Legislature(1995 - 1996)
02/15/1996 08:04 AM STA
* first hearing in first committee of referral
= bill was previously heard/scheduled
= 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.