Legislature(1995 - 1996)
02/15/1996 08:04 AM House STA
| Audio | Topic |
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* first hearing in first committee of referral
+ teleconferenced
= bill was previously heard/scheduled
+ teleconferenced
= bill was previously heard/scheduled
HOUSE STATE AFFAIRS STANDING COMMITTEE
February 15, 1996
8:04 a.m.
MEMBERS PRESENT
Representative Jeannette James, Chair
Representative Scott Ogan, Vice Chair
Representative Joe Green
Representative Ivan Ivan
Representative Brian Porter
Representative Caren Robinson
Representative Ed Willis
MEMBERS ABSENT
Representative Ivan Ivan
COMMITTEE CALENDAR
* HOUSE BILL NO. 432
"An Act relating to the practice of veterinary medicine."
- PASSED FROM COMMITTEE
* HOUSE BILL NO. 384
"An Act relating to payment requirements for retention in the
Pioneers' Home; and providing for an effective date."
- PASSED FROM COMMITTEE
* HOUSE BILL NO. 463
"An Act establishing restrictions on certain regulatory
enforcement."
- SCHEDULED BUT NOT HEARD
* HOUSE BILL NO. 63
"An Act relating to special request licenses depicting the sport of
dog mushing."
- SCHEDULED BUT NOT HEARD
HOUSE BILL NO. 405
"An Act relating to the Board of Examiners in Optometry; relating
to licensure of dispensing opticians; and providing for an
effective date."
- CANCELLED FOR THIS DATE
HOUSE BILL NO. 457
"An Act relating to the unlicensed practice of certain occupations
for which licenses are required."
- CANCELLED FOR THIS DATE
PREVIOUS ACTION
BILL: HB 432
SHORT TITLE: VETERINARY LICENSING
SPONSOR(S): LABOR & COMMERCE
JRN-DATE JRN-PG ACTION
01/19/96 2484 (H) READ THE FIRST TIME - REFERRAL(S)
01/19/96 2485 (H) STATE AFFAIRS, LABOR & COMMERCE
02/15/96 (H) STA AT 08:00 AM CAPITOL 102
BILL: HB 384
SHORT TITLE: PIONEERS' HOME - INABILITY TO PAY
SPONSOR(S): REPRESENTATIVE(S) ROKEBERG
JRN-DATE JRN-PG ACTION
12/29/95 2366 (H) PREFILE RELEASED
01/08/96 2367 (H) READ THE FIRST TIME - REFERRAL(S)
01/08/96 2367 (H) STATE AFFAIRS, HES, FINANCE
02/15/96 (H) STA AT 08:00 AM CAPITOL 102
WITNESS REGISTER
GEORGE DOZIER, Legislative Assistant
to Representative Pete Kott
State Capitol, Room 432
Juneau, Alaska 99801-1182
Telephone: (907) 465-3777
POSITION STATEMENT: Provided sponsor statement for HB 432.
CATHERINE REARDON, Director
Central Office
Division of Occupational Licensing
Department of Commerce and Economic Development
P.O. Box 110806
Juneau, Alaska 99811-0806
Telephone: (907) 465-2534
POSITION STATEMENT: Provided testimony on HB 432.
REPRESENTATIVE NORMAN ROKEBERG
Alaska State Legislature
State Capitol, Room 110
Juneau, Alaska 99801-1182
Telephone: (907) 465-4968
POSITION STATEMENT: Sponsor of HB 384.
ANN JANZEN
P.O. Box 6205
Sitka, Alaska 99835
Telephone: (907) 747-6398
POSITION STATEMENT: Provided testimony in favor of HB 384.
JAMES KOHN, Deputy Director
Pioneers' Home Central Office/Advisory Board
Division of Senior Services
Department of Administration
P.O. Box 110211
Juneau, Alaska 99811-0211
Telephone: (907) 465-4400
POSITION STATEMENT: Provided testimony on HB 384.
ACTION NARRATIVE
TAPE 96-16, SIDE A
Number 0000
The House State Affairs Committee was called to order by Chair
Jeannette James at 8:04 a.m. Members present at the call to order
were Representatives Porter, Robinson, Willis, Green and James.
Members absent were Representatives Ogan and Ivan.
CHAIR JEANNETTE JAMES announced Representative Ivan Ivan was at a
sub-committee meeting.
