02/04/2016 03:00 PM House HEALTH & SOCIAL SERVICES
| Audio | Topic |
|---|---|
| Start | |
| SB23 | |
| HB226 | |
| HB260 | |
| HB262 | |
| Adjourn |
+ teleconferenced
= bill was previously heard/scheduled
| += | HB 226 | TELECONFERENCED | |
| += | HB 260 | TELECONFERENCED | |
| += | HB 262 | TELECONFERENCED | |
| += | SB 23 | TELECONFERENCED | |
| + | TELECONFERENCED |
ALASKA STATE LEGISLATURE
HOUSE HEALTH AND SOCIAL SERVICES STANDING COMMITTEE
February 4, 2016
3:04 p.m.
MEMBERS PRESENT
Representative Paul Seaton, Chair
Representative Liz Vazquez, Vice Chair
Representative Neal Foster
Representative Louise Stutes
Representative David Talerico
Representative Geran Tarr
Representative Adam Wool
MEMBERS ABSENT
All members present
OTHER LEGISLATORS PRESENT
Representative Lynn Gattis
COMMITTEE CALENDAR
CS FOR SENATE BILL NO. 23(JUD)
"An Act relating to opioid overdose drugs and to immunity for
prescribing, providing, or administering opioid overdose drugs."
- MOVED HCS CSSB 23(HSS) OUT OF COMMITTEE
HOUSE BILL NO. 226
"An Act extending the termination date of the Alaska Commission
on Aging; and providing for an effective date."
- MOVED HB 226 OUT OF COMMITTEE
HOUSE BILL NO. 260
"An Act relating to the recovery of overpayments of day care
assistance and child care grants; and providing for an effective
date."
- HEARD & HELD
HOUSE BILL NO. 262
"An Act relating to eligibility requirements of the Alaska
senior benefits payment program; and providing for an effective
date."
- HEARD & HELD
PREVIOUS COMMITTEE ACTION
BILL: SB 23
SHORT TITLE: IMMUNITY FOR PROVIDING OPIOID OD DRUG
SPONSOR(s): SENATOR(s) ELLIS
01/21/15 (S) READ THE FIRST TIME - REFERRALS
01/21/15 (S) HSS, JUD
03/18/15 (S) HSS AT 1:30 PM BUTROVICH 205
03/18/15 (S) Heard & Held
03/18/15 (S) MINUTE(HSS)
03/23/15 (S) HSS AT 1:30 PM BUTROVICH 205
03/23/15 (S) Moved SB 23 Out of Committee
03/23/15 (S) MINUTE(HSS)
03/25/15 (S) HSS RPT 3DP 2NR
03/25/15 (S) DP: STEDMAN, ELLIS, GIESSEL
03/25/15 (S) NR: KELLY, STOLTZE
04/01/15 (S) JUD AT 1:30 PM BELTZ 105 (TSBldg)
04/01/15 (S) Moved CSSB 23(JUD) Out of Committee
04/01/15 (S) MINUTE(JUD)
04/02/15 (S) JUD RPT CS 4DP NEW TITLE
04/02/15 (S) DP: MCGUIRE, COGHILL, COSTELLO,
WIELECHOWSKI
04/18/15 (S) TRANSMITTED TO (H)
04/18/15 (S) VERSION: CSSB 23(JUD)
04/19/15 (H) READ THE FIRST TIME - REFERRALS
04/19/15 (H) HSS, JUD
01/26/16 (H) HSS AT 3:00 PM CAPITOL 106
01/26/16 (H) Heard & Held
01/26/16 (H) MINUTE(HSS)
02/04/16 (H) HSS AT 3:00 PM CAPITOL 106
BILL: HB 226
SHORT TITLE: EXTEND ALASKA COMMISSION ON AGING
SPONSOR(s): REPRESENTATIVE(s) HAWKER
01/19/16 (H) PREFILE RELEASED 1/8/16
01/19/16 (H) READ THE FIRST TIME - REFERRALS
01/19/16 (H) HSS, FIN
01/28/16 (H) HSS AT 3:00 PM CAPITOL 106
01/28/16 (H) Heard & Held
01/28/16 (H) MINUTE(HSS)
02/04/16 (H) HSS AT 3:00 PM CAPITOL 106
BILL: HB 260
SHORT TITLE: DAY CARE ASSISTANCE & CHILD CARE GRANTS
SPONSOR(s): RULES BY REQUEST OF THE GOVERNOR
01/19/16 (H) READ THE FIRST TIME - REFERRALS
01/19/16 (H) HSS, FIN
01/28/16 (H) HSS AT 3:00 PM CAPITOL 106
01/28/16 (H) Heard & Held
01/28/16 (H) MINUTE(HSS)
02/04/16 (H) HSS AT 3:00 PM CAPITOL 106
BILL: HB 262
SHORT TITLE: SENIOR BENEFITS PROG. ELIGIBILITY
SPONSOR(s): RULES BY REQUEST OF THE GOVERNOR
01/19/16 (H) READ THE FIRST TIME - REFERRALS
01/19/16 (H) HSS, FIN
01/28/16 (H) HSS AT 3:00 PM CAPITOL 106
01/28/16 (H) Heard & Held
01/28/16 (H) MINUTE(HSS)
02/04/16 (H) HSS AT 3:00 PM CAPITOL 106
WITNESS REGISTER
SENATOR JOHNNY ELLIS
Alaska State Legislature
Juneau, Alaska
POSITION STATEMENT: Testified and answered questions as the
sponsor of SB 23.
