Legislature(2003 - 2004)
03/04/2004 03:04 PM House MLV
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* first hearing in first committee of referral
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+ teleconferenced
= bill was previously heard/scheduled
ALASKA STATE LEGISLATURE
HOUSE SPECIAL COMMITTEE ON MILITARY AND
VETERANS' AFFAIRS
March 4, 2004
3:04 p.m.
MEMBERS PRESENT
Representative Nick Stepovich, Chair
Representative Beverly Masek, Vice Chair
Representative Nancy Dahlstrom
Representative Bob Lynn
Representative Bruce Weyhrauch
Representative Sharon Cissna
Representative Max Gruenberg
MEMBERS ABSENT
All members present
COMMITTEE CALENDAR
HOUSE BILL NO. 440
"An Act relating to the Alaska Pioneers' Home, and the Alaska
Veterans' Home; relating to eligibility for admission to the
Alaska Pioneers' Home and Alaska Veterans' Home; relating to
state veterans' home facilities; making conforming amendments;
and providing for an effective date."
- HEARD AND HELD
PREVIOUS COMMITTEE ACTION
BILL: HB 440
SHORT TITLE: PIONEERS' HOMES/VETERANS' HOMES
SPONSOR(S): RULES BY REQUEST OF THE GOVERNOR
02/05/04 (H) READ THE FIRST TIME - REFERRALS
02/05/04 (H) MLV, HES, FIN
03/04/04 (H) MLV AT 3:00 PM CAPITOL 120
WITNESS REGISTER
DENNIS DeWITT, Special Staff Assistant
Office of the Governor
Juneau, Alaska
POSITION STATEMENT: Reviewed the changes encompassed in the
proposed CSHB 440, Version D.
JOHN VOWEL, Director
Division of Longevity Programs
Department of Health and Social Services (DHSS)
Juneau, Alaska
POSITION STATEMENT: During discussion of HB 440, answered
questions.
ACTION NARRATIVE
TAPE 04-1, SIDE A
Number 0001
CHAIR NICK STEPOVICH called the House Special Committee on
Military and Veterans' Affairs meeting to order at 3:04 p.m.
Representatives Stepovich, Masek, Weyhrauch, Dahlstrom, Cissna,
and Gruenberg were present at the call to order.
Representatives Lynn arrived as the meeting was in progress.
HB 440-PIONEERS' HOMES/VETERANS' HOMES
[Not on tape, but reconstructed from the committee secretary's
log notes, was the following:
CHAIR STEPOVICH announced that the only order of business would
be HOUSE BILL NO. 440, "An Act relating to the Alaska Pioneers'
Home, and the Alaska Veterans' Home; relating to eligibility for
admission to the Alaska Pioneers' Home and Alaska Veterans'
Home; relating to state veterans' home facilities; making
conforming amendments; and providing for an effective date."
Number 0015
REPRESENTATIVE MASEK moved to adopt CSHB 440, Version 23-
GH2085\D, Mischel, 3/1/04, as the working document. There being
no objection, Version D was before the committee.]
[The recording begins at this point.]
CHAIR STEPOVICH reviewed what was included in the committee
packet for HB 440.
Number 0043
DENNIS DeWITT, Special Staff Assistant, Office of the Governor,
turned attention to page 6, line 30, of the original draft.
There was concern with the language "The state may maintain
facilities known as the Alaska Pioneers' Home", which was
stylistic drafting that shouldn't have been allowed. Therefore,
Version D changes the "may" to "shall" so that there is a
specific obligation to continue the pioneers' homes, which was
the intent. Furthermore, it has been the intent since early on
to only convert the Palmer Pioneers' Home into a veterans' home,
which is specified in the language on page 7, lines 2-4, of
Version D. He acknowledged some have expressed concern that
there might be several conversions, and noted that [the
governor] agreed with those folks that any other conversions
should result in a policy discussion before the legislature.
Mr. DeWitt highlighted that on page 8, line 7, of Version D the
word "sale" is removed because there was never any intention to
sale the homes. Should anyone seek the sale of the homes, it
should result in a policy debate before the legislature. The
language on page 9, lines 18, of the original version referred
to "veterans' benefits paid under 38 U.S.C. 1110". The benefits
under 38 U.S.C. 1110 are for someone living in a veterans' or
pioneers' home. However, veterans' groups recommended that
language be removed so that the funds would be available for
providing care for the individuals. After talking with the
Veterans Administration, it was determined those benefits would
be used for living expenses.