HB 432 - VETERINARY LICENSING
The first order of business to come before the House State Affairs
Committee was HB 432.
CHAIR JAMES called on George Dozier, Legislative Assistant to
Representative Pete Kott to present the sponsor statement for HB
432.
Number 0085
GEORGE DOZIER, Legislative Assistant to Representative Pete Kott,
said HB 432 was suggested by a local veterinarian in Eagle River
who felt the definition of the unauthorized practice of
veterinarian medicine was too vague. It was also discovered the
licensing statutes referenced examinations administered by the
National Board of Veterinary Medical Examiners and the American
Veterinary Association's Education Commission for Foreign
Veterinary Graduates that no longer administered them.
Consequently, the House Labor and Commerce Committee filed HB 432.
Mr. Dozier said it was a relatively simple bill. The bill
substituted the names of the examinations to bring the current
statutes into conformity with actual examination practices. He
cited the examinations were now administered by the National Board
Examination Committee and the National Board Examination
Committee's Education Commission for Foreign Veterinary Graduates.
He further said HB 432 defined the nature of unlicensed veterinary
practice for the state of Alaska and made it a criminal penalty -
a unclassified misdemeanor with a potential penalty of up to one
year in jail and a $10,000 fine. The bill also required veterinary
technicians be licensed by the state. He said there were
veterinarians standing by in Anchorage to articulate their
concerns.
Number 0302
CHAIR JAMES wondered about veterinary medicine in general, and
questioned if the bill prohibited dog mushers, for example, from
giving shots to their own dogs.
Number 0350
MR. DOZIER replied the bill was intended to not affect individuals
who cared for their own animals, but rather for individuals who
held themselves as a competent animal caregiver.
Number 0368
CHAIR JAMES replied, therefore, a dog musher such as Susan Butcher
could take care of her own dogs, but she could not take care of
anybody else's dog.
Number 0406
MR. DOZIER said, "I don't believe that that's the intent of the
bill."
CHAIR JAMES mentioned farmers who took care of their own animals.
She also mentioned artificial insemination, and wondered if a
farmer could perform such a service.
MR. DOZIER replied, "I don't believe that it would have to be a
veterinarian, Madame Chair."
Number 0414
CHAIR JAMES further wondered about pet shops that sold animals
without a check-up, and questioned if there was a law that
prohibited that.
Number 0470
MR. DOZIER said he did not know definitively if there a law that
prohibited a pet shop from selling diseased animals. The intent of
HB 432, however, was to prohibit the unauthorized practice of
veterinarian medicine, he asserted.
Number 0505
REPRESENTATIVE CAREN ROBINSON mentioned the problems regarding the
humane societies and the ability to give the appropriate shots.
She suggested Mr. Dozier look into that matter further.
Number 0549
CHAIR JAMES said she was concerned about the cost getting too high
for the benefits to a society, such as the humane society.
Number 0577
REPRESENTATIVE BRIAN PORTER questioned if the restrictions should
be placed on a person that performed the service for money rather
than a person that performed it for free. He said he did not want
his neighbor who helped his dog with its broken leg to commit a
misdemeanor.
Number 0612
CHAIR JAMES responded she remembered when it was illegal to cut
somebody else's hair in the state of Oregon. The act did not
delineate between a service charge or not. It was protectionism
for the barbers and hairdressers.
Number 0660
MR. DOZIER referred the committee members to Section 7 which
indicated the practice of veterinary medicine did mean for
compensation.
Number 0674
REPRESENTATIVE JOE GREEN said the questions had gone askew. The
focus of HB 432 dealt with the practice of veterinarian medicine
and not what friends did for each other. He suggested keeping the
focus on the practice of veterinarian medicine.
Number 0728
REPRESENTATIVE ROBINSON suggested hearing from Catherine Reardon,
Department of Commerce and Economic Development, to explain the
lack of a zero fiscal note from the department.
Number 0817
CATHERINE REARDON, Director, Central Office, Division of
Occupational Licensing, Department of Commerce and Economic
Development, said a fiscal note was not submitted because it was
not requested. She said it would be a zero fiscal note from the
department and she would be happy to prepare one for the committee.
CHAIR JAMES replied, "it would be appreciated."
Number 0840
REPRESENTATIVE ROBINSON questioned the zero fiscal note because the
bill stated the department would be setting up regulations, and
wondered if staff existed already.
