Legislature(2003 - 2004)

04/22/2003 03:27 PM HES

Audio Topic
* first hearing in first committee of referral
+ 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.                                                                                                      

Document Name Date/Time Subjects