03/20/2001 03:38 PM House MLV
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+ teleconferenced
= bill was previously heard/scheduled
ALASKA STATE LEGISLATURE
HOUSE SPECIAL COMMITTEE ON MILITARY AND
VETERANS' AFFAIRS
March 20, 2001
3:38 p.m.
MEMBERS PRESENT
Representative Mike Chenault, Chair
Representative Beverly Masek
Representative Lisa Murkowski
Representative Joe Green
Representative Pete Kott
Representative Sharon Cissna
Representative Joe Hayes
MEMBERS ABSENT
All members present
OTHER LEGISLATORS PRESENT
Representative Richard Foster
COMMITTEE CALENDAR
SENATE JOINT RESOLUTION NO. 10
Urging the United States Congress to fully fund the operational
readiness and recapitalization requirements of the United States
Coast Guard.
- MOVED HCS SJR 10(MLV) OUT OF COMMITTEE
HOUSE BILL NO. 88
"An Act changing the name of the Alaska Pioneers' Home to the
Alaska Pioneers' and Veterans' Home and of the Alaska Pioneers'
Homes Advisory Board to the Alaska Pioneers' and Veterans' Home
Advisory Board; relating to services for veterans in the home;
relating to the advisory board for the home; making other
amendments to the statutes relating to the home; making
conforming amendments to other statutes; and providing for an
effective date."
- HEARD AND HELD
PREVIOUS ACTION
BILL: SJR 10
SHORT TITLE:US COAST GUARD FUNDING
SPONSOR(S): SENATOR(S) AUSTERMAN
Jrn-Date Jrn-Page Action
01/30/01 0221 (S) READ THE FIRST TIME -
REFERRALS
01/30/01 0221 (S) STA
01/31/01 0237 (S) COSPONSOR(S): WILKEN, KELLY,
COWDERY
01/31/01 0237 (S) ELTON, LEMAN
02/13/01 (S) STA AT 3:30 PM BELTZ 211
02/13/01 (S) Moved Out of Committee
MINUTE(STA)
02/14/01 0367 (S) STA RPT 5DP
02/14/01 0367 (S) DP: THERRIAULT, PHILLIPS,
PEARCE,
02/14/01 0367 (S) DAVIS, HALFORD
02/14/01 0367 (S) FN1: ZERO(S.STA)
02/14/01 0374 (S) COSPONSOR(S): PEARCE, TAYLOR
02/16/01 (S) RLS AT 10:45 AM FAHRENKAMP
203
02/16/01 0405 (S) RULES TO CALENDAR 2/16/01
02/16/01 (S) MINUTE(RLS)
02/16/01 0410 (S) READ THE SECOND TIME
02/16/01 0410 (S) COSPONSOR(S): LINCOLN, WARD
02/16/01 0411 (S) ADVANCED TO THIRD READING
UNAN CONSENT
02/16/01 0411 (S) READ THE THIRD TIME SJR 10
02/16/01 0411 (S) PASSED Y15 N- E5
02/16/01 0414 (S) SJR 10 TRANSMITTED TO (H)
02/19/01 0363 (H) READ THE FIRST TIME -
REFERRALS
02/19/01 0363 (H) MLV
02/19/01 0363 (H) REFERRED TO MLV
02/19/01 0375 (H) CROSS SPONSOR(S): WILSON,
STEVENS
03/13/01 (H) MLV AT 3:30 PM CAPITOL 120
03/13/01 (H) -- Meeting Canceled --
03/13/01 0579 (H) CROSS SPONSOR(S): MURKOWSKI
03/20/01 (H) MLV AT 3:30 PM CAPITOL 120
BILL: HB 88
SHORT TITLE:PIONEERS' AND VETERANS' HOME/ADVISORY BD
SPONSOR(S): RLS BY REQUEST OF THE GOVERNOR
Jrn-Date Jrn-Page Action
01/24/01 0155 (H) READ THE FIRST TIME -
REFERRALS
01/24/01 0155 (H) MLV, STA, FIN
01/24/01 0156 (H) FN1: ZERO(ADM)
01/24/01 0156 (H) GOVERNOR'S TRANSMITTAL LETTER
01/24/01 0156 (H) REFERRED TO MLV
03/20/01 (H) MLV AT 3:30 PM CAPITOL 120
WITNESS REGISTER
SEAN RILEY, Staff
to Senator Alan Austerman
Alaska State Legislature
Capitol Building, Room 417
Juneau, Alaska 99801
POSITION STATEMENT: Presented SJR 10 on behalf of the sponsor
and answered questions.
CLIFFORD J. STONE, Staff
to Representative Alan Austerman
Alaska State Legislature
Capitol Building, Room 417
Juneau, Alaska 99801
POSITION STATEMENT: Responded to question on SJR 10.
FRANK KELTY, Resource Analyst
City of Unalaska
P.O. Box 610
Unalaska, Alaska 99685
POSITION STATEMENT: Testified in support of SJR 10.
JIM DUNCAN, Commissioner
Department of Administration
PO Box 110200
Juneau, Alaska 99811-0200
POSITION STATEMENT: Presented HB 88 on behalf of the governor.
JIM KOHN, Director
Division of Alaska Longevity Programs
Department of Administration
PO Box 110211
Juneau, Alaska 99811-0211
POSITION STATEMENT: Answered questions regarding HB 88.
MG PHILLIP OATES, Adjutant General/Commissioner
Department of Military & Veterans' Affairs
PO Box 5800
Fort Richardson, Alaska 99505-0800
POSITION STATEMENT: Testified that [HB 88] is a great solution
that is worthy of full support.