Number 0856
MS. REARDON replied the department had a regulation specialist and
the projects would compete with each other. She stated there would
be advertising, and if the committee wanted, she could include the
public interest cost, but the department would generally absorb it
like any other regulation project.
Number 0889
REPRESENTATIVE ROBINSON wondered if this was a conformation to a
new law because it sounded like a lot of it was already in place.
MS. REARDON replied HB 432 was a clean-up of the existing statute.
Number 0909
CHAIR JAMES stated the bill added veterinary technicians.
MS. REARDON replied the bill allowed the board to adopt
regulations. The board currently licensed veterinary technicians,
but did not have the regulatory authority. She stated the bill
improved the system.
REPRESENTATIVE ROBINSON moved that HB 432 move from the committee
with individual recommendations and zero fiscal notes including the
commitment from Catherine Reardon to provide a zero fiscal note
from the Department of Commerce and Economic Development. Hearing
no objection, HB 432 was moved from the House State Affairs
Committee.
HB 384 - PIONEERS' HOME - INABILITY TO PAY
The next order of business to come before the House State Affairs
Committee was HB 384.
CHAIR JAMES called on the sponsor of HB 384, Representative Norman
Rokeberg.
Number 1025
REPRESENTATIVE NORMAN ROKEBERG read the following statement into
the record.
"HB 384 gives statutory protection to what has been the standard
policy since the beginning of the Pioneers' Homes in Alaska -- that
residents who cannot pay are not evicted. HB 384 will provide a
statutory safety net that prevents the state from evicting
residents.
"Currently 86 out of the 603 residents in the states' six Homes
cannot pay the full rent. Since significant annual rate increases
have been proposed by the governor, many of the residents are
living in fear of the consequences if they cannot afford the
proposed rates."
REPRESENTATIVE ROKEBERG diverted from his sponsor statement to
mention his mother was a member of the Anchorage Pioneer Home. He
stated she was 84 years old and had lived there for about 3 years.
As a result of visiting her, it came to his attention that the
residents were very frightened of their future. He said he saw
fear in the faces of the residents because they lived on modest
incomes. He referred the committee members to the fee schedule
illustrating the estimated monthly cost from the state of $3,862
while the present monthly cost was $860. He further stated the
concept of the Alaska Pioneers' Homes had changed. The residents
were older now because of the desire to stay in their homes.
Therefore, the range of care had changed also. He stated, less
than 20 percent to 25 percent of the residents were actually at a
residential level. The assisted living style had increased to the
Alzheimer's Disease and Related Disabilities (ADRD) level. He said
the Alaska Pioneers' Homes were the only institutions that provided
a place for alzheimer patients. He further stated the fee schedule
was adjusted by the Governor. He cited the first year went from
$860 to $1,288 or a 50 percent increase. The next year was 33
percent, and further cited 25 percent, 17 percent, 14 percent and
11 percent increases for the next 7 years. He referred the
committee members to a memorandum dated January 25, and read
"unwritten policies should be set out in either statute regulation
or department policy and procedure manuals so that the affected
members of the public were informed of the policies and procedures
that applied to them when dealing with a state agency."
Number 1351
CHAIR JAMES said she had watched the struggle for four years now on
how the Pioneers' Homes would be financed. She wondered how the
burgeoning cost would be dealt with after HB 384. She cited
medicaid/medicare funds as a possibility.
Number 1384
REPRESENTATIVE ROKEBERG said he was on a sub-committee with
Representative Robinson that addressed legislation to privatize the
Pioneers' Homes. He stated, as a result of a work session in
Anchorage this summer, HB 384 was introduced. The main thrust of
the before mentioned bill was to determine how the cost would
impact the budget, and the attempt to privatize the Pioneers' Homes
was an option. The bill was tabled because there was not a market
to buy these homes based on the testimony. He further stated
because of legal challenges the resident requirements went from 15
years to 1 year, and consequently there was a huge pool of people,
and a wait list option was now available as well. He cited there
were over 300 people on the waiting list. He stated the medigrant
program being discussed in Congress obviated the problem by taking
money out of one pocket and putting it into another. The federal
government paid 50 percent of the medicaid amounts now, therefore,
those that qualified for medicaid, the state would get that 50
percent, while the block grant created a finite amount of money.