REPRESENTATIVE MIKE HAWKER
Alaska State Legislature
Juneau, Alaska
POSITION STATEMENT: Testified and answered questions as the
sponsor of HB 226.
DUANE MAYES, Director
Central Office
Division of Senior and Disabilities Services
Department of Health and Social Services
Juneau, Alaska
POSITION STATEMENT: Answered questions during discussion of HB
226.
JACQUELLI ZIEGENFUSS, Administration Operations Manager
Central Office
Division of Senior and Disabilities Services
Department of Health and Social Services
Juneau, Alaska
POSITION STATEMENT: Testified and answered questions during
discussion of HB 226.
LISA MORLEY, DSDS Grants
Central Office
Division of Senior and Disabilities Services
Department of Health and Social Services
Juneau, Alaska
POSITION STATEMENT: Testified and answered questions during
discussion of HB 226.
SEAN O'BRIEN, Director
Director's Office
Division of Public Assistance
Department of Health and Social Services (DHSS)
Juneau, Alaska
POSITION STATEMENT: Responded to questions during discussion of
HB 260 and HB 262.
MONICA MITCHELL, Chief
Policy & Program Development
Division of Public Assistance
Department of Health and Social Services (DHSS)
Juneau, Alaska
POSITION STATEMENT: Responded to questions during discussion of
HB 262.
ACTION NARRATIVE
3:04:59 PM
CHAIR PAUL SEATON called the House Health and Social Services
Standing Committee meeting to order at 3:04 p.m.
Representatives Seaton, Tarr, Wool, Talerico, and Vazquez were
present at the call to order. Representatives Foster and Stutes
arrived as the meeting was in progress. Also in attendance was
Representative Gattis.
SB 23-IMMUNITY FOR PROVIDING OPIOID OD DRUG
3:05:28 PM
CHAIR SEATON announced that the first order of business would be
CS FOR SENATE BILL NO. 23(JUD), "An Act relating to opioid
overdose drugs and to immunity for prescribing, providing, or
administering opioid overdose drugs."
3:07:15 PM
SENATOR JOHNNY ELLIS, Alaska State Legislature, reported that
there had been statewide support for the proposed bill, with no
known opposition.