FRANCES PURDY
1741 Westview Circle
Anchorage, Alaska 99504
POSITION STATEMENT: Testified in support of a veterans' home or
veterans' homes, but expressed concerns with HB 88.
MARTY MARGESON
1401 West 13th Avenue
Anchorage, Alaska
POSITION STATEMENT: Expressed concerns with HB 88.
ACTION NARRATIVE
TAPE 01-6, SIDE A
Number 0001
CHAIR MIKE CHENAULT called the House Special Committee on
Military and Veterans' Affairs meeting to order at 3:38 p.m.
Members present at the call to order were Representatives
Chenault, Murkowski, Kott, and Hayes. Representatives Masek,
Green, and Cissna arrived as the meeting was in progress. Also
present was Representative Foster.
SJR 10 - US COAST GUARD FUNDING
Number 0026
CHAIR CHENAULT announced the first item of business, SENATE
JOINT RESOLUTION NO. 10, Urging the United States Congress to
fully fund the operational readiness and recapitalization
requirements of the United States Coast Guard.
Number 0125
SEAN RILEY, Staff to Senator Alan Austerman, Alaska State
Legislature, came forward to present SJR 10 on behalf of the
sponsor. He referred briefly to the written sponsor statement,
then told members it seems the perfect time to send a clear
message to Washington, D.C., that Alaskans have a critical
relationship with the U.S. Coast Guard. Mr. Riley suggested
that if Alaskans fully support funding the U.S. Coast Guard,
"Washington, D.C., will listen" because the country depends on
Alaska, which has unique geography and rich resources.
MR. RILEY reported that the U.S. Coast Guard is facing a $91
million deficit, "reducing its air and sea patrols by over 10
percent." It is running in the red because of higher-than-
expected energy costs and higher pay; its workhorse, the C-130
aircraft that operate out of Kodiak, will soon begin a 33
percent reduction in flight hours. Furthermore, U.S. Coast
Guard patrols have already spent 3,000 fewer hours in the air
and close to 5,000 fewer hours at sea.
MR. RILEY informed members that the U.S. subcommittee chair of
the Department of Transportation has said that lack of adequate
resources has seriously weakened the U.S. Coast Guard's ability
"to defend our borders and to patrol our waterways from harm."
Furthermore, Rear Admiral [Thomas J.] Barrett has said his
budget is being squeezed so tightly that missions are having to
be delayed. Mr. Riley emphasized that [if legislators] unite in
one voice to Washington, D.C., there will be a much better
opportunity for the U.S. Coast Guard to be funded. He pointed
out that being a resolution, SJR 10 has no fiscal note.
Number 0377
REPRESENTATIVE MURKOWSKI expressed 100 percent support for the
U.S. Coast Guard, including "more than adequate funding and full
funding." However, "full funding" is subject to different
interpretations. She referred to [page 2, beginning at line
27], where it read "fully fund the United States Coast Guard's
operational readiness and recapitalization requirements". She
asked whether there is a more direct way to say that.
MR. RILEY asked whether Representative Murkowski had a
recommendation regarding that language.
REPRESENTATIVE MURKOWSKI said no, clarifying that she was
wondering whether the meaning of full funding was discussed in
the [Senate].
MR. RILEY offered to get back to her with an answer.
REPRESENTATIVE MURKOWSKI specified that she didn't wish to hold
up the resolution [in order to address the meaning of "fully
fund"].
Number 0548
REPRESENTATIVE HAYES asked whether this is a supplemental
request or is a request for FY02 funding.
MR. RILEY answered, "This is supplemental. Initially, it was
not accepted, and now we're going to be going through the second
rounds and having another opportunity."
REPRESENTATIVE HAYES asked why, if this is for full supplemental
funding in order to make it through this year's budget, that
isn't stated in the resolution; it sounds [in SJR 10] as if the
request is for the next year's monies.
MR. RILEY said he believed Representative Hayes to be correct.
He asked whether Representative Hayes had a suggestion to
clarify that language.
REPRESENTATIVE HAYES answered that he would think about it and
come up with something.
Number 0703
REPRESENTATIVE MURKOWSKI concurred with Representative Hayes,
noting that it reads [beginning on page 2, line 28] "fully fund
the ... operational readiness and recapitalization requirements
to ensure that this ... remains 'semper paratus' throughout the
Twenty-First Century." She commented that it is a pretty broad
statement, with which Alaskans probably would agree. She asked,
however, whether it is the message the sponsor wants to send.
Or is the request more direct, to address the immediate problem
with the federal budget?
MR. RILEY responded that he didn't have a problem with rewriting
it to be more specific, but he believed it was a figurative, not
literal, intent, in order to strengthen [the resolution].
Number 0796
REPRESENTATIVE KOTT remarked that he agreed with the previous
speakers. He said he would be curious to have "some
conversation with our senior [U.S.] Senator, since he is a
powerful individual in Washington, D.C., that controls, to a
large extent, what is appropriated around the country; and I
know he's a strong supporter of the military."
REPRESENTATIVE KOTT asked whether there was any discussion in
previous committees with regard to including the name of Rear
Admiral Barrett in the list of people to receive copies of the
resolution. He explained that he always likes to send something
to "the most senior individual in the state, to let him know
we're behind him."
MR. RILEY deferred to Mr. Clifford Stone.
Number 0874
CLIFFORD STONE, Staff to Representative Alan Austerman, Alaska
State Legislature, came forward to respond to Representative
Kott's question. He noted that Rear Admiral Barrett has been
kept fully informed, and had, in fact, given a full presentation
in the Senate State Affairs Standing Committee regarding SJR 10.
