
Anchorage, Alaska
POSITION STATEMENT: Answered questions during discussion of the
HCS for CSSB 25, Version U.
JOHN RILEY, Physician Assistant
Anchorage, Alaska
POSITION STATEMENT: Testified on SB 105.
BOB LABBE, Deputy Commissioner
Department of Health & Social Services (DHSS)
Juneau, Alaska
POSITION STATEMENT: Testified on the HCS for CSSB 105,
Version H, and the fiscal note.
ACTION NARRATIVE
TAPE 03-35, SIDE A
Number 0001
CHAIR PEGGY WILSON called the House Health, Education and Social
Services Standing Committee meeting to order at 3:27 p.m.
Representatives Wilson, Gatto, Wolf, and Coghill were present at
the call to order. Representatives Seaton and Cissna arrived as
the meeting was in progress.
SB 25-TEACHERS' HOUSING/AHFC LOANS
CHAIR WILSON announced that the first order of business would be
CS FOR SENATE BILL NO. 25(FIN), "An Act relating to the
acquisition of teachers' housing by regional educational
attendance areas and to teachers' housing loan programs in the
Alaska Housing Finance Corporation; and providing for an
effective date."
Number 0126
REPRESENTATIVE GATTO moved to adopt HCS CSSB 25, Version 23-
LS0080\U, Cook, 4/17/03, as the working document. There being
no objection, Version U was before the committee.
CHAIR WILSON said the only difference between Version U and CSSB
25(FIN) is that [Version U] adds registered nurses (RNs). She
pointed out that the shortage of RNs is worse than the shortage
of teachers. Currently, the state has 5,200 RNs, with an 11.5
vacancy rate. Moreover, the 24 percent turnover rate in nursing
indicates difficulty in retention. She noted that 110 nurses a
year are produced in the state. In the next four years, growth
in the [health] industry will result in the need [in Alaska] for
another 4,100 nurses. She said the nursing shortage is
nationwide and thus adding nurses to this legislation makes
sense.
Number 0349
LARAINE DERR, President, Alaska State Hospital and Nursing Home
Association (ASHNHA), agreed with Chair Wilson's statistics.
She said recently ASHNHA reviewed how much money is going
outside each year that hospitals pay for "travelers" to fill
vacant positions. Eleven of the twenty-nine programs that use
nurses throughout the state spend $16.3 million each year
bringing in nurses to fill vacant positions. A small facility
such as Mount Edgecumbe Hospital spends $273,000 for this;
Ketchikan spends $750,000 a year; Bartlett Regional Hospital in
Juneau spends over $370,000 a year; and Providence Health
System, the largest hospital in the state, spends $10.2 million
to bring in nurses, and thus most of that money goes outside.
Ms. Derr opined that [a nurse] who purchases a house is likely
to stay in the area. Thus anything that can be done to keep
nurses in the state is [great].
Number 0492
REPRESENTATIVE GATTO related his belief that many nurses being
brought in from out-of-state probably like the ability to travel
to various states for work.
MS. DERR agreed it's a lifestyle choice for some. She noted
that the [traveling] nurses make a lot more money than those
living in the area.
CHAIR WILSON estimated that the standard rate is over $50 an
hour [for the traveling nurses]. If the nurses used were in-
state, the costs for the hospitals would drop dramatically, she
said.
Number 0588
REPRESENTATIVE COGHILL asked if the greatest need is for RNs.
If someone is a specialized nurse, would that nurse be at this
level or greater?
CHAIR WILSON answered that many nurses are specialized in an
area. Someone can be an RN and obtain specialized
[certification] in several different areas. Although RNs cover
several different kinds of nurses, it does not include a nurse's
aide or a licensed practical nurse (LPN).
REPRESENTATIVE SEATON asked if [the legislation includes
language] that makes nurses who purchase a house not considered
traveling nurses.
CHAIR WILSON explained that [in order to receive the loan] the
nurse would have to be employed by the hospital, which is the
same for the teachers.