He further commented the language change in the committee
substitute allowed the resident to determine how much he or she
paid, or provided a loop hole in the original bill. He said the
language in the original bill was not tight enough.
Number 1561
REPRESENTATIVE PORTER commented the original intent of the
Pioneers' Homes had been subverted. He said he was sympathetic
towards the current residents because they entered with certain
expectations. He further stated HB 384 affected subsequent
residents, and felt it was not appropriate for future residents to
transfer their assets so that the state had to take care of them
for the rest of their lives.
Number 1640
REPRESENTATIVE ROKEBERG replied Representative Porter was referring
to the spending-down phenomena common among the elderly to qualify
for medicaid. He said he discovered there was a law on the book in
the state of Alaska that required a child to be responsible for the
debts of his or her parents. He stated Representative Porter made
an excellent point, and fraudulent spending needed to be addressed
further. He said he did not intend to address it today before the
House State Affairs Committee because it was such a major problem.
Number 1714
REPRESENTATIVE PORTER said he was concerned about the elderly that
intentionally tried to defraud the state. However, he agreed at
some point, the state would have to eat a certain percentage of the
cost, but according to HB 384 that would not happen.
Number 1750
REPRESENTATIVE ROKEBERG replied he did not understand exactly what
Representative Porter said. The state had a contractual and legal
obligation once it accepted a resident into a Pioneers' Home.
Number 1787
REPRESENTATIVE PORTER said he would vote for HB 384 if it said
"existing residents." However, he stated, he could not support the
bill if it affected every future resident because it was a gigantic
loop hole.
Number 1816
CHAIR JAMES wondered about the future, 20 years from now. She
stated she did not want to bind the future to anything that the
state would not be able to follow-up on. She said she had no
problem protecting the current resident, but the long-term
commitment made her nervous.
Number 1864
REPRESENTATIVE ROKEBERG stated he would like to get the departments
reaction regarding the new entry. He reiterated, when a resident
entered the Pioneers' Homes, the state was obligated. He said he
did not care if it was tomorrow or 20 years from now, the state was
obligated. He stated future administrators and legislators might
sell, dispose of, or consolidate the Pioneers' Homes, for example.
The state would still be obligated even if it were to pay to
transfer that patient to a new home.
Number 1919
CHAIR JAMES replied the residents should know what they were faced
with when entering the Pioneers' Homes. She agreed a commitment
should be followed through with, but she was concerned about the
bigger problem. She stated, her biggest fear was that no matter
how hard the state tried, it would not happen.
Number 1947
REPRESENTATIVE JOE GREEN stated an open checkbook would cover
future residents with less assets. He alleged HB 384 would force
closure due to budget cuts and cited the longevity bonus program as
a similar example. He further said he was concerned about the zero
fiscal note. He stated somewhere the cost needed to be covered,
and asserted he could not support HB 384 until it stayed within the
objective of the legislature to cut the budget.
Number 2009
REPRESENTATIVE SCOTT OGAN replied the zero fiscal note reflected
the current policy, therefore, HB 384 would not increase the cost.
REPRESENTATIVE GREEN replied no effort was shown how to cover the
cost.
Number 2036
REPRESENTATIVE ROBINSON said the intent of HB 384 was wonderful.
The House State Affairs Committee members agreed that under no
circumstances they wanted the residents today to fear they would be
kicked-out. She further stated she agreed with Representative
Rokeberg that there was a tendency every year to change the
policies. Therefore, every resident deserved the same right even
though they were admitted last week, for example. She asserted the
state would take on some responsibility due to the ADRD residents.
Number 2104
REPRESENTATIVE PORTER said he agreed with Representative Robinson's
position, and suggested drafting language to prevent future
eviction, if the cost increased since the original entrance. He
commented HB 384 was too much.
Number 2134
CHAIR JAMES said she agreed with Representative Robinson's premise
of her statement. She further stated there was not enough room in
the Pioneers' Homes to accommodate those that would qualify for the
services. She wondered about expanding the Pioneers' Homes and
suggested privatization as an example. However, she wondered who
would privatize a "loser" due to insufficient funds. She said this
was a serious issue. She stated, if the original intent of the
Pioneers' Homes was followed, this would not be an issue. She
agreed the needs were the same, but if it were opened up to
everybody, the public might not be willing to pay for it. She
cited this was very distressing to discuss, but the state needed to
be realistic. She stated she liked the idea and would like to see
it in the big picture. She further stated HB 384 put the
contractual position of the Pioneers' Homes into a statute, so that
it would operate no other way, except the existing way.