Number 0385
REPRESENTATIVE GRUENBERG surmised then that originally the
benefits paid under 38 U.S.C. 1110 were going to be disregarded,
but in Version D those benefits will be included. He asked if
that change will cause any veterans hardship.
MR. DeWITT answered that he didn't believe so. He highlighted
that the change was brought forth by the veteran community.
REPRESENTATIVE GRUENBERG inquired as to how much this benefit
would be monthly.
Number 0442
JOHN VOWEL, Director, Division of Longevity Programs, Department
of Health and Social Services (DHSS), noted that presently seven
residents in the pioneers' home system are veterans. Although
the amount varies for each veteran, he estimated that the
average monthly benefit would amount to approximately $815.
REPRESENTATIVE WEYHRAUCH asked if veterans in Alaska receive
additional funds for the cost of living in Alaska.
MR. DeWITT replied no. He then continued with his overview of
Version D. In the original version a definition of "veteran"
that has been used in other areas of Alaska Statute. However,
after discussion with veterans groups and the U.S. Veterans
Administration (Veterans Administration), the only criteria for
access to a state veterans' home under the Veterans
Administration requirement is that the veteran be discharged on
a basis other than a dishonorable discharge. The initial
definition included honorable discharge and a minimum of 180
days of service. However, it was pointed out that injured
military personnel in the military a shorter period than 180
days would be precluded. Therefore, the definition in Version D
on page 12, lines 21-23, reflects the Veterans Administration
criteria.
CHAIR STEPOVICH asked if the veterans are aware of the
aforementioned change.
MR. DeWITT said he believes so.
CHAIR STEPOVICH emphasized that he wanted to be sure that the
veterans and the pioneers are all on board with this matter.
Number 0636
MR. DeWITT reiterated that he believes the change is responsive
to the concern [the veterans expressed] at the last hearing.
Mr. DeWitt continued his review of Version D by directing
attention to Section 25. He explained that the original version
[repealed] AS 47.55.035, which deals with 30-year residents
being able to go outside the state while remaining on the wait
list for the pioneers' homes. He noted that the aforementioned
hasn't been challenged. If it were challenged, it would likely
be found unconstitutional. Therefore, the intent was to address
it. However, the pioneers raised the issue that there are
instances in which individuals may need to go outside the state.
If the 30-year criteria was eliminated, individuals could [live
in the state] for one year, be placed on the waiting list, and
be allowed to leave the state and remain on the waiting list.
Mr. DeWitt said that [the governor] doesn't have a good solution
to the problem, and therefore he recommended that the provision
not be repealed but rather see how long it lasts. Therefore,
the language repealing it wasn't included in Version D.
MR. DeWITT noted that Version D includes a repeal of AS
44.29.400, which was the first attempt to obtain a veterans'
home in Alaska. He explained that AS 44.29.400 specifies that
the veterans' home should be a stand-alone facility and fully
self-supporting. The problem with the aforementioned is that
the economics to make a veterans' home fully self-supporting
don't work. Furthermore, it's in conflict with the intent of HB
440. Mr. DeWitt explained that AS 44.29.400 specifies that the
veterans' home would have to fully fund itself, without using
any general funds. He posed a situation of a home that housed
10 individuals that were indigent and 10 that were not with the
cost of care in the home at $2,000 a month. In such a
situation, half of the individuals in the home would be there
for free while the other half would have to pay $4,000 a month.
Without a subsidy to address those who are indigent, it's
unlikely to impossible to have people come into a veterans' home
and pay twice the cost of care for themselves in order to cover
the cost of the indigent. Mr. DeWitt noted that he was
surprised that AS 44.29.400 was still in statute.
MR. DeWITT continued with his review of Section 25. He pointed
out that it deletes the pilot project that would have allowed
work toward getting all of the homes certified for providing
veterans' home services. However, the pilot project didn't work
and wasn't acceptable to the Veterans Administration. Because
there is a process in HB 440 that will work, those sections of
law are being removed.