He explained the reason for the wording in SJR 10:
We drafted the resolution ... in this form to address
other concerns, ... in kind of a generic sense, if you
will. It seemed to be what the Coast Guard wanted,
when we ran this past both Admiral Barrett and his
staff. And this was born out of ... the Pacific
Fisheries Legislative Task Force, because they could
see ... the dollars drifting away from the Coast
Guard. And so, the ... task force came up with this
generic language, which we tweaked ... [to be]
specific to Alaska, and made some recommended changes.
...
This same resolution, in essence, is going to come
from the other states; there [are] about six other
states in this task force that are going to send that
same resolution back to their congressional leaders
and the cabinet members and the Vice President, to
address what they feel is a very serious undermining
of the ... United States Coast Guard. We did receive
... some input from Admiral Barrett, and we did make
those additions in the resolution. ...
Certainly, it could ... be more specific and to the
point. ... Senator [Austerman] would certainly
entertain ... any language, and we could work on that.
We could try and go back, both to our congressional
delegation in D.C. and to Admiral Barrett, to see if
we can't be a little more specific and if they felt it
would make a bigger impact back there in D.C. So, we
could certainly work on that before we requested ...
it go to the floor for a vote.
Number 1017
REPRESENTATIVE KOTT said he wasn't sure that he would hold it up
for that particular purpose, depending on the timeline involved.
He suggested that the congressional delegation members are smart
enough to figure out what [the legislature] is trying to
achieve. He restated, however, that for any resolution dealing
with the State of Alaska, as a courtesy, a copy should go to the
highest-ranking military official in charge of that operation.
As to whether Secretary Principi [Anthony J. Principi, Secretary
of Veterans Affairs] should get a copy, that is another
argument, he added.
MR. STONE agreed [regarding Rear Admiral Barrett] and stated,
"We'll go ahead and get that in there." He also said that
perhaps the commander of the Pacific should be added after
getting that person's full title.
REPRESENTATIVE MURKOWSKI responded, "Admiral Blair." She then
suggested that if this message could be better used by the
congressional delegation if [SJR 10] were more specific, then it
would be worth asking, even by telephone. If U.S. Senator
Stevens comes back and states that it would be helpful to
specify that the legislature supports full funding for the
supplemental for this budget - even in a specific amount, if
desired - that could be done. If, however, he said it didn't
make any difference, SJR 10 could be sent to [Congress] as soon
as possible, in order to be in [Washington, D.C.] in conjunction
with the other states' [resolutions]. She questioned whether it
was desirable or appropriate procedurally, however, to make a
conceptual amendment that was contingent upon a response to a
telephone call.
Number 1283
REPRESENTATIVE MURKOWSKI asked Representative Kott, as chairman
of the House Rules Standing Committee, whether an amendment
could be added in that committee to conform with the current
committee, in order to not hold up [SJR 10].
REPRESENTATIVE KOTT said he would "entertain that option." At
that point, it could either be amended in the House Rules
Standing Committee or a floor amendment could be prepared. If
this current language is best for what is being attempted, that
is fine, he added, but he suspects that some language could be
used to address the concerns expressed.
Number 1351
REPRESENTATIVE MURKOWSKI made a motion to amend SJR 10 to add
both Rear Admiral Barrett and Admiral Blair to the list of
individuals who will receive copies. There being no objection,
it was so ordered.
Number 1419
FRANK KELTY, Resource Analyst, City of Unalaska, came forward to
testify in support of SJR 10. He offered some personal
background, noting that he had worked 30 years in the Alaskan
seafood industry in the Aleutian Islands, in Unalaska and Dutch
Harbor, and was an elected official [mayor] in the community for
18 years.
MR. KELTY explained that the U.S. Coast Guard's mission, both
nationwide and in Alaska, is of critical importance. When he
first moved to the Aleutians, there were few resources. Many
nights, choppers would leave Kodiak to come to the middle of the
Bering Sea to assist with a rescue, which took hours. He noted
that C-130s had to respond. He had experienced working with
vessels that sank and tragedies that occurred, he told members,
emphasizing the importance of the U.S. Coast Guard in that
regard. In addition to search-and-rescue missions, the U.S.
Coast Guard enforces the 200-mile limit and stops incursions
into the pollock fishing grounds on the border. The U.S. Coast
Guard also conducts high-seas driftnet patrols in order to
protect Alaska's salmon returns. The large area that must be
patrolled and protected is incredible, he added.
MR. KELTY reminded members that the Bering Sea crab fisheries
are the most dangerous in the nation. The U.S. Coast Guard has
responded by keeping helicopters at Saint Paul Island during
some of the crab [seasons] around the Pribilof Islands, and by
keeping helicopters on the 378-foot cutters on patrol, in order
to respond to events. For example, this past crab season, three
fishing vessels lost their pilothouse windows on one day; the
U.S. Coast Guard had to respond and assist those vessels in
order for them to get back to port and make repairs.
MR. KELTY noted that Unalaska has a marine safety detachment
that does a great job of doing safety inspections of vessels.
As a result, there are fewer tragedies, as well as better
equipment and training for the fishing fleet. Furthermore, [the
U.S. Coast Guard] responds to pollution events such as the
incident a few years ago in which a Japanese tramper went
aground; the U.S. Coast Guard rescued the crew and coordinated
the cleanup of 40,000 gallons [of fuel] that inundated the
community.