REPRESENTATIVE SEATON said it sounds as though some nurses make
the circuit and travel repeatedly to the same location. He
asked if there could be a situation in which a traveling nurse
could purchase a house at 100 percent financing and still remain
a traveling nurse.
CHAIR WILSON specified that in order to obtain the pay of a
traveling nurse, the nurse is not a resident of the state.
Number 0737
MS. DERR said anyone who has worked 80 hours in a facility would
be eligible to purchase a house. However, a traveling nurse is
paid as a special category, and thus the facility would not
provide the benefit of buying a house. This legislation only
applies to permanent employees.
REPRESENTATIVE SEATON said he'd read the legislation to allow a
permanent traveling nurse to qualify for 100 percent financing.
MS. DERR pointed out that the legislation requires having a
state license, which should address the concern.
REPRESENTATIVE SEATON asked if a nurse from Southeast Alaska can
be employed as a traveling nurse at Providence Health Care
System in Anchorage, for example, or whether having a license
from Alaska prevents someone from being a traveling nurse [in
the state].
MS. DERR answered that a nurse from one part of the state can
travel to another facility and be considered a traveling nurse.
REPRESENTATIVE SEATON expressed the need to close the
aforementioned loophole.
CHAIR WILSON suggested inserting the language "who is a
permanent resident of the state" could eliminate the loophole.
REPRESENTATIVE CISSNA said she believes a traveling nurse has a
certain type of contract, which is distinct from the normal
contract. Therefore, the contract should be different.
CHAIR WILSON asked if this could be addressed through the
criteria of the loan when it actually take place.
Number 0970
SHEILA PETERSON, Staff to Senator Gary Wilken, Alaska State
Legislature, responded on behalf of Senator Wilken, sponsor.
Ms. Peterson said she believes the legislation includes language
allowing the Alaska Housing Finance Corporation (AHFC) the
ability to write regulations to implement the loan. However,
she said she wasn't sure whether AHFC would have the authority
to restrict it to exempt traveling nurses. Therefore, if the
committee wished to do so, it should probably be placed in
statute, she suggested.
CHAIR WILSON asked if AHFC will give loans to residents of the
state. If someone is a resident, she said at least that
individual [is likely] to stay in the state.
Number 1024
PAUL KAPANSKY, Mortgage Operations Director, Alaska Housing
Finance Corporation (AHFC), Department of Revenue, explained
that when AHFC reviews a loan for a borrower who is new to the
state, [approval for a loan] would be based on the extent to
which the borrower has shown the intent to establish residency.
CHAIR WILSON asked if a nurse living in Wrangell, where there
was no vacancy, would be able to purchase a house in Wrangell
with no down payment and still go to Providence Health Care
Systems [in Anchorage] and receive traveler's pay.
MR. KAPANSKY answered that [the home purchased with no down
payment] would have to be the nurse's primary residence. He
agreed [AHFC] would take care of that [during the loan process].
CHAIR WILSON wondered whether the language "to be employed and
not under contract" could be added for clarification.
Number 1146
DANIEL R. FAUSKE, Chief Executive Officer/Executive Director,
Alaska Housing Finance Corporation (AHFC), Department of
Revenue, related his belief that it isn't the intent of the
committee to restrict the fact that there may a nurse that lives
in Anchorage but works in the Bush.
CHAIR WILSON replied no.
MR. FAUSKE said he imagined there would be quite a few
situations such as the foregoing.
MR. KAPANSKY pointed out that Version U [on page 2, lines 3-4]
specifies that a loan "may be made under this program only for
owner-occupied, single-family housing."
CHAIR WILSON agreed that would take care of it.
REPRESENTATIVE GATTO posed a situation in which a nurse in
Anchorage works in Fairbanks and her sister, who lives in
Fairbanks, goes to work in Anchorage. In such a situation, each
would be a traveling nurse and still possibly qualify for this
loan, he suggested.
MR. KAPANSKY highlighted that at the time of application, the
nurses would have to indicate to AHFC that the home under the
loan would be the primary residence. What happens after the
loan closes isn't something over which AHFC has control.
REPRESENTATIVE CISSNA inquired as to the criteria AHFC requests
when establishing residency. Is there any requirement as to the
status of the individual's employment?