Number 2280
REPRESENTATIVE ROKEBERG suggested hearing the balance of the
testimony before debating the bill. He said there were statutes
and procedures in place to overcome some of the concerns raised by
the House State Affairs Committee. He stated the 603 residents of
the Pioneers' Homes were looking to the legislature for some
assurance for their future, and that was the intention of HB 384.
The intent was not to rewrite the entire state policy regarding the
Pioneers' Homes.
Number 2310
CHAIR JAMES replied she understood the intent of HB 384. She
further stated it was good for the teleconference witnesses to
listen to the concerns of the House State Affairs Committee before
they provided their testimony to allow for rebuttal.
CHAIR JAMES called on the next witness via teleconference in Sitka,
Ann Janzen.
Number 2350
ANN JANZEN said she and her husband were residents of the Sitka
Pioneers' Home due to her husband's health. She thanked the state
of Alaska because her husband was alive today because of the home.
She also thanked Representative Rokeberg for introducing HB 384.
She cited HB 246 was introduced last year and increased the anxiety
level, and blood pressure of the residents in Sitka. She said if
the rates jumped the residents would not be able to pay. Ms.
Janzen suggested looking at the issue of asset transfer. She
further said the committee did not need to worry about a flood of
people moving to Alaska to enter the Pioneers' Homes. She
commented seniors would probably move south if the rates increased.
She did not want to put that pressure on her children even if it
meant she did not live quit as well. She said she was grateful to
the state and happy to be an Alaskan.
Number 2420
CHAIR JAMES said she supported families and seniors staying
together for the quality and extension of life, 100 percent. She
thanked Ms. Janzen for her testimony.
CHAIR JAMES called on the next witness in Juneau, James Kohn.
Number 2445
JAMES KOHN, Deputy Director, Pioneers' Homes Central
Office/Advisory Board, Division of Senior Services, Department of
Administration, said the division and department supported HB 384
for the same reasons Representative Rokeberg stated. Historically,
this was the procedure for caring for the residents. He cited from
1913 to 1990 indigent applicants were given admittance preference
over non-indigents. In 1990 the legislature changed it so that
indigents were no longer given preference, resulting in a rate
increase. The Governor's advisory board toured the homes in
September of 1995 and talked to the residents about raising the
rates to a cost of care over a period of time. The residents
feared they would be evicted if they could not pay the rate.
Therefore, HB 384 spoke to that fear.
MR. KOHN further stated many of the opinions expressed today were
not supported by facts. He stated 95 percent of the people on the
waiting list had been in Alaska for over 15 years. Furthermore,
boat loads of people were not coming to Alaska to get on the
waiting list. The homes were still serving the same people as in
the past, he alleged. Moreover, the statistics indicated people
were born in Alaska to be elderly. He cited Alaska was the least
state in the union where the elderly stayed in the state, and
overall there was an out-migration of the elderly. He further
stated the mission of the Pioneers' Homes had changed from a
residential to an assisted living program whereby 80 percent of the
residents had needs based on ADRD. He cited the Sourdough Unit at
Harbor View was being closed and programs were being developed to
accommodate their special needs and treatments. Mr. Kohn stated
alzheimer patients were increasing and somebody had to pay for that
care. Currently, the home asked the residents to pay as much as
they could based on their income and assets. He cited in FY96 the
home collected $5.2 million in revenue from the resident. The plan
was to collect $7.9 million in FY97. He further stated statistics
indicated the home would collect between $9 million to $17 million
out of a total budget of $30 million. He asserted the home was
trying to reduce the liability of the state and increase direct
payment. He said medicare and medicaid did not cover patients with
ADRD in Alaska. He also suggested retaining the one year residency
requirement to void participation in the federal programs. He
further said block grants did not guarantee more money. He cited
there were 600 beds and currently 300 people on the active waiting
list. However, many did not want to come in right away so the wait
had decreased to about 1.5 years.
TAPE 96-16, SIDE B
Number 0369
CHAIR JAMES said in 1991 or 1992 only 40 percent of the senior that
collected the longevity bonus had been in the state for three years
or less. She did not begrudge children bringing their parents to
the state. She wondered if it would be dangerous to get rid of the
one year residency.