3:08:17 PM
CHAIR SEATON moved to adopt Amendment 1, labeled 29-S0058\E.6,
Wallace, 2/3/16, which read:
Page 1, line 1, following "Act":
Insert "relating to the practice of pharmacy;
relating to the dispensing of opioid overdose drugs by
a pharmacist; and"
Page 1, following line 3:
Insert new bill sections to read:
"* Section 1. AS 08.80.030(b) is amended to read:
(b) In order to fulfill its responsibilities,
the board has the powers necessary for implementation
and enforcement of this chapter, including the power
to
(1) elect a president and secretary from
its membership and adopt rules for the conduct of its
business;
(2) license by examination or by license
transfer the applicants who are qualified to engage in
the practice of pharmacy;
(3) assist the department in inspections
and investigations for violations of this chapter, or
of any other state or federal statute relating to the
practice of pharmacy;
(4) adopt regulations to carry out the
purposes of this chapter;
(5) establish and enforce compliance with
professional standards and rules of conduct for
pharmacists engaged in the practice of pharmacy;
(6) determine standards for recognition and
approval of degree programs of schools and colleges of
pharmacy whose graduates shall be eligible for
licensure in this state, including the specification
and enforcement of requirements for practical
training, including internships;
(7) establish for pharmacists and
pharmacies minimum specifications for the physical
facilities, technical equipment, personnel, and
procedures for the storage, compounding, and
dispensing of drugs or related devices, and for the
monitoring of drug therapy;
(8) enforce the provisions of this chapter
relating to the conduct or competence of pharmacists
practicing in the state, and the suspension,
revocation, or restriction of licenses to engage in
the practice of pharmacy;
(9) license and regulate the training,
qualifications, and employment of pharmacy interns and
pharmacy technicians;
(10) issue licenses to persons engaged in
the manufacture and distribution of drugs and related
devices;
(11) establish and maintain a controlled
substance prescription database as provided in
AS 17.30.200;
(12) establish standards for the
independent administration by a pharmacist of vaccines
and related emergency medications under AS 08.80.168,
including the completion of an immunization training
program approved by the board;
(13) establish standards for the independent
dispensing by a pharmacist of an opioid overdose drug
under AS 17.20.085, including the completion of an
opioid overdose training program approved by the
board.
* Sec. 2. AS 08.80.168(b) is amended to read:
(b) In this section,
(1) "opioid overdose drug" has the meaning
given in AS 17.20.085;
(2) "related emergency medication" includes
an epinephrine injection or other medication for the
treatment of a severe allergic reaction to a vaccine.
* Sec. 3. AS 08.80.168 is amended by adding a new
subsection to read:
(c) A pharmacist may independently dispense an
opioid overdose drug if the pharmacist has completed
an opioid overdose drug training program approved by
the board and otherwise complies with the standards
established by the board under AS 08.80.030(b).
* Sec. 4. AS 08.80.480(27) is amended to read:
(27) "practice of pharmacy" means the
interpretation, evaluation, and dispensing of
prescription drug orders in the patient's best
interest; participation in drug and device selection,
drug administration, drug regimen reviews, and drug or
drug-related research; provision of patient counseling
and the provision of those acts or services necessary
to provide pharmaceutical care; the administration of
vaccines and related emergency medication; the
independent dispensing of opioid overdose drugs; and
the responsibility for compounding and labeling of
drugs and devices except labeling by a manufacturer,
repackager, or distributor of nonprescription drugs
and commercially packaged legend drugs and devices;
proper and safe storage of drugs and devices; and
maintenance of proper records for them;"
Page 1, line 4:
Delete "Section 1"
Insert "Sec. 5"
Renumber the following bill section accordingly.
REPRESENTATIVE VAZQUEZ objected for discussion.
CHAIR SEATON explained that the proposed amendment would allow a
pharmacist to dispense the opioid overdose drugs independent of
a prescription by adding to the responsibilities of the Board of
Pharmacy and to the definition of the practice of pharmacy. He
pointed out that this proposed amendment added to the title of
the proposed bill to include the practice of pharmacy, as well
as adding four new Sections, which contained: inclusion of
standards for independent dispensing of opioid drug overdose and
an opioid overdose training program as the responsibility of the
Board of Pharmacy; inclusion of opioid overdose drugs with the
definition of emergency medications; allowance for pharmacists
to independently dispense opioid overdose drugs if training has
been completed and standards of the Board of Pharmacy have been
fulfilled; and, inclusion of independent dispensing of opioid
overdose drugs in the practice of pharmacy. He reminded the
committee that the amendment included a title change for the
proposed bill.
SENATOR ELLIS noted that other states had already made these
changes, that the Fred Meyer stores in the Pacific Northwest
were ready to make this drug available, and there appeared to be
unanimous favor.
3:11:55 PM
REPRESENTATIVE VAZQUEZ removed her objection. There being no
further objection, Amendment 1 was adopted.