Number 1273
LAURIE HOLTE, Residential Loan Officer, Chief Underwriting
Supervisor, Alaska Housing Finance Corporation (AHFC),
Department of Revenue, explained that when underwriting an
owner-occupied loan in order to establish that a home is an
individual's primary residence, AHFC reviews whether the
applicant's employment does not take that person away from their
primary residency for more than six months of the year; reviews
whether housing is readily available in the location where the
individual is employed; and reviews the address of residence for
voting privileges, driver's license, and so forth.
CHAIR WILSON directed attention to page 2, lines 15-16, and said
the purpose is to retain teachers and nurses in Alaska. She
reiterated her earlier suggestion that the language "not under a
traveling contract" could be added as one of the criteria.
REPRESENTATIVE CISSNA suggested that the language "not under a
traveling contract outside the state" could be inserted.
CHAIR WILSON offered her belief that the language "outside the
state" isn't necessary.
REPRESENTATIVE SEATON clarified that he didn't want to ensure
another benefit for an individual under a long-term traveling
nurse contract. The idea is to provide an incentive for long-
term traveling nurses to convert to registered nurses in the
state. Therefore, Representative Seaton said he believes the
legislation should include language specifying that someone
qualifying for the loan may not maintain employment as a
traveling nurse.
Number 1413
CHAIR WILSON pointed out that there could be a situation in
which there would be the desire to keep a nurse inside the
state, although there may not be enough employment in the area
where the individual resides and thus he/she would have to go to
Anchorage for a job. The desire is for that individual to stay
in Alaska, although he/she might be a traveler.
REPRESENTATIVE CISSNA noted that there are no other medical
personnel who travel and work fairly consistently in rural areas
and go back and forth [between their work and primary
residence]. Representative Cissna said she assumed that the
problem isn't with people working in the state, but with people
coming into the state for a short time [and abusing this].
CHAIR WILSON asked if AHFC gives loans to people outside of the
state.
MR. KAPANSKY said no.
CHAIR WILSON said that takes care of it.
Number 1552
REPRESENTATIVE SEATON related that [there is no intention] to
prevent people from going to rural communities and taking a
contract while living in another area of the state. However,
the problem is related to those traveling nurses who are on an
extended stay; they receive higher pay under contract, and
giving them an additional incentive, through the 100 percent
loan, he did not believe was the intention. However, he said he
didn't know how to distinguish the two in this legislation.
CHAIR WILSON highlighted that AHFC doesn't give loans to
nonresidents. She related her belief that the majority of
traveling nurses never take residency.
[Ms. Derr nodded in agreement.]
REPRESENTATIVE GATTO asked what would happen if the eligibility
for [this 100 percent loan were tied] to eligibility for the
permanent fund dividend (PFD), which has rather stringent
requirements and penalties for not being truthful. Since it
would take too long for PFD eligibility, he proposed having the
same requirements, but without the waiting period. He asked if
that would satisfy most of the concerns.
MS. PETERSON answered that tying it to the PFD eligibility might
make it more complex than it is currently. For a teacher to
obtain a housing loan, that person merely needs to be a teacher
in a public school. There is no limit with regard to how long
such a person needs to stay before applying for the loan, which
is what she said [the sponsor] wants to encourage.
REPRESENTATIVE GATTO emphasized that the PFD language makes it
clear that the individual has to want and intend to stay in the
state.
REPRESENTATIVE SEATON recalled that such was AHFC's criteria for
obtaining the loan.
MR. KAPANSKY reiterated that on page 2 the legislation states
that the program is only for "owner-occupied, single-family
housing". Therefore, applicants would have to demonstrate that
they are actually going to be living in the home and be
residents of the state.
REPRESENTATIVE SEATON said although he saw that as a potential
problem "on the traveling nurse," he wasn't going to insist it
be corrected.
Number 1734
REPRESENTATIVE GATTO moved to report HCS CSSB 25, Version 23-
LS0080\U, Cook, 4/17/03, out of committee with individual
recommendations and the accompanying fiscal notes. There being
no objection, HCS CSSB 25(HES) was reported from the House
Health, Education and Social Services Standing Committee.