Number 0425
MR. KOHN replied many of the seniors, according to their
applications, had left the state and returned. They left when they
were young and hardy then returned in need to their family. He
further stated the medicare/medicaid issue was complex. He said
medicare/medicaid covered skilled nursing care and the Pioneers'
Homes never did skilled nursing care compared to other long-term
care facilities. The home was moving towards complete assisted
living care because of ADRD. He cited a social model was very
helpful and presently not supported by medicare or medicaid.
Number 0524
CHAIR JAMES wondered if the acceleration of cost caused the
residents to run out of money sooner.
Number 0533
MR. KOHN replied, "yes." Currently, 87 residents did not pay the
full cost of care. He cited after the last rent increase the
number of residents who could not pay the full cost of care went
from 71 to 87. A running tally of the bill to the state was also
kept and if the resident came into money or passed away the estate
was attached to the tally.
Number 0590
REPRESENTATIVE PORTER asked if that policy was in a statute.
MR. KOHN replied, "yes."
Number 0599
CHAIR JAMES asked what it took to get on the waiting list.
Number 0603
MR. KOHN replied it took a statement of qualification of residency.
The active waiting list required a certificate of need based on
disability. A physician's history and physical was also required
to validate and assess the need.
Number 0649
CHAIR JAMES responded an person just needed to apply and the home
pigeon holed the applications accordingly. Therefore, payment
information was voluntary. She wondered if more applicants were
applying based on their ability to pay.
Number 0685
MR. KOHN said people applied because of the mission towards ADRD
care. He stated, the applicants were very willing to pay the rates
for the care.
Number 0710
REPRESENTATIVE GREEN suggested looking at moving towards a quasi-
medical care facility rather than a pioneer home. He asked Mr.
Kohn what the projected resident would be like in 10 years.
Number 0830
MR. KOHN said he could not project 10 years, but in 3 to 5 years
the majority of the residents would be more incapacitated and in
need of ADRD care. He cited the assisted living legislation that
would accommodate low level ADRD cases. The mission of the
Pioneers' Homes, he stated, was to take those individuals that
exceeded the resources of their family and the community. He
described an individual that could not pay was probably demented,
and did not have funds, and wondered where that individual would
go. He reiterated the home asked the residents to pay as much as
they could, and the state subsidized the rest.
Number 0996
CHAIR JAMES replied it appeared the only solution to the Pioneers'
Homes was to continue to fund with state revenue. Therefore, this
must be factored into the long-term planning. The state made an
obligation that it could not get out of. She said she did not
necessarily buy that agreement because there were other funding
sources. She mentioned the struggle of paying for a government
service and suggested an exercise to determine the best way to
provide a service using the least amount of revenue. She
reiterated she agreed with Mr. Kohn's assessment, but she did not
want to close the issue off and because there was not an
alternative.
Number 1112
MR. KOHN responded Alaska had a growing senior population rate. He
stated there were other ways to do this, and cited other states
were putting the elderly with ADRD into state mental institutions.
The other states did not have a pioneers' home to transform when
the problem came along. Alaska was very fortunate to have the
facilities and history to address the problem head on. He
reiterated the home wanted to decrease its reliance on the general
fund.
Number 1239
CHAIR JAMES responded there was a need to expand, if the senior
population was increasing.
Number 1248
MR. KOHN said for the time being the Pioneers' Homes would admit
people with increased acuity needs. He reiterated in the future
the lower level ADRD cases would be taken care of in the community,
while the home would take care of those that exceeded the ability
of their families and the community.
Number 1294
REPRESENTATIVE GREEN wondered if the increased senior population
was a result of individuals moving to Alaska. He further said he
did not see how the home would decrease its reliance on the general
fund when there was an increasing elderly population that could not
pay the rates. He suggested looking at a completely different
program rather than patching-up the existing one.
Number 1389
MR. KOHN responded the residents would pay all that they could pay
and create a debt to the state in-the-event they could not pay the
entire rate. He further stated Alaskans were aging in place.
Alaska was not a net migration in-state, but a net migration out-
state. He said he did not agree with the idea of not extending
this to future residents. He said the home would ask the current
and future residents to pay up-to-the cost of care. He said some
residents would be able to pay the full cost, but only a handful.
