Legislature(2003 - 2004)

03/04/2004 03:04 PM MLV

Audio Topic
* first hearing in first committee of referral
+ 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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