CHAIR WILSON informed the committee that she would have a
resolution drafted because of the need to suspend the rules to
allow for the change in title.
SB 105-MEDICAID:CHILDREN/PREGNANT WOMEN/FACILITY
[Contains discussion of HB 172]
CHAIR WILSON announced that the next order of business would be
CS FOR SENATE BILL NO. 105(HES) am(efd fld), "An Act relating to
eligibility requirements for medical assistance for certain
children, pregnant women, and persons in a medical or
intermediate care facility."
Number 1794
REPRESENTATIVE COGHILL moved to adopt the proposed House
committee substitute (HCS), Version 23-GS1128\H, as the working
document. There being no objection, Version H was before the
committee.
CHAIR WILSON explained that CSSB 105(HES) am(efd fld) uses 175
percent of the poverty level, while Version H uses 200 percent
of the poverty level, which she said is the same as HB 172 that
was previously reported from this committee.
REPRESENTATIVE COGHILL said although he is a proponent of the
175 percent of poverty level, he wouldn't object to [Version H]
at this point.
Number 1864
JOHN RILEY, Physician Assistant, informed the committee that he
works in a practice that serves the uninsured and the medically
underserved. Every day he said he deals with barriers to
appropriate treatment for patients who cannot afford the cost of
ongoing [care]. There are over 90,000 uninsured Alaskans. Mr.
Riley pointed out that Governor Murkowski was fortunate to have
health coverage when he suffered from symptoms that ultimately
led to the discovery of a blocked artery in his heart, and to
have it treated. However, an uninsured person would have had to
forgo this evaluation due to the possible cost of over $10,000.
MR. RILEY highlighted the National Republican Party agenda and
President George W. Bush's recognition of the necessity for
health care access for Americans, as it is essential to the
well-being and productivity of America's workforce. Mr. Riley
said it is well documented that the uninsured have [poor] health
outcomes, have increased mortality once diagnosed with major
illnesses, and receive emergency care [instead of going to a
primary physician]. "Health care is not a luxury," he stated.
This legislation is a "double hit" to those who currently
qualify for Denali KidCare, and drops those between 175 percent
and 200 percent of the poverty level. By fixing the income
level, (indisc.) cut off by the level of inflation each year.
MR. RILEY said in the next ten years he anticipates a 20 percent
reduction in the income qualification level, with more than
10,000 Alaskans losing eligibility over the next five years. He
said 71 percent of the cost of Denali KidCare is provided by a
federal match, and any decrease in the coverage will decrease
those federal dollars.
CHAIR WILSON surmised that Mr. Riley was speaking to the
original Senate bill, but said the HCS before the committee
[Version H] maintains the existing situation and freezes the
requirements in place now.
Number 1995
REPRESENTATIVE CISSNA related her understanding that Version H
is a change [from the existing situation] because it removes the
300 percent rule and replaces it with a dollar figure.
CHAIR WILSON said in the long run it would be the same.
REPRESENTATIVE CISSNA directed attention to page 2, line 16, of
Version H.
CHAIR WILSON specified that the "$1,656" is the 300 percent.
REPRESENTATIVE CISSNA maintained that it is a significant
difference because it doesn't allow for [inflation-proofing].
CHAIR WILSON agreed.
REPRESENTATIVE CISSNA pointed out that if ["$1,656"] is placed
in statute, it is a change.
CHAIR WILSON reiterated that the Version H freezes the current
criteria.
Number 2068
BOB LABBE, Deputy Commissioner, Department of Health & Social
Services (DHSS), related his belief that Version H mirrors the
legislation that the governor introduced, which uses essentially
the same language. That language proposes freezing the
eligibility levels at the 2002 income standards. He clarified
that it was not only Denali KidCare, but also the special income
standard for nursing home and community-based care. He agreed
that there wouldn't be any inflation[proofing].
REPRESENTATIVE SEATON turned attention to the fiscal note.
CHAIR WILSON said it reflects a slight change.