He said the home had not done that in the past. The bill,
therefore, took away the anxiety of the resident from being
evicted. He stated, "I think we're going to reduce our reliance on
the general funds, not increase."
Number 1526
REPRESENTATIVE ROBINSON mentioned she was proud of the Pioneers'
Homes. She stated she would support the Pioneers' Homes and
believed in the direction of HB 384. She said a state should honor
its seniors and hoped when she reached 80 years old a program such
as the Pioneers' Home was still available. She further stated she
did not have a problem with the seniors returning to Alaska with
their families. She stated Alaska was her home for the rest of her
life and wanted a place to bring her family. She wondered what the
criteria was for families remaining together in the homes.
The record reflected the arrival of Representative Ivan Ivan at
9:25 a.m.
Number 1660
MR. KOHN said it was common to see one spouse needing more care
than another, and a provision was made so that they could live
under the same roof. He stated it made sense from a humane and
care point-of-view because the resident who needed ADRD care
responded better to the spouse.
Number 1736
REPRESENTATIVE OGAN said the discussion was covering a lot of broad
based issues and drifting from an accomplishment. He mentioned the
testimony from Ms. Janzen suggesting an asset shift. He cited
children sold their homes to their parent for $100, for example, to
shift their assets to avoid taxes. He suggested a conceptual
amendment to provide provisions that addressed asset shifting. He
stated he supported the concept and associated himself with the
comments made from Representatives Green and Porter that the state
needed to grandfather the current residents. He stated his wife
worked for several years for the Pioneers' Home in Palmer and
stated it was turning into a long-term care facility for dementia
residents. He suggested, in general, the state needed to look at
taking care of those that could not support themselves for moral
and constitutional reasons. He also said the state had enough
assets. He commented if there were significant social reforms in
other areas, there would be more than enough money to take care of
those that could not.
Number 1961
CHAIR JAMES said the Pioneers' Homes were intended for ambulatory
individuals who wanted a place to stay. Now, the residents needed
intensive care of some kind when admitted. She said, in concept,
she supported HB 384 and agreed with the grandfather approach. She
stated there was a growing senior population due to improved health
care, and a younger population that could barely take care of their
own needs. This was an overall family problem and families needed
to take better care of each other. She stated a better way was
needed to take care the needs of the elderly in general and
continue to look at providing services.
Number 2227
MR. KOHN said there was a lot of research being done on ADRD and
commented a treatment was possible, hopefully, in the future so a
home would not be needed for this type of care. However, right now
care was needed, until such a treatment.
Number 2302
REPRESENTATIVE ED WILLIS said, "the longer we talk the more
confused I get and if I get any more confused I'll be applying to
get into the Pioneers' Homes." He commented at the present time
the home had not required anybody to leave for non-payment, and at
some point the home might have to ask somebody to leave. "Is that
not correct, if I understand it correctly?" he asked.
Number 2391
MR. KOHN replied the practice had been, if a resident was unable to
pay, the state subsidized the difference. However, many of the
residents wanted the policy clarified as a result of the new rates.
The statutes addressed indigent residents and the conceptual
framework was such that residents were not able to pay. However,
it was not clear regarding the discharge of residents.
Number 2460
CHAIR JAMES said HB 384 gave peace of mind to the residents of the
Pioneers' Homes and by putting it into statute it bound future
legislators. She suggested accepting the committee substitute.
TAPE 96-17, SIDE A
Number 0030
REPRESENTATIVE OGAN moved to adopt CSHB 384 9-LS1450/F. Hearing no
objection, it was so adopted.
Number 0053
REPRESENTATIVE PORTER said he was offended by a few things that
were intimated today, and cited, if he did not support HB 384,
seniors would be lined up in halls tied to wheelchairs and resented
that implication. He said the intent of the Pioneers' Homes did
not anticipate the dementia rate. He stated the Pioneers' Homes
responded to the needs, but to say that there was a commitment
because that was the intention, was totally incorrect. He cited,
today the status of the Pioneers' Homes was a process of evolution.
However, he reiterated it was not the original intent. House Bill
384 presented the bigger overall budget and fiscal gap of the state
by keeping as much as possible the programs and benefits provided
to the residents, or running the serious risk of not having another
Prudhoe Bay and close the Pioneers' Homes because the state could
not afford to operate it at all. That was the discussion, he
asserted, and not the desire to reduce benefits to seniors.