MR. KELTY concluded by saying he has seen, firsthand, the work
that they do [in spite of] terrible weather conditions out
there. He urged the committee to support the U.S. Coast Guard,
which definitely needs the tools to do the job, not just for
Alaska and the seafood industry, but also for the nation.
Number 1581
CHAIR CHENAULT asked whether there were questions, then thanked
Mr. Kelty. He returned the discussion to the committee.
REPRESENTATIVE KOTT remarked that he thinks [SJR 10] is a worthy
resolution, and that under the circumstances discussed
previously, [members] would look for the sponsor to provide
input in order to resolve the funding language.
Number 1605
REPRESENTATIVE KOTT made a motion to move SJR 10, as amended,
out of committee with individual recommendations and the zero
fiscal note. There being no objection, HCS SJR 10(MLV) was
moved out of the House Special Committee on Military and
Veterans' Affairs.
HB 88-PIONEERS' AND VETERANS' HOME/ADVISORY BD
CHAIR CHENAULT announced the final order of business, HOUSE BILL
NO. 88, "An Act changing the name of the Alaska Pioneers' Home
to the Alaska Pioneers' and Veterans' Home and of the Alaska
Pioneers' Homes Advisory Board to the Alaska Pioneers' and
Veterans' Home Advisory Board; relating to services for veterans
in the home; relating to the advisory board for the home; making
other amendments to the statutes relating to the home; making
conforming amendments to other statutes; and providing for an
effective date."
Number 1745
JIM DUNCAN, Commissioner, Department of Administration (DOA),
presented HB 88 on behalf of the governor. Commissioner Duncan
informed the committee that Alaska has had a long-standing
commitment to recognize the commitments veterans have made to
this country and the State of Alaska. However, Alaska is one of
two states that does not have a state veterans' home. In 1992
the legislature passed a statute that DOA would establish a
veterans' home and would allow application for federal
assistance for construction of such a home. The statute clearly
said that the operating costs of the home should be paid for by
the residents and the federal government. However, nothing
materialized as a result of that legislation. In 1998 [DOA]
made an amendment to that statute in order to allow nursing
homes to provide nursing care [to veterans] in an attempt to
increase federal dollars and make state general funds
unnecessary. Again, nothing happened. Therefore, [DOA] is
present today without a facility or system in place specifically
for veterans.
COMMISSIONER DUNCAN explained that due to the lack of action,
the governor appointed a cabinet-level task force to review what
has been done, where the situation is, and what might be done to
recognize the veterans in Alaska. That task force was comprised
of the Commissioners of the Department of Administration, the
Department of Military & Veterans' Affairs, and the Department
of Health & Social Services. The task force evaluated several
options before agreeing on this proposal [embodied in HB 88].
The option of a stand-alone veterans' home in Alaska was
reviewed. However, it was found to be costly. An 80-bed stand-
alone veterans' home would cost about $24.3 million to
construct, of which the state's share would be $8.5 million and
the federal government would provide the remainder. Operation
of such an 80-bed home would cost about $7.2 million a year, of
which $2.4 million would be from the state's general fund. The
conclusion was that a stand-alone veterans' home would be
costly, and furthermore it would require veterans to move to a
central location in the state, away from their community and
family.
COMMISSIONER DUNCAN turned to the second option that was
evaluated: the Alaska Pioneers' Home system. There are six
such homes spread across the state. Commissioner Duncan related
his belief that the Alaska Pioneers' Home system is a fine
system. That system was evaluated in regard to what could be
done to recognize the commitment that veterans have made and how
that system could be expanded to recognize veterans as well as
to provide a veterans' preference. As a result of this
evaluation it became clear that the Alaska Pioneers' Home system
provided a system that was already in place, with infrastructure
that isn't being fully utilized in that there is unused
capacity. Secondly, use of the Pioneers' Home system would be
less expensive than constructing a stand-alone home. Thirdly,
because the Pioneers' Homes are located throughout the state,
veterans could enter those homes and stay closer to their
families and communities while receiving quality care.
Therefore, the task force recommended to the governor that [he]
proceed with legislation, HB 88, that is before the committee
today.
Number 1951
COMMISSIONER DUNCAN explained that HB 88 would accomplish the
following. Firstly, it provides recognition to the veterans in
this state. Secondly, it provides for a veterans' preference in
the Pioneers' Home system. Thirdly, it provides veteran
representation on the Pioneers' Home Advisory Board. The
recognition is due to the recommendation to change the name from
the Alaska Pioneers' Home system to the Alaska Pioneers' and
Veterans' Home system. The veterans' preference would be for
125 beds, which amounts to 21 percent of the funded beds, in the
current system. Currently, there is a system capacity of 600
beds. Therefore, if there were vacant beds and there were less
than 125 veterans in the homes and a bed became available, the
next veteran on the list would be admitted. At present, there
are 90 veterans in the Pioneers' Homes. Of the 183 persons on
the active waiting list, 56 are veterans. Therefore, if the
veterans' preference was in place and the beds were fully
funded, there would be 90 more beds funded and another 35
veterans could be admitted as well as 50 some people who may or
may not be veterans. Commissioner Duncan highlighted that the
real benefit of HB 88 would be that it serves veterans and
pioneers that are nonveterans. He informed the committee that
currently there are 90 vacant beds, which are primarily located
in the Anchorage, Palmer, and Sitka Pioneers' Homes.
COMMISSIONER DUNCAN turned to the topic of how the veterans'
preference would work in regard to the number of men versus
women. He informed the committee that of the 90 veterans
already in the homes, 9 are females and 82 are males. Clearly,
there are female veterans who would also benefit from this
proposal.