MR. LABBE offered his belief that Version H is basically the
same as for HB 172 and that the fiscal note would be the same
for Version H [as for HB 172].
REPRESENTATIVE COGHILL remarked that the fiscal note is
significantly different.
CHAIR WILSON clarified that her comparison was that [Version H]
wasn't any different from HB 172 when it passed out of this
committee.
Number 2185
REPRESENTATIVE CISSNA directed attention to page 5, line 31, of
Version H, which specifies that a pregnant woman alone in a
household is considered a household of two persons. She said
she understood that to be a change and requested an explanation.
MR. LABBE explained that under federal law when eligibility is
determined for a pregnant woman, [a pregnant woman alone in a
household] is considered to be a household of two persons. Thus
a larger income level is used.
Number 2254
REPRESENTATIVE WOLF moved to report HCS CSSB 105, Version 23-
GS1128\H, out of committee with individual recommendations and
the accompanying fiscal notes.
REPRESENTATIVE CISSNA objected. She noted that there is a
nationwide crisis in access to health care. She said most
states grappling with this have focused on taking care of the
children, which is why Medicaid made this program possible.
Alaska is unique in that it's a young state that does not have
the infrastructure that other states have. Families in Alaska
face huge problems. Locking this in at a dollar figure takes
away that little bit that is available, which she indicated
meant a lot to the families. In order to ensure the safety of
Alaska's children, she said, the 300 percent should be
specified.
A roll call vote was taken. Representatives Gatto, Wolf,
Coghill, Seaton, and Wilson voted in favor of reporting the
bill, Version 23-GS1128\H, from committee. Representative
Cissna voted against it. Therefore, HCS CSSB 105(HES) was
reported from the House Health, Education and Social Services
Standing Committee by a vote of 5-1.
SB 124-ALCOHOLISM AND DRUG ABUSE GRANTS
[Contains discussion of HB 167]
TAPE 03-35, SIDE B
CHAIR WILSON announced that the final order of business would be
SENATE BILL NO. 124(efd fld), "An Act relating to grants for
alcoholism and drug abuse programs."
Number 2320
REPRESENTATIVE COGHILL moved to adopt the proposed House
committee substitute (HCS), Version 23-GS1111\D, Ford, 4/17/03,
as a work draft. There being no objection, Version D was before
the committee.
Number 2326
CHAIR WILSON explained that [Version D] would put the grants for
alcoholism and drug abuse programs in a transition phase. The
difference is that the Senate bill increased the amount to 25
percent that communities have to contribute; however, the bill
the House Health, Education and Social Services Standing
Committee passed out of committee last month [HB 167] allowed
for a phased-in approach. The grantees know the cuts are
coming, but this is phased in. Chair Wilson said that is the
only difference between the House and Senate bills. In response
to Representative Seaton, she said the [House] committee
substitute allows the grantees to only have to contribute 17.5
percent this year, and then next year it goes up to 25 percent.
The Senate bill goes directly to the 25 percent contribution
this year, so there is no phased-in approach.
REPRESENTATIVE COGHILL commented that when the committee adopted
the House committee substitute, the committee took the amendment
and put it in the Senate bill.
CHAIR WILSON said that is correct.
Number 2214
REPRESENTATIVE CISSNA referred to Section 1, lines 5-6, where it
says "grants shall be awarded in a ratio of 75 percent state
money to 25 percent community money". On page 2, lines 5-7,
under "Transition", she noted that it says July 2004.
CHAIR WILSON responded that this coming fiscal year, beginning
July 1, 2003, there would be a transition year [during which
communities would have to contribute 17.5]. When fiscal year
2004 begins, the percentage of community contribution will be 25
percent. She reiterated that this HCS simply changes the Senate
bill so it is identical to the bill the committee passed earlier
[HB 167].
Number 2140
REPRESENTATIVE SEATON moved to report HCS SB 124, Version 23-
GS1111\D, Ford, 4/17/03, out of committee with individual
recommendations and the corrected fiscal notes. There being no
objection, HCS SB 124(HES) was reported 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 4:23 p.m.
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