3:12:10 PM
CHAIR SEATON moved to adopt Amendment 2, labelled 29-LS0058\E.4,
Wallace, 1/29/16, which read:
Page 2, line 5, following "program":
Insert "; education and training under this
paragraph may be provided by any reasonable means,
including through the use of electronic, video, or
automated education or training resources"
Page 2, line 15, following "program":
Insert "; education and training under this
paragraph may be provided by any reasonable means,
including through the use of electronic, video, or
automated education or training resources"
REPRESENTATIVE VAZQUEZ objected for discussion.
CHAIR SEATON paraphrased from Amendment 2, stating that it was
intended to ensure that the training for administration of the
opioid overdose drug, required by the proposed bill, could be
provided by any reasonable means.
3:12:59 PM
REPRESENTATIVE VAZQUEZ removed her objection. There being no
further objection, Amendment 2 was adopted.
3:13:22 PM
SENATOR ELLIS reflected on the training component mentioned in
Amendment 2. He reported that, although the drug was safe and
there had not been any problems, he wanted to make sure that
people other than medical personnel also had reasonable access
to the training.
3:14:15 PM
CHAIR SEATON moved to adopt Amendment 3, labeled 29-LS0058\E.3,
Wallace, 1/28/16, which read:
Page 2, line 20, following "assistant,":
Insert "nurse,"
Page 3, line 15, following "assistant,":
Insert "nurse,"
REPRESENTATIVE VAZQUEZ objected for discussion.
CHAIR SEATON explained that Amendment 3 would allow a nurse to
provide the required training.
3:14:56 PM
REPRESENTATIVE VAZQUEZ removed her objection. There being no
further objection, Amendment 3 was adopted.
3:15:30 PM
REPRESENTATIVE VAZQUEZ moved to report CSSB 23(JUD), Version 29-
LS0058\E, as amended, out of committee with individual
recommendations and the accompanying fiscal notes. There being
no further objection, HCS CSSB 23(HSS) was moved from the House
Health and Social Services Standing Committee.
3:16:26 PM
The committee took an at-ease from 3:16 p.m. to 3:19 p.m.
3:19:19 PM
CHAIR SEATON brought the committee back to order, and noted
there was also a resolution in support of CSSB 23(JUD) from the
Kenai Peninsula Borough [included in members' packets].
HB 226-EXTEND ALASKA COMMISSION ON AGING
3:19:49 PM
CHAIR SEATON announced that the next order of business would be
HOUSE BILL NO. 226, "An Act extending the termination date of
the Alaska Commission on Aging; and providing for an effective
date."
3:20:35 PM
REPRESENTATIVE MIKE HAWKER, Alaska State Legislature, clarified
that there were now three new fiscal notes. He explained that,
as the Alaska Commission on Aging (ACOA) existed in the State of
Alaska, the qualifications of certain federal statutes for
funding had been met. He reported that ACOA also fulfilled an
obligation and requirement for the Alaska Mental Health Trust
Authority (AMHTA). He directed attention to the fiscal note,
OMB Component Number 2674, which listed $119,100 under the Fund
Source from MHTAAR (Mental Health Trust Authority Agency
Receipts) as the money contributed by AMHTA to fulfill its
obligations. He shared that the General Fund and I/A Receipts
also listed under the Fund Source were from Department of Health
and Social Services, which had designated ACOA as the agency to
fulfill the federal requirements. He pointed out that there
were now fiscal notes from the Senior and Disabilities Services
Administration, OMB Component Number 2663, showing a receipt of
$603,200 in federal receipts [listed under Fund Source], and
from the Senior Community Based Grants, OMB Component Number
2787, which reflected a federal receipt of $5,771,300 [listed
under Fund Source]. He stated the key point was that "ACOA
serves a real purpose here. By having it, we are able to avail
ourselves of the federal money that's available for the state
for these particular programs." He pointed out that, should
ACOA not be re-authorized, the state would either have to cease
participation in these programs, or designate another state
agency to take its place. He stated that this clarified the
need for three fiscal notes, the exact role of ACOA, and that it
satisfied requirements from the federal government for Alaska to
receive money for senior benefits and requirements from AMHTA to
satisfy its obligations. He declared that ACOA served a good
purpose, and there was great leverage from the general funds
invested in these services.
3:25:23 PM
REPRESENTATIVE VAZQUEZ asked about the interplay between the
three fiscal notes.