Number 2176
COMMISSIONER DUNCAN continued with the veteran representation on
the advisory board. The Pioneers' Home Advisory Board is
currently a 7-member advisory board and will remain so under HB
88. However, the legislation requires that at least two of the
members of the advisory board will be veterans. Currently, two
veterans serve on the advisory board. It would also be required
that one of the veterans on the Pioneers' Home Advisory Board
would be the chair of the Alaska Veterans Advisory Council.
COMMISSIONER DUNCAN highlighted the fact that the new system
[being proposed in HB 88] would not become part of the federal
VA (U.S. Department of Veterans Affairs) system. Commissioner
Duncan said, "We are not interested in seeing the federal
government assume control of this system and our legislation
does not provide for that." This point was made clear to the
Secretary of the Department of Veterans Affairs. "We want to
maintain a state-run system," he said. There is no desire to
fall under federal regulations, rules, or requirements because
Alaska's residency and age requirements would be impacted.
COMMISSIONER DUNCAN noted that there is no federal funding
requested for this system. This legislation does have a fiscal
note of about $5.2 million of which $2.6 million would come from
the general fund and $2.6 million from Pioneers' Home receipts.
That [total of $5.2] would allow the Pioneers' Homes to hire the
staff necessary to fully staff the 90 beds and thus allow the
system to operate at capacity. "Without those dollars, we
couldn't staff those beds and ... residents could not occupy
those beds," he pointed out.
[The tape was reversed to Side B early, and therefore there are
approximately 8 minutes of blank tape at the end of Side A.
There is approximately 4 minutes of blank tape at the beginning
of Side B.]
TAPE 01-6, SIDE B
COMMISSIONER DUNCAN remarked, "But if you look at the benefit of
the dollars that are being requested and compare that to what
the cost would be if we were to operate a stand-alone home, I
think you'll find it's money well-used." Although "we" aren't
interested in allowing "our" system to be controlled by the
federal government, "we" are interested in working with the VA
administration to determine whether Alaska's veterans can
receive a waiver in order that the benefits veterans receive in
veterans' homes in other states could be accessed under the
proposed system. There has been no agreement on that to this
point. However, Commissioner Duncan noted that work exploring
the possibility of a demonstration program is continuing so that
a federal waiver could be obtained in order to allow VA benefits
to be used by veterans in the state. Although such a waiver
would be beneficial, it wouldn't impact the general fund request
because [the waiver] would allow the benefit to go directly to
the veteran to help pay for their cost of care.
COMMISSIONER DUNCAN informed the committee that the Pioneers
Advisory Board reviewed HB 88 and recommended support of it.
Commissioner Duncan noted that he has reviewed HB 88 and doesn't
see a downside; it doesn't do anything that would weaken the
present Pioneers' Home system. In fact, he viewed HB 88 as
strengthening the current system and allowing full utilization
of the system while providing needed care to veterans and
pioneers alike.
Number 2081
REPRESENTATIVE GREEN pointed out that the committee packet
includes a letter from the governor that says there are 78 on
the waiting list while Commissioner Duncan is saying that there
are 90 on the waiting list. He asked if the numbers are a
"moving target" or are there different sources of data.
COMMISSIONER DUNCAN said that the numbers do change as people
enter and leave the home. He specified that he was quoting
numbers from January 31 and February 1. Furthermore, a better
census of the number of those in the home has been done that has
produced a more definitive number for the number of veterans in
the Pioneers' Homes [than the original number]. The numbers
change on a daily basis.
REPRESENTATIVE GREEN inquired as to why there are waiting lists
if there are vacant beds.
Number 2003
JIM KOHN, Director, Division of Alaska Longevity Programs,
Department of Administration, explained that currently there are
90 vacant beds that are classified as residential level care.
Residential care means that residents would receive assistance
with meals, room, heavy housecleaning, and emergency response.
However, there was no staffing for that area other than the
kitchen crew and some housekeeping staff. Those residential
beds have never been staffed with direct care staff. He pointed
out that the applicants to the waiting list are all in need of
direct care services with most of them requiring 24-hour
oversight. Therefore, the lack of direct care staff forces
those beds to be vacant and thus the $5.2 million would provide
sufficient staff to bring in those applicants and serve their
needs.
REPRESENTATIVE MURKOWSKI noted that currently in the Pioneers'
Home there are attempts to accommodate spouses of those on the
waiting list. She related her understanding that the same would
be true for veterans' spouses. However, she inquired as how the
veteran's spouse would be counted, that is would the spouse be
counted as a veteran or nonveteran.
MR. KOHN said that when couples wanted to enter the home at the
same time, the home tried to accommodate them. In recent
history, one of the spouses typically has Alzheimer's disease or
a related disability and the spouse or independent wants to
enter the home at the same time. The policy has been to wait
until one of the spouses reaches the top of the list and then
there is an attempt to accommodate both at the same time. If
the beds are open in the varying levels of care at the same
time, then it is fairly easy. However, if the beds in the
varying level of care aren't open at the same time, it is more
difficult. He explained that in such circumstances the policy
has been to hold the spouse at the top of the active waiting
list [until such time that both individuals could be
accommodated].
MR. KOHN informed the committee that he was asked by the Senate
State Affairs Committee to draft some regulations. One of the
items included in the regulations is to place the aforementioned
policy in regulation. He specified, "It wouldn't have anything
to do with veterans or nonveterans; it would have to do with
spouses." He indicated that the [draft regulations regarding
this matter] read as follows: "As one spouse would get to the
top of the waiting list - whether they got to the top of the
waiting list because they were a veteran or because they [were]
waiting in line on their own accord - ... we would then ...
would try to accommodate the other spouse at the same time or at
least keep the spouse at the top of the waiting list until a bed
opened up for that spouse."