Number 0963
REPRESENTATIVE MASEK turned attention to page 6, line 30, where
the language was changed from "may" to "shall". She asked if
that language change should also be made on page 7, line 3.
MR. DeWITT said that the use of "may" [on page 7, lines 1-3] is
the reason it was used on page 6, line 30. Mr. DeWitt informed
the committee that he believes, after working with the Veterans
Administration, that [the state] is close to a deal. He
estimated that about 5 percent of the deal is left to complete
and it may be left even after the legislature adjourns. Mr.
DeWitt said that the state wouldn't want to be in a position of
being mandated to convert the Palmer Pioneers' Home if it
couldn't be certified. Therefore, this is permissive
legislation to move forward [on certification], which led the
drafter to draft that entire section in a permissive voice
without understanding the difference.
Number 1068
REPRESENTATIVE CISSNA inquired as to what would happen if
certification wasn't granted.
MR. DeWITT answered that without certification, conversion to a
veterans' home can't happen. He explained that the federal
veteran home process is being used and the federal government
will provide 65 percent of the capital costs. To bring the
facility up to Veterans Administration standards would amount to
about $3.5 million. Before that, the Veterans Administration
will pay $26.95 a day for those veterans in the home. Those
[funds] wouldn't be available if certification isn't obtained.
Mr. DeWitt related that representatives of the Veterans
Administration have visited the Palmer Pioneers' Home and the
Anchorage Pioneers' Home, shared operation information, and
visited the plant. The representatives were very impressed.
Mr. DeWitt said, "We're very, very comfortable that it's going
to happen, but nobody's signed the line yet." Therefore, it's
inappropriate to have a mandate and thus the language change to
a permissive tone. In response to Chair Stepovich, Mr. DeWitt
said that he was virtually certain that certification would be
obtained. He highlighted that one of the differences between
this proposal and past proposals is that the Veterans
Administration has worked on this and is "on board with this
approach" and are supportive of it. Furthermore, with the
funding in the fast track supplemental appropriation, this will
be on-line much sooner. In fact, [the Veterans Administration]
is looking into its budget in order to determine how much of its
budget can be certified prior to the fiscal year beginning
October 1st.
Number 1254
REPRESENTATIVE WEYHRAUCH asked if the pioneers' home standards
are higher than those of the Veterans Administration.
MR. DeWITT said that there are some minor issues, perhaps. He
said that all of the standards are being reviewed, and the
intent is to continue to run the Palmer Veterans' Home
essentially identical to pioneers' homes throughout the system.
Mr. DeWitt highlighted that the Alaska veterans' home will be
operated within the same system the pioneers' homes are operated
now. Often states will run veterans' homes under its department
of military and veterans' affairs. However, the department's
primary focus isn't operating a veterans' home and thus the
decision has been made to operate Alaska's veterans' home within
DHSS and under the same division that operates the pioneers'
homes. He related the belief that the state offers a quality of
care that's far above what is seen in veterans' homes in other
states.
REPRESENTATIVE WEYHRAUCH inquired as to whether there would be a
wing for veterans and a wing for nonveterans. He asked if the
proposed veterans' home would upset the current demographic
scheme of the Palmer Pioneers' Home.
MR. DeWITT said that one would see very little difference in the
Palmer Pioneers' Home today and five years from now. There may
be a bit more veteran activity than currently. He explained
that by converting the home one only has to worry that 75
percent of the residents have to be veterans and 25 percent can
fall into the other category. The [veterans'] home will be
operated as a home so that the full array of services can be
provided. If a wing were converted, it would be problematic
because one would have to delineate specific rooms, beds, staff,
and activities that could be used for one and not the other. If
there was a designated veteran bed and a nonveteran was in need
of that bed, that [nonveteran] couldn't use that bed. "The
notion of wings precludes reasonable and good operation of the
home, both in terms of management and in terms of the services
that we would provide to ... the residents in that home," he
explained.
Number 1466
REPRESENTATIVE LYNN directed attention to page 3, line 27
through page 4, line 2, and inquired as to why the term "health
care facility" excludes the Alaska Pioneers' Home and the Alaska
Veterans' Home.