REPRESENTATIVE HAWKER reiterated that all three fiscal notes
defined allocations in the various budgets which appropriated
money and provided a fund source for this money. He directed
attention to the Allocation on each fiscal note, which was "the
most granular level within the budget where this money is
appropriated as both an expenditure and we provide a fund source
for it." He pointed to the Appropriation, which he explained
was the next tier of the budget, and was within the Department,
listed just above it. He shared that, although all three fiscal
notes were appropriated into the Senior and Disabilities
Services, the allocations were to different areas, hence the
need for three separate fiscal notes. He explained that, with
the passage of any bill with an attached fiscal note, this
fiscal note was added to the budget through an appropriation
that identified the specific fiscal note. He pointed out that,
as this was a reauthorization bill, the money was already in the
current budget, but would disappear without reauthorization of
the agency, a consequence should proposed HB 226 not be passed.
He clarified that should that happen, the money would not be
spent or received, which was reflected in the fiscal notes. He
stated that the policy call was for whether there was sufficient
value and merit from this agency and its activities.
REPRESENTATIVE VAZQUEZ directed attention to the fiscal note
labeled OMB Component Number 2663, and asked about the nature of
the services for $520,300 listed under Operating Expenditures.
REPRESENTATIVE HAWKER referenced the back page of the fiscal
note, noting that it explained the services in general, although
a very specific explanation would come from the agency.
CHAIR SEATON clarified that the fiscal note OMB Component Number
2674 had been updated on 02/04/16.
3:32:06 PM
DUANE MAYES, Director, Central Office, Division of Senior and
Disabilities Services, Department of Health and Social Services,
in response to Representative Vazquez, said that this money was
for two reimbursable services agreements (RSAs), one to the Long
Term Care Ombudsman in the Department of Revenue and the other
to the Alaska Commission on Aging.
REPRESENTATIVE VAZQUEZ offered her belief that funds to the
Alaska Commission on Aging would be through Personal Services,
under Operating Expenditures in the aforementioned fiscal note.
MR. MAYES relayed that he was unsure why these Services had not
been included under Personal Services on the fiscal note.
3:34:26 PM
JACQUELLI ZIEGENFUSS, Administration Operations Manager, Central
Office, Division of Senior and Disabilities Services, Department
of Health and Social Services, explained that RSAs were paid
from the Services line, which included any passage of funds onto
another state agency.
REPRESENTATIVE VAZQUEZ asked why the funding to the Alaska
Commission on Aging was not on the Personal Services line,
instead of the Services line.
MS. ZIEGENFUSS directed attention to the fiscal note OMB
Component Number 2663 and explained that those funds go out
through the Services line and then, on fiscal note OMB Component
Number 2674, move into the Personal Services line for the Alaska
Commission on Aging. She directed attention to page 2, final
paragraph, of the aforementioned fiscal note, which stated that
the commission was funded in part by an RSA from the Senior and
Disabilities Services Administration component, while a small
portion of this was federal funding.
REPRESENTATIVE VAZQUEZ asked whether the Alaska Commission on
Aging was funded through the Personal Services on fiscal note
OMB Component Number 2663 and then additionally through an RSA
from the Senior and Disabilities Services Administration.
MS. ZIEGENFUSS directed attention to Fund Source, I/A Receipts
(interagency receipts) on the fiscal note OMB Component Number
2674, which helped fund the Personal Services under Operating
Expenditures. She stated that these funds, $348,100, were used
for the expenditure of personal services.
REPRESENTATIVE VAZQUEZ asked if this money was received from the
Senior and Disabilities Services Administration.
MS. ZIEGENFUSS stated her agreement.
REPRESENTATIVE TARR asked if the other dollars not reflected in
the fiscal notes were awarded through a competitive grant
process, and what evaluation process was used to ensure that the
money was distributed "to the best places."
3:38:38 PM
LISA MORLEY, DSDS Grants, Central Office, Division of Senior and
Disabilities Services, Department of Health and Social Services,
explained that the other funds not accounted for in the fiscal
note were distributed directly from the Administration on
Community Living, part of the Older Americans Act. The funds
identified in this fiscal note were from Title III, and were a
combination of funds for grants and services directly to
seniors, the Long Term Care Ombudsman, the Alaska Commission on
Aging, and administration. She stated that Title IV funds were
discretionary and competitive, and that the State of Alaska was
not currently receiving any of these funds. She explained that
Title V funds were for workforce for seniors, and were
distributed to the Department of Labor & Workforce Development.