Number 1737
REPRESENTATIVE MURKOWSKI expressed concern that she has heard
regarding whether a veteran's spouse that enters the home [at
the same time as the veteran] would be counted as one of the 125
veterans' beds. If so, the 125 veterans' beds wouldn't
necessarily be filled with veterans if the spouse is allowed
entrance at the same time and takes a veteran preference bed.
MR. KOHN explained that the presently drafted regulations would
not count a nonveteran spouse as part of the 125 [veterans'
preference beds]. The regulation that would allow spouses to
enter the home at the same time wouldn't be dependent upon
whether the spouses were veterans or nonveterans, only that one
of the spouses would be at the top of the [waiting] list for
whatever reason.
REPRESENTATIVE KOTT said that he was sure Mr. Kohn was familiar
with letters that the committee has received from Lisa Caress-
Beu, Vice President, Center for Advocacy and Rights of the
Elderly (CARING), and Aileen Herring. Both letters contain some
strong allegations that he thought should be addressed.
Number 1618
REPRESENTATIVE KOTT then turned to Commissioner Duncan and his
testimony that there is ongoing work with the federal Department
of Military & Veteran Affairs (DMVA) in order to ensure that
Alaska's veterans receive the same monetary amounts that
veterans around the country receive. He noticed that the
committee packet contains a letter from U.S. Senator Stevens
that expresses his support of such a concept and willingness to
help with any statutory changes in Congress. He asked if, in
order for Alaska's veterans to receive the same benefits as
veterans in other states, it would require a statutory change.
COMMISSIONER DUNCAN answered that at this point it isn't clear
whether a statutory change would be required. Those discussions
are just beginning.
REPRESENTATIVE KOTT returned to his question to Mr. Kohn. He
expressed his discomfort in the allegations [contained in the
aforementioned letters] that a study was funded and the
University of [Southern] California experts were told what "we
wanted to hear."
Number 1509
MR. KOHN began by addressing the University of Southern
California study. He informed the committee that [those that
performed the study] included the Chief of [the Division of]
Geriatrics, a world-renowned expert on assisted living, and
others. Those folks surveyed the Anchorage Pioneers' Homes and
wrote a report that Mr. Kohn offered to share with the
committee. That report didn't mention that there were no
nursing level residents in the Pioneers' Homes. Mr. Kohn said,
"Of course there are nursing level residents in the Pioneer
Homes." Furthermore, the entire country, including the VA is
going to assisted living homes for long-term care for the
elderly. He pointed out, "In fact, about 80 percent of the
elderly in nursing homes are there temporarily .... They are
transitioned from acute care, which would be hospital care, into
nursing home care for rehabilitation and then out into the
community to assisted living homes, their own home with in-home
care, or many other options ...." The fact that the VA has only
domiciliary care, a type of residential care, in veterans' homes
has been noted by U.S. Secretary Principi. Secretary Principi
also expressed the need for the VA to catch up with the rest of
the nation to move in the direction of assisted living care.
Mr. Kohn paraphrased Secretary Principi to have said that since
the Pioneers' Homes are assisted living homes, this would be
good a opportunity to demonstrate veterans being cared for in
assisted living homes and help the VA move in that direction.
MR. KOHN said that the controversy penned in the letters is one
that he believes is a national controversy. He explained that
over the last 20 years or so the concept of skilled nursing care
facilities where elderly lived out their lives has changed.
Generally, the elderly don't live out their lives in skilled
nursing homes anymore. The current concept is one in which the
elderly enter assisted living homes, which provide nurturing
care and a social model of care with medical care to support the
residents. Mr. Kohn remarked that the Pioneers' Homes are
somewhat unlike other assisted living homes in the nation
because they have a strong medical model. For example, in
pioneers' homes nurses are on staff around the clock, which is
usually not the case with assisted living homes. Furthermore,
the pioneers' homes do care for individuals who could be nursing
level residents.
MR. KOHN turned to one of the concerns expressed in one of the
letters regarding the amount of staffing if a pioneers' and
veterans' home program was implemented. The $5.2 million price
was developed to take care of the applicants on the waiting list
that would fill the approximately 90 beds. That price was based
on 4.9 hours [of care] per resident per day. He explained that
in the long-term care industry staffing is discussed in terms of
the number of hours that can be given to each resident in each
24-hour period. Mr. Kohn said, "We have tried to maintain, and
have maintained for the most part, 4.9 hours per resident per
day." In the Lower 48, skilled nursing facilities provide an
average of 2.5 [hours of care per resident per day].
MR. KOHN informed the committee that the Pioneers' Homes are
currently in the process of accrediting the homes with a
national group, the Joint Commission on [Accreditation of]
Healthcare Organization (JCAHO). That commission certifies
hospitals and has done so for maybe 50 or more years and now are
certifying assisted living homes. The Alaska Pioneers' Homes
will be the first [assisted living homes] to be certified across
the state. A couple of months ago, "we" met with a
representative of JCAHO who taught a class on what was necessary
to achieve certification. After the program, "we" walked
through the Anchorage Pioneers' Home and the JCAHO
representative remarked that it was a very high medical model
assisted living home while also taking in nursing home level
residents. Therefore, there have been others in the home
besides the University of Southern California that feel the
same.
Number 1037
MG PHILLIP OATES, Adjutant General/Commissioner, Department of
Military & Veterans' Affairs, testified via teleconference.