MR. DeWITT pointed out that the first five pages of Version D
specify adding the language "or Alaska Veterans' Home". Because
the official statutory designation will be changed from a
pioneers' home to a veterans' home, it was necessary to add the
language "or Alaska Veterans' Home". The aforementioned means
that the veterans' home will be managed, operated, and treated
under statute as a pioneers' home. He related that the
exclusion is because the pioneers' homes are licensed assisted
living facilities as opposed to a health care facility. The
health care facility definition in AS 18.07.111(8) is with
reference to certificate of need, from which it's exempt.
REPRESENTATIVE LYNN surmised then that the veterans' home will
only be an assisted living home, not a skilled health care
facility.
MR. DeWITT agreed with that understanding, but added that under
statute and the operational aspects of pioneers' homes, they
offer a wide and intensive range of services, although they
aren't licensed skilled nursing facilities.
Number 1600
REPRESENTATIVE LYNN turned attention to page 4 [Section 4],
which refers to places where smoking is regulated. He related
his understanding that the Alaska Veterans' Home would be a no
smoking facility. He noted his belief that smoking is a health
hazard at any age.
MR. VOWEL specified that the smoking restrictions would be based
on the laws of the community in which the facility is located.
In further response to Representative Lynn, Mr. Vowel related
that the average age in Alaska's pioneers' homes, including the
veterans, is about 84 years old.
REPRESENTATIVE LYNN noted that he is a veteran. He recalled
that many veterans acquired the habit of smoking in the military
and have smoked for many years. He expressed the need for life
to be made as pleasant as possible for these folks, and
therefore he said he didn't believe it would be an appropriate
time to force a veteran to quit smoking. He asked if it would
be possible to create a space for those veterans who choose to
continue to smoke.
MR. DeWITT drew attention to page 4, line 8, which says "except
as allowed under AS 18.35.310". The aforementioned statute in
part says, "a portion of a place or vehicle that is designated
as a smoking section under AS 18.35.320". Therefore, although
there is a general prohibition against smoking, there is the
ability to designate smoking areas. He explained that in the
homes the common areas open to everyone are kept smoke free.
Number 1796
REPRESENTATIVE GRUENBERG turned to the definition of "veteran"
found on page 12, and inquired as to the possibility of
including those serving in the Merchant Marine during times of
combat or war time.
MR. DeWITT related his understanding that when the Merchant of
Marine is federalized, it comes under the definition of armed
forces. However, he offered to check on that with the Veterans
Administration. Mr. DeWitt said that the definition in HB 440
was used because it was believed to be consistent with what is
allowed under the federal requirements.
REPRESENTATIVE GRUENBERG commented that if the term "armed
forces" is a term of art, it isn't necessarily apparent from the
state statute. Therefore, he suggested that the language might
want to specify the U.S. code in which it is defined.
MR. DeWITT interjected that he would also ensure that the Coast
Guard is included because it isn't under the Department of
Defense, save times of war.
Number 1901
REPRESENTATIVE DAHLSTROM drew attention to page 6, Section 14,
which discusses the longevity bonus program. She asked if the
provision is even necessary since the changes to the program.
MR. DeWITT said that the statute referenced in Section 14 is
still in statute and relates to pioneers' homes. Therefore, the
drafter suggested that the change be made.
Number 1985
MR. DeWITT returned to his presentation. He explained that the
State of Alaska has been working on developing a veterans' home
for a number of years. As noted earlier, the legislature passed
a statute in 1992 that attempted to have a self-supporting
stand-alone veterans' home. However, that failed. Around 2002,
there was a proposal allowing for a pilot project with the
Veterans Administration that would allow the [pioneers' homes]
to be designated as providing care for veterans for which
reimbursement would be received. The Veterans Administration
wasn't interested because it would open up the possibility of
providing benefits in any state institution throughout the U.S.