She relayed that Title VI funds were awarded directly to the
tribal governments, about $4 million during the past year. She
concluded with the Title VII funds which were awarded to the
Long Term Care Ombudsman in the Department of Revenue.
REPRESENTATIVE VAZQUEZ asked where the public could look at the
list of grantees.
MS. MORLEY asked if the reference was for grantees receiving
funds to provide direct services in Alaska or those who receive
Title III funds.
REPRESENTATIVE VAZQUEZ asked about any grantees receiving grants
from the Division of Senior and Disabilities Services.
MS. MORLEY replied that these were online in an operating grants
book, which listed every grant funded program by region and by
grantee, and included the dollar amounts. She offered her
belief that this was listed under the Department of Health and
Social Services, Finance and Management Services. She offered
to provide the link.
REPRESENTATIVE TARR asked for how long the Older Americans Act
was reauthorized relative to the longevity of the funds.
MS. MORLEY replied that she did not recall.
MR. MAYES said that he would supply the information.
There being no further objection, the amended fiscal notes were
adopted.
3:42:49 PM
REPRESENTATIVE VAZQUEZ moved to report HB 226, Version 29-
LS1089\A, out of committee with individual recommendations and
the accompanying amended fiscal notes. There being no
objection, HB 226 was moved from the House Health and Social
Services Standing Committee.
3:43:21 PM
The committee took an at-ease from 3:43 p.m. to 3:45 p.m.
HB 260-DAY CARE ASSISTANCE & CHILD CARE GRANTS
3:45:49 PM
CHAIR SEATON announced that the next order of business would be
HOUSE BILL NO. 260, "An Act relating to the recovery of
overpayments of day care assistance and child care grants; and
providing for an effective date."
REPRESENTATIVE TARR stated that she would keep working with
community partners on an amendment for the payment structure.
REPRESENTATIVE VAZQUEZ relayed that she had raised concern about
recovery of overpayments in the heating assistance program.
3:48:16 PM
SEAN O'BRIEN, Director, Director's Office, Division of Public
Assistance, Department of Health and Social Services (DHSS),
relayed that the division had no objection to either the heating
assistance program or senior benefits being added to the
proposed bill. He stated that initially the proposed bill had
focused primarily on new regulations and new federal
requirements.
CHAIR SEATON, in response to Representative Vazquez, suggested
that the Legislative Legal Services draft an amendment as it was
"more complicated than just changing a number."
REPRESENTATIVE VAZQUEZ explained that she had been waiting for
the response from the Department of Health and Social Services,
in case there was a valid reason for not adding to the proposed
bill.
CHAIR SEATON directed attention to the written response from the
division, noting that DHSS had agreed to the suggestion
[Included in members' packets].
REPRESENTATIVE VAZQUEZ said that she would have an amendment
drafted.
3:51:18 PM
CHAIR SEATON said that HB 260 would be held over until the
amendment was available.
HB 262-SENIOR BENEFITS PROG. ELIGIBILITY
3:52:36 PM
CHAIR SEATON announced that the final order of business would be
HOUSE BILL NO. 262, "An Act relating to eligibility requirements
of the Alaska senior benefits payment program; and providing for
an effective date."
3:52:49 PM
REPRESENTATIVE VAZQUEZ moved to adopt the proposed committee
substitute (CS) for HB 262, labeled 29-GH2770\W, Glover, 2/2/16,
as the working draft. There being no objection, Version W was
in front of the committee.
CHAIR SEATON noted that there were three levels of senior
benefits referenced in the proposed bill. He asked if the
numbers were available.
SEAN O'BRIEN, Director, Director's Office, Division of Public
Assistance, Department of Health and Social Services (DHSS),
offered his belief that those numbers were available.
3:54:13 PM
MONICA MITCHELL, Chief, Policy & Program Development, Division
of Public Assistance, Department of Health and Social Services
(DHSS), stated that, although she did not have the exact
numbers, at the highest income level there were about 5300
recipients, at the mid income level there were about 4000
recipients, and at the lowest income level there were about 2000
recipients. In response to Chair Seaton, she explained the
senior benefits program and its three income levels. She
reported that the senior benefits program was a cash benefit
program for individuals over 65 years of age. She stated that
the different payment levels were based on income up to a
specific percentage of the federal poverty level. She detailed
that individuals with incomes up to 75 percent of the federal
poverty level receive the highest monthly benefit amount, $250;
between 75 percent and 100 percent of the federal poverty level
receive a monthly benefit amount of $175; between 100 percent
and 175 percent of the federal poverty level receive a monthly
benefit amount of $125.