General Oates remarked that one of the most vexing challenges he
has had has been to help craft a solution to provide care to
Alaska's veterans. For many reasons, it hasn't been possible to
acquire the funding for a stand-alone veterans' home.
Furthermore, construction of a stand-alone veterans' home would
be in one location. The model that had been considered provided
fewer beds in only one location, with a greater cost and thus
would have been of less service than the proposal embodied in HB
88. General Oates emphasized the need to do something for
Alaska's veterans. He pointed out that Alaska has the second
highest per capita number of veterans in the nation. Alaska is
one of two states that doesn't have a veterans' home and is the
only state that isn't in the process of building one.
Therefore, [the proposal in HB 88] is an important step forward
in providing some veterans with necessary care. General Oates
charged anyone on the committee who had reservations to provide
another solution. He specified that there hasn't been a
solution thus far because of the dollars involved.
GENERAL OATES explained that [HB 88] will provide, in essence,
six veterans' homes across the state and will provide an
opportunity to work with the VA in a direction that it desires
to move. He related his belief that [HB 88] is a great solution
that is worthy of full support. Furthermore, the time is now to
move forward. He discussed Alaska's historical ties to the
military. He concluded by saying that [HB 88] will not only
solve the problem but also provide a model for the nation.
Number 0771
REPRESENTATIVE MURKOWSKI turned to the difficulties of a stand-
alone veterans' facility and noted her agreement that if a
combination Pioneers' and Veterans' Home could be achieved, it
could be a model that other states could look to. Therefore,
she wanted to find a way to make it work. She then pointed out
that the veterans' priorities include $200,000 to perform a
study of a stand-alone veterans' home as well as identifying the
needs of veterans in Alaska. She inquired as to the status of
that funding.
GENERAL OATES explained that the $200,000 is in the DMVA budget
to allow required studies, surveys of the exact care that exists
in the state, as well as to work all the needs of all veterans
at all levels. He acknowledged that the Pioneers' and Veterans'
Home would be for veterans that are 65 and older. There are
other veterans with other needs, and therefore he indicated the
need to establish the proper database in order to allow the VA
to meet the needs of the veterans that won't be met by this
study. Also, [there is the need] to provide greater involvement
in the Pioneers' Home system with veterans' service officers so
that it can be determined what further can be established with
the Pioneers' Homes systems. He noted that could mean
[providing] veterans' clinics on either a permanent or rotating
basis, or making pharmacies available to the veterans' program,
or surveying the expansion of the Pioneers' Home in order to
determine whether there could be improvements or extensions to
those homes without encumbering all the rules of the VA. He
echoed earlier testimony that the VA is looking for new and
innovative ways to proceed.
Number 0522
REPRESENTATIVE MURKOWSKI noted that she and General Oates had
the opportunity to speak with U.S. Secretary Principi regarding
his ideas and what may be acceptable to the VA. During that
conversation, the term "pilot project" came up. She asked if
there is any further discussion or movement in that direction.
GENERAL OATES answered that [the department] has an ongoing
dialogue with the VA, although the majority of the work is being
done at the state level. He informed the committee of a pending
visit to the Pioneers' Homes in order to determine if they are
adequate. He reiterated that U.S. Secretary Principi was highly
impressed with the Pioneers' Homes during his visit and
commented that the Pioneers' Home system is better than what
currently exists in many veterans' homes. Therefore, General
Oates felt that the survey would illustrate that the Pioneers'
Homes are a high standard and would allow a nontraditional
approach.
GENERAL OATES informed the committee that Alaska's congressional
delegation has remarked on the importance of the state taking
the first step forward. He expressed his confidence that
federal assistance will be available. He noted that there has
been a pledge of support from U.S. Senator Stevens and
Murkowski. He predicted that if the state takes the first step,
more federal assistance will be secured while, at the same time,
the full support of Alaska's congressional delegation and the VA
would be obtained.
Number 0278
FRANCES PURDY testified via teleconference in support of
veterans' homes or a veterans' home. She recognized that the
Pioneers' Homes afford the ability to have a noncentralized
veterans' home. However, she was concerned with the figures
provided by the administration. She informed the committee that
the $12.6 million in fees that are to be generated by the 90
beds would average to about $2,400 a month. However, the
current cost of a Pioneers' Home at the Alzheimer's Disease and
Related Dementia (ADRD) level is $4,040 a month and thus the
state will have to subsidize those beds. For comprehensive
care, the cost is $4,920 a month and [is projected] to increase
to $6,450 a month. Therefore, she questioned how realistic the
underwriting is for these 90 beds. The numbers don't add up.
MS. PURDY informed the committee that the reason there are
vacant beds is because, over time, more people enter the homes
at a higher level of care such as an enhanced level of care, the
ADRD level, or comprehensive care. The Pioneers' Home hasn't
been able to maintain the staff to meet the increasing levels
[of care]. Although she acknowledged that perhaps the Pioneers'
Homes provide 4.9 hours of nursing care a day, the speech
therapy, special nutrition needs, and physical and occupational
therapy are not provided. "To some degree, we don't actually
have the answers from the Pioneer Home, the Department of
Administration, [regarding] what the impact is of the higher
number of people coming in at the higher level of care."
MS. PURDY informed the committee that the administration also
hasn't addressed the issue of the increased number of people on
the stipend program. She explained that the stipend program is
the state's answer to not placing people on Medicaid.
TAPE 01-7, SIDE A
MS. PURDY continued by pointing out that the stipend is 100
percent state funds. If people were [required] to apply for
Medicaid, then the state would only fund 50 percent and the
federal government would provide the other 50 percent. However,
in order to receive Medicaid, some changes regarding the
residency requirement for the Pioneers' Home would have to be
made. Ms. Purdy said, "What we appear to be doing with this [HB
88] ..., the financing part of this, is that the state will have
an increasingly higher burden financially in order to sustain
the services."