Subsequently, Governor Frank Murkowski charged the department
with making [an Alaska Veterans' Home] happen. Discussions
ensued with the Veterans Administration with regard to what
alternatives it could support and Alaska could as well. At the
same time there were discussions with regard to having economic
strength within the pioneers' home system. Mr. DeWitt informed
the committee that the Veterans Administration has a formula
that specifies how many beds a state is allowed to have in its
veterans' home, which amounted to 79 beds for Alaska. It so
happens that the Palmer Pioneers' Home has 82 beds and the
Veterans Administration indicated that it would be willing to
provide a waiver and allow the use of the extra three beds. The
aforementioned coupled with whether the home could support the
type of programmatic issues raised by veterans pointed to the
Palmer Pioneers' Home as a good fit. Furthermore, the
construction standards were reviewed, and again the Palmer
Pioneers' Home was found to be a good candidate. All this led
representatives from the Veterans Administration to review the
Palmer Pioneers' Home with which they were very impressed.
MR. DeWITT said that the next step was to move toward the
process of converting, which includes bringing the issue before
the legislature for consideration. Along the way, the
legislature commissioned the McDowell Group to perform a study
on the pioneers' home system and the potential of a veterans'
home. One of the recommendations of that study was the
conversion of the Palmer Pioneers' Home to a veterans' home.
Therefore, HB 440 was introduced. With Version D, the
conversion will be limited to the Palmer Pioneers' Home. He
opined that with the additional ability to secure benefits for
those veterans entitled to them, it will add additional
revenues. Therefore, the entire system would be strengthened.
He further opined that the programmatic approach requested by
the Veterans Administration is consistent with the geriatric
care the pioneers' homes provide. Mr. DeWitt said that he's
excited about this.
Number 2212
MR. DeWITT specified that the other matter of importance in this
legislation is the ability for folks in the pioneers' home to
access Medicaid benefits as well as other types of federal and
state benefits. Historically, in order to access Medicaid
benefits, the entrance age to the pioneers' homes would have had
to be changed from 65 to an open age. The legislature and past
administrations that he recalls haven't been willing to do the
aforementioned. However, with the enactment of the Older
Americans Act there are other ways to access some Medicaid
funds, other than the traditional method of accessing it through
the certification as a skilled nursing facility or intermediate
care facility. Therefore, the entrance age requirement and the
geriatric approach to care wouldn't have to be changed. Mr.
DeWitt specified that this legislation will allow the state to
access those funds while strengthening the fiscal integrity of
the pioneers' home system over the long term.
CHAIR STEPOVICH asked if a veteran's per diem would be
considered part of the veteran's income in relation to the
amount the veteran would pay for his or her care.
MR. DeWITT replied yes. If the individual has no income and the
state is fully subsidizing that individual's cost of care, the
money, a little over $800 a month, that individual would receive
would go to the home and offset state general funds for that
individual. On the other hand, if someone was paying his or her
full way, that individual would have control over the $800 a
month.
CHAIR STEPOVICH asked if there will be any requirements with the
level of care associated with the per diem payment.
MR. DeWITT clarified that the per diem payment is for
domiciliary care. He remarked that [the department] has its own
opinion regarding whether the level of care the pioneers' home
is providing would be at the level of nursing care. The belief
is that the aforementioned is a battle to be fought after
certification is obtained.
TAPE 04-1, SIDE B
MR. DeWITT explained that the first step should be taken and
once that is resolved, the different increments of funding could
be addressed. In terms of the level of care, the individual
will receive the same quality and level of care that one would
find in any pioneers' home in the system. In further response
to Chair Stepovich, Mr. DeWitt informed the committee that the
pioneers' home system started in 1913 in Sitka.
Number 2310
CHAIR STEPOVICH expressed the need to keep the pioneers' home
system in tact. He then inquired as to the impact this change
would have on the entire pioneers' home system.
MR. DeWITT opined that the result will be very positive. The
opportunity for veterans in the pioneers' home system and those
new to it to secure veterans' benefits is a strong step forward.
In terms of the individual's finances as well as those of the
entire system, it would be positive. Mr. DeWitt highlighted
that HB 440 includes transitional language so that no veteran is
forced to move into or out of the Palmer Pioneers' Home as a
result of the conversion. The Veterans Administration has
indicated that it's "positively disposed to resolving that
problem favorably in terms of handling the transition.
Therefore, it's a win-win situation.