Therefore, he stated he could not support the CSHB 384 in its
current form. He said he would support a grandfather provision for
the current residents, but had a problem binding future legislators
that might have to vote against seniors to the extend of
jeopardizing the program.
Number 0359
REPRESENTATIVE OGAN said he agreed with Representative Porter and
wanted to see the bill amended to include a grandfather provision.
He said the state owed the residents of the Pioneers' Homes that
peace of mind, and cited the seniors in his district were very,
very anxious and upset. He suggested a conceptual amendment, for
example, to address disqualification based on asset shifting. He
said it was a tough debate due to the timing surrounding an asset
shift, however. He cited there were legal ramification if assets
were shifted surrounding an Internal Revenue Service (IRS) bill.
Number 0512
CHAIR JAMES stated the amendments needed to be in writing rather
than conceptually because they were major, and ruled against a
conceptual amendment
Number 0539
REPRESENTATIVE WILLIS asked Chair James what was her intention of
HB 384.
CHAIR JAMES replied it was up to the House State Affairs Committee
members.
REPRESENTATIVE WILLIS wondered where HB 384 went next.
CHAIR JAMES replied it went to the floor.
Number 0561
REPRESENTATIVE ROKEBERG replied HB 384 was referred to the House
Health, Education and Social Services Committee (HESS), and the
House Finance Committee. The zero fiscal note might influence the
Finance Committee referral, however. The full review of the bill,
belonged in the HESS Committee, he asserted. He said he preferred
to see the bill move to the next committee of referral, but he
understood the lack of comfort of some members of the House State
Affairs Committee. He assured the committee members he would do
everything necessary in the interim to correct and meet some of the
issues addressed today. He apologized to the Chair regarding his
apparent criticism of the methodology of the House State Affairs
Committee. He entertained an amendment to address existing
residents in-order-to move the bill forward.
Number 0654
CHAIR JAMES reiterated the responsibility of the House State
Affairs Committee was to focus on the state as a whole. Therefore,
the committee heard budget issues and at times the testimony
appeared to move away from the issue, but it was necessary to look
at the bigger picture.
REPRESENTATIVE ROKEBERG replied that he agreed.
CHAIR JAMES continued by stating it was a different approach
compared to other committees.
Number 0725
REPRESENTATIVE OGAN suggested moving HB 384 to the next committee
of referral - the House Health, Education and Social Services
Committee with individual recommendations to amend the bill. He
stated the sponsor recognized the concerns of the House State
Affairs Committee, and it was an issue that probably should be
debated in HESS.
Number 0756
CHAIR JAMES said if the committee members really believed an
amendment was needed it should be drafted in the House State
Affairs Committee to not lose its voice. However, HESS could
remove the amendment which would be an appropriate action. She
stated, if the sponsor would accept a conceptual amendment, the
bill could be redrafted before going to the HESS Committee.
Number 0794
REPRESENTATIVE ROKEBERG said he would accept a conceptual amendment
as to the existing residents. He stated he did not want to accept
the amendment Representative Ogan suggested due to existing
provisions in statutes and it was not really the intent of the
bill. He complimented Chair James on her analysis of the bill.
Number 0846
REPRESENTATIVE PORTER referred the committee members to page 1,
line 12, and read his suggested changes, "The department may not
evict a person from the Pioneers' Home whose residency began before
the effective date of this bill, if the income and assets...." He
said he would leave it up to the drafter.
Number 0884
REPRESENTATIVE OGAN moved to adopt the conceptual amendment as
stated by Representative Porter. Hearing no objection, it was so
adopted.
CHAIR JAMES asked what was the will of the House State Affairs
Committee.
Number 0940
REPRESENTATIVE ROBINSON moved CSHB 384(STA) from committee with
individual recommendations and a zero fiscal note. Hearing no
objection, it was so moved from the House State Affairs Committee.
REPRESENTATIVE ROKEBERG thanked the Chair and the committee for
their time and effort.
Number 0978
CHAIR JAMES asked the committee members to at a resolution related
to revised statute 2477.
MR. WILCOX said he would provide the committee members with a copy
of the resolution.
CHAIR JAMES asked the committee members to voice their concerns to
her regarding the resolution.
Number 1051
ADJOURNMENT
CHAIR JAMES adjourned the House State Affairs Committee at 9:50
a.m.
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