Number 0150
MARTY MARGESON testified via teleconference. She read the
following testimony:
My father is a veteran and has been a resident in the
Anchorage Pioneer Home ADRD unit since 1997; his rates
have more than doubled in his 3-year residency. In
July he will pay $4,655 for assisted living. The
staffing shortage is so acute that the Pioneer Home is
unable to fill its beds and has approximately 45 beds
vacant in the Anchorage Home alone. I do not believe
this bill will provide enough staffing for the
incoming residents because it only staffs to the
enhanced assisted living level needs - this level of
care continues to be readily available in our
community small assisted living homes with rates
starting at $2,000 a month; the Pioneer Home cost is
$4,490 per month for this level of care. Why would a
veteran leave a small homey assisted living home and
pay double for institutional care?
My dad left his wonderful small assisted living home
when he required 24-hour monitoring in the "alarmed"
... ADRD unit in 1997 .... My dad moved [into the
ADRD unit] for nursing care. ... although his rates
have doubled, the number of nurses has declined.
There is no longer a doctor on staff; there is no
longer 24-hour RN coverage in the ADRD unit. This is
important, because injuries occur when dementia
residents become violent. When my dad was beaten by
another resident there was no RN in the building to
assess his injuries - the LPN thought she could
bandage his wounds. The emergency room doctor
required full facial X-rays and stitches. Had I
listened to the LPN assessment I would have endangered
my dad's health. More RN coverage is needed. During
the night you are lucky to have one RN for 200 plus
residents.
This bill will encourage veterans needing higher
levels of care in the ADRD-Comprehensive units to
enter the Pioneer Home, but this bill will not furnish
enough staff to cover their needs, and therefore the
current residents will suffer more shortages. As an
advocate for my father [and] a member of Caring and
Anchorage Northside Family Council, I continue to
report lack of staffing to feed residents, bath
residents, and to provide individual therapeutic
activates and exercise programs necessary to the
health and dignity of dementia residents. Our
shortages are great. How can one physical therapist
or one activity specialist who often doubles as a bus
driver provide enough stimulation for a 200 plus
highly dependent resident population. Our seniors
deserve better care, but this bill is not the right
approach.
Number 0417
MS. MARGESON continued:
First, this bill will continue to incur state cost.
Veterans like my father do not qualify for nursing
home or assisted living benefits. To qualify for
nursing home benefits, my father would need a 70
percent service-related mental or physical disability.
He has none. What percentage of the Pioneer Home
veterans meets this disability requirement?
Secondly, although the VA Home is a great idea, the
majority of new residents will, like my father, enter
at the ADRD-Comprehensive level, which will accelerate
the number of people requiring nursing care. This
will continue to stretch state coffers. Furthermore,
it makes no sense to pull these veterans from nursing
homes where they can receive Medicaid, which is 50
percent federal monies 50 percent state monies, and
put them in the Pioneer Home stipend program which
costs the state 100 percent for their care. How many
residents were on the stipend five years ago? How
many are on the stipend today? How many will be on
the stipend five years from now? The state can no
longer afford 100 percent coverage - we need to look
to federal monies. Veterans and pioneers can qualify
for Medicaid if they have skilled nursing needs.
Pioneer Home residents on feeding tubes, physical
therapy, et cetera meet this criteria. Small assisted
living homes in our community already take advantage
of federal funds through the Medicaid Choice waiver
program. Residents with dementia can and do qualify
for these federal assistance programs.
I believe the Pioneer Home should reinstate the
skilled nursing license to half the home. I believe
we, as Alaskans, should welcome federal guidance and
oversight, which comes with this money. If our homes
have health-safety risks, which place them below
federal standards, then we need to upgrade them. Our
seniors deserve the best; they at least deserve the
care provided by federal guidelines. I understand
that federal monies will not be available if we
continue the one-year residency requirement. I don't
think we can afford to keep this requirement.
Certainly, if we're willing to turn our beloved
Pioneer Home into a veteran's home, we could be
willing to abolish the residency requirement and keep
our home's name, the Pioneers' Home.
Number 0602
MS. MARGESON concluded:
I hardily support the building of a VA Home. I do not
support this merger which seeks to create additional
funding to fill vacant beds, but does not provide
enough funding to cover the higher needs ADRD-
Comprehensive [unit] and most likely new residents. I
do not support the further decline of care which
results from higher needs residents not having
sufficient staff for feeding, bathing, exercise, and
therapeutic activity. I do not support increasing the
number of residents on the stipend program - this
would be an inevitable outcome since most residents
cannot afford the $5,000 to $6,000 a month. I do not
support seeking VA federal monies for which few
veterans will qualify. I do support seeking federal
monies by relicensing for skilled nursing, and
abolishing the residency requirement. When our
Pioneer Home offered skilled nursing, it was full.
Our Anchorage skilled nursing homes have long waiting
lists. Filling our vacancies by restoring the nursing
license would restore quality care, update and remove
our current health-safety hazards, and bring in
federal governments monies, which would hopefully
abolish the need for the stipend program.
CHAIR CHENAULT announced that Mr. Laddie Shaw, the only
remaining witness to testify, could return next Tuesday to
testify. [HB 88 was held.]
ADJOURNMENT
There being no further business before the committee, the House
Special Committee on Military and Veterans' Affairs meeting was
adjourned at 5:15 p.m.
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