REPRESENTATIVE LYNN commented that although he preferred a
stand-alone veterans' home, this proposal is a good initial step
to obtain the goal of a stand-alone home. He mentioned that
Alaska and Hawaii are the only two states that don't have
veterans' homes. He thanked everyone for his or her work.
Number 2210
REPRESENTATIVE WEYHRAUCH inquired as to the presence of the
Veterans Administration in Alaska, in terms of personnel.
MR. VOWEL answered that the Veterans Administration has a
central office in Anchorage where there are medical facilities
[for veterans]. He characterized the presence in Anchorage as a
very large presence.
MR. DeWITT, in response to Representative Weyhrauch, confirmed
that the Veterans Administration personnel are federal
employees. Mr. DeWitt pointed out that a state veterans' home
is not a federal institution rather it's state-owned and -
operated, and therefore its employees will be state employees.
Number 2148
REPRESENTATIVE GRUENBERG inquired as to what prevents veterans
from other states, which might be experiencing overcrowding,
from coming to Alaska.
MR. DeWITT informed the committee that the [department] has the
ability to establish entry criteria. For 75 percent of the
veterans' home beds the entry criteria will be that the
individual meet pioneer home criteria and be a veteran. For the
25 percent of beds that aren't required to be veteran beds, the
entry criteria will be pioneer home criteria, which is one year
of residency.
REPRESENTATIVE GRUENBERG asked if the aforementioned would
conflict with the federal requirements.
MR. DeWITT stated that the [Veterans Administration] is aware of
the criteria and it has indicated that it's the state's call.
REPRESENTATIVE GRUENBERG asked if that is in writing. He said
he would hate for personnel to change and a position to change
with it.
MR. DeWITT remarked that he is comfortable that "Secretary
Principi will have his fingerprint on this." The difficulty of
obtaining such in writing is the fact that there is an ultimate
"sign off" and negotiations occur up to the point of an
announcement that "we've got it." He stated that this isn't an
issue that's been raised at any level, including the legal
counsel level. However, he specified that the intention is to
have [the criteria] as part of the final agreement.
Number 2033
REPRESENTATIVE WEYHRAUCH related his understanding that 19
percent of the residents of the Palmer Pioneers' Home are
currently veterans.
MR. DeWITT specified that at the end of January, there were 17
veterans in the Palmer Pioneers' Home. He pointed out that
there are 22 vacant beds that "we" are working to fill. "But,
again, this is an issue of having beds that are appropriate for
their level of need," he explained.
REPRESENTATIVE WEYHRAUCH asked if any of the veterans who are
residents of the [Palmer Pioneers' Home] meet a criteria of
being dishonorably discharged and subject to removal.
MR. DeWITT answered that he wasn't aware of any. Of those
[residents] who have shared that they are veterans, none have
mentioned being dishonorably discharged. Should such arise,
that individual could be moved from the "veterans count" to the
"nonveterans count" or if necessary from the veterans' home to a
pioneers' home. The system affords the ability to accommodate
pioneers' within the system.
MR. DeWITT, in response to Chair Stepovich, informed the
committee of the number of veterans in each facility, as
follows: Sitka - 13; Fairbanks - 23; Palmer - 17; Anchorage -
33; Ketchikan - 4; and Juneau - 7. Therefore, there was a total
of 97 veterans in the system at the end of January. He noted
that next week the February report will be available.
Number 1914
REPRESENTATIVE GRUENBERG commented that younger veterans seem to
be suffering from debilitating diseases such as Agent Orange.
However, the legislation on page 8, line 11, specifies that an
individual entering a home must be 65 or older. He asked if
there will be any flexibility for those younger veterans who
need to be in a home.
MR. DeWITT replied no. Mr. DeWitt agreed with Representative
Lynn's earlier statement that this legislation is a good first
step. In the pioneers' homes, a quality geriatric program is
offered, this is a program that isn't appropriate for younger
individuals.
REPRESENTATIVE GRUENBERG expressed the need to address, at the
state level, those younger veterans with problems.
CHAIR STEPOVICH agreed that the aforementioned would be an
issue, but reminded the committee that it isn't part of HB 440.
ADJOURNMENT
There being no further business before the committee, the House
Special Committee on Military and Veterans' Affairs meeting was
adjourned at 4:08 p.m.
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