CHAIR SEATON acknowledged that benefits were being cut in many
programs, and he questioned whether the monthly cash payments to
individuals with income of 175 percent of the federal poverty
level should be reconsidered. He noted that the House Finance
Committee should review this, but he "wanted to open up that
policy discussion for us to have here since in all of the other
committees that we're in, we're talking about raising taxes..."
He stated that, as this was revenue sharing to individuals
beyond the Permanent Fund Dividend, it should be open for
discussion.
REPRESENTATIVE VAZQUEZ stated that the total number in the
program statewide was only 11,300 individuals. She said that
this was "more of a safety net" and that the income limits were
very low. She reported that to qualify for the highest amount
of monthly benefit, $250, an individual's annual income could
not exceed $11,040, about $920 each month. She went on to
report that, for a married couple to qualify for the highest
monthly benefit, income could not exceed $14,940, about $1,245
each month. She emphasized that this amount of money "doesn't
go far." Moving on to the monthly benefit of $175, an
individual could not have an annual income of more than $14,720,
or $1,227 each month; whereas, a married couple could not have
an annual income to exceed $19,920, or $1,660 each month, which
she declared was "doing marginally as far as income in light of
the cost of living in Alaska." She relayed that for the monthly
benefit amount of $125, an individual could not have an income
which exceeded $25,760, or $2,146 each month; whereas a married
couple could not have an income which exceeded $34,860, or about
$2905 per month. She emphasized that it was necessary to
understand each level of income.
CHAIR SEATON pointed out that the question was not for the lower
end of the scale, as those were "poverty and need." He relayed
that there was a question whether the state could afford a
subsidy for a couple earning $35,000 each year. He asked if
there was also an asset test along with the income test.
MS. MITCHELL replied that there was not an asset test. She
pointed out that these regulations for senior benefits allowed
for an adjustment based on the appropriation, and that the
current regulation package allowed for a cut to the highest
benefit level first, and then to subsequent benefit levels, if
not enough money had been appropriated for the program.
CHAIR SEATON reflected that the discussion was on policy,
whereas the adjustment was for a budgetary constraint. He asked
if this adjustment for budgetary constraint was good policy or
whether it was better to address the upper level of benefits.
He pointed out that a lack of asset limitation allowed an
individual to own a home and other things, yet the individual
would be subsidized with a benefit if the direct income was
below a certain level. He declared that it was necessary to
have a discussion for what levels the state could afford.
REPRESENTATIVE TARR expressed her personal opinion that these
were modest benefits, even at the lowest level of payment. She
reported that her constituents were considered moderate to low
income, and the average rent in the low income neighborhoods was
$1,200 to $1,500 per month. She pointed out that this meant
more than half of a monthly income was spent for rent, with
utilities above this. She observed that most of these
subsidized individuals were on a fixed income and in retirement,
so there was not a lot of opportunity to supplement their
income. She suggested a gradual change to these benefits to
allow for any adjustments to living arrangements. She reminded
the committee that there had been a strong response against
change during the last year, "in large part because people just
didn't feel like they had time to make any adjustment." She
requested some transitional time period, noting that a loss of
housing which forced an individual into institutional housing
would have a have an even greater cost to the state.
REPRESENTATIVE WOOL acknowledged some of the difficulties with
asset qualifications, pointing out that assets did not guarantee
expendable income. He expressed support for the lack of an
asset test.
CHAIR SEATON stated that, without an asset test, there was a
very broad group of people who qualify for benefits. He noted
that people could have homes and "a lot of stuff," but an income
that did not exceed the benefit limits. He opined that they
might not be spending much, either. He questioned whether the
higher income definition for poverty was too high, and he
emphasized that no one was talking about eliminating the program
entirely. He expressed his own discomfort for having a program
which could then be underfunded, although he was glad that the
regulation stated that payment at the highest income levels
would be stopped first. He shared that, although he did not
plan to introduce an amendment, he wanted to have this
discussion regarding benefits to higher income individuals given
the current budget deficit. He noted that it was unclear of an
individual's real needs without an asset test, although he
acknowledged that the cost to administer the program would then
become more expensive than the cost of the program.
REPRESENTATIVE WOOL asked if dividends and reverse mortgages
would be considered income.
MS. MITCHELL replied that a reverse mortgage was considered a
conversion of an asset, and would not be considered income. In
response to Representative Wool, she said that a regular monthly
payment would be considered income.
REPRESENTATIVE FOSTER opined that the profit from the sale of a
home was income, but a reverse mortgage was not income.
MS. MITCHELL explained that the house was considered an asset,
and the cash from the sale was also an asset, as it was not a
regular monthly income.
CHAIR SEATON pointed out that these assets were not counted, yet
the income could be low enough to qualify for the benefit. He
noted that it was necessary to review the system to determine
whether it was accomplishing the intended goals without having
any unintended consequences.
REPRESENTATIVE VAZQUEZ asked about the cost to implement an
asset test to the highest income tier, and expressed her
agreement that this could cost more than the payment.
MS. MITCHELL explained that, in order to implement the asset
test, it would be necessary to change the application and
reprogram the legacy system, and, although she did not have an
exact dollar amount, it would have a big financial impact.
REPRESENTATIVE VAZQUEZ acknowledged that it was also necessary
to train staff and send notifications to present recipients,
noting that this was all part of the cost when determining the
feasibility. She pointed out that there was not an asset test
for other programs, including Denali Kid Care or Medicaid
expansion enrollees, and that this same argument could be made
for those programs.
REPRESENTATIVE WOOL asked to confirm that the minimum age for
these benefits was 65 years, and how often was it necessary to
enroll for the program.
MS. MITCHELL replied that there was a yearly review process.
REPRESENTATIVE TARR asked if it was possible for "some kind of
spot check" to attain a sample snap shot for information, which
was not very expensive. She pointed out that an asset test was
required for an elderly person with a need for Medicaid
services. She acknowledged that there had been similar
criticism for the Alaska Longevity Bonus program as it did not
have any income guidelines.
MS. MITCHELL offered that there could be a cross match for
individuals who were also eligible for other programs that did
have an asset test for benefits. In response to Chair Seaton,
she explained that an individual with senior benefits who also
received food stamps and/or adult public assistance would have
been required to have an asset test to qualify for either of
those programs.
CHAIR SEATON asked to see this information if it was not too
onerous to collect, as it offered a potential mechanism for
reviewing the programs. He stated that it was necessary to
effectively target resources for what they were intended. He
noted that a review of wealth across the state pointed to
concentration among those over 65 years of age, that this group
was the wealthiest population in the state.
REPRESENTATIVE TARR asked if the program could be adjusted to be
parallel with social security benefits.
MS. MITCHELL agreed that there was an age requirement in the
statutes for senior benefits, and this could be amended to
reference the federal statute for social security.
REPRESENTATIVE TARR asked if there was an age breakdown of the
current recipients to this program.
MS. MITCHELL reported that the average age of the recipients was
75 years, and the maximum age was 104 years.
CHAIR SEATON asked for any other helpful information that was
readily available.
MS. MITCHELL said that she did not have any other information
that had not already been discussed.
CHAIR SEATON reported that this proposed bill was trying to
tighten up the eligibility standards for this program to include
a requirement to be a citizen of the United States, or a
qualified alien. He offered his belief that the program needed
some refinements. He said that the proposed bill would be held
over until the cross check information could be obtained from
DHSS for further discussion. He stated that his intention was
to move the bill out of committee at the next opportunity.
REPRESENTATIVE VAZQUEZ asked if it made sense to likewise
tighten the qualification criteria to a program like the heating
assistance program.
MS. MITCHELL asked for clarification.
REPRESENTATIVE VAZQUEZ asked if this program should be made
similar to the criteria for a general fund program, similar to
the heating assistance program.
MR. O'BRIEN clarified that, as the heating assistance program
was a federal and state program, there was a distinction between
the funding and the qualifications.
4:24:33 PM
CHAIR SEATON opened public testimony. After ascertaining no one
wished to testify, closed public testimony.
[HB 262 was held over.]
4:25:21 PM
ADJOURNMENT
There being no further business before the committee, the House
Health and Social Services Standing Committee meeting was
adjourned at 4:25 p.m.