Legislature(2009 - 2010)SENATE FINANCE 532
02/25/2009 09:00 AM Senate FINANCE
| Audio | Topic |
|---|---|
| Start | |
| SB45 | |
| SB13 | |
| SB87 | |
| Adjourn |
* first hearing in first committee of referral
+ teleconferenced
= bill was previously heard/scheduled
+ teleconferenced
= bill was previously heard/scheduled
| + | SB 45 | TELECONFERENCED | |
| + | SB 13 | TELECONFERENCED | |
| + | SB 87 | TELECONFERENCED | |
| + | TELECONFERENCED |
SENATE FINANCE COMMITTEE
February 25, 2009
9:03 a.m.
9:03:27 AM
CALL TO ORDER
Co-Chair Stedman called the Senate Finance Committee meeting
to order at 9:03 a.m.
MEMBERS PRESENT
Senator Lyman Hoffman, Co-Chair
Senator Bert Stedman, Co-Chair
Senator Charlie Huggins, Vice-Chair
Senator Johnny Ellis
Senator Kim Elton
Senator Donny Olson
Senator Joe Thomas
MEMBERS ABSENT
None
ALSO PRESENT
Representative Bill Stoltze; Sharon Long, Staff, Senator
Huggins; McHugh Pierre, Liaison, Department of Military and
Veterans Affairs; Senator Gene Therriault, Sponsor; Nicki
Neal, Director, Division of Personnel and Labor Relations,
Department of Administration; Senator Bettye Davis, Sponsor;
Don Burrell, Staff, Senator Bettye Davis, Sponsor; Rod
Betit, President, Alaska Hospital Association; Jorden Nigro,
President of the Alaska Association of Homes for Children;
Jon Sherwood, Director, Office of Program Review, Department
of Health and Social Services; Senator Bill Wielechowski,
Sponsor; Michelle Sydeman, Staff to Senator Weilechowski;
Marie Darlin, President, AARP Capital City Task Force.
PRESENT VIA TELECONFERENCE
Pat Luby, Advocacy Director, Alaska Association of Retired
Persons (AARP), Anchorage; Joseph Fields, Self, Fairbanks;
Carletta Mack, Director, Covenant House Alaska; Dahna
Graham, Anchorage Faith and Action Congregations Together,
Anchorage; Lorie Morris, Executive Director for AK Baptist
Family Services; Pat Senner, Alaska Nurses Association.
SUMMARY
SB 13 "An Act relating to eligibility requirements for
medical assistance for certain children and
pregnant women; and providing for an effective
date."
SB 45 "An Act relating to state employment preferences
for veterans, former prisoners of war, and members
of the Alaska National Guard; authorizing the
Department of Military and Veterans' Affairs to
establish and maintain Alaska veterans'
cemeteries; establishing the Alaska veterans'
cemetery fund in the general fund; and authorizing
the legislature to appropriate income from fees
collected for commemorative veterans' plates to
the Alaska veterans' cemetery fund."
SB 87 "An Act expanding medical assistance coverage for
eligible children and pregnant women; relating to
cost sharing for certain recipients of medical
assistance; and providing for an effective date."
SENATE BILL NO. 45
"An Act relating to state employment preferences for
veterans, former prisoners of war, and members of the
Alaska National Guard; authorizing the Department of
Military and Veterans' Affairs to establish and
maintain Alaska veterans' cemeteries; establishing the
Alaska veterans' cemetery fund in the general fund; and
authorizing the legislature to appropriate income from
fees collected for commemorative veterans' plates to
the Alaska veterans' cemetery fund."
SHARON LONG, STAFF, SENATOR HUGGINS, presented the
legislation to create a new veterans' cemetery in Fairbanks.
Fairbanks is home to a significant military population, but
does not have a designated veterans' cemetery. Alaskan
veterans' cemeteries are located in Sitka and Anchorage. The
Veteran Cemetery Fund will be a subaccount of the general
fund pending legislation. The fund would receive deposits
through appropriation, and proceeds from the purchase of
special Veterans' license plates.
Senator Huggins stated that the proposed cemetery is a state
veterans' cemetery, while the cemeteries in Sitka and
Anchorage are national veterans' cemeteries. For a state
cemetery, the state contributes the land, and the federal
government builds the cemetery.
9:07:41 AM
Senator Huggins maintained that veterans in Fairbanks
deserve the state's efforts. The land cost is $750,000. The
operation costs are the responsibility of the state and
equal approximately $250,000 per year. He stated that $250
thousand were removed the upcoming budget for this effort by
the Governor, which delays the project by one year.
9:08:40 AM
Co-Chair Hoffman noted his support for SB 45. He informed
that Bethel developed a veterans' cemetery, with the city
absorbing some costs. He wondered if the legislation
utilizes fees to assist municipal veterans' cemeteries.
9:09:27 AM
Senator Huggins commented on Bethel's successful efforts. He
noted that Bethel received a grant to assist in the
cemetery's establishment.
Co-Chair Stedman expressed concern about creating another
fund while the legislature worked to eliminate existing
funds. He asked why the expense was not included in the
capital budget process, which would eliminate the need for
an additional fund.
Senator Huggins answered that veterans are purchasing
cemetery license plates to display pride in representing
their country and supporting their cause. He preferred not
to debate the amount of existing funds and the creation of
new funds.
9:12:23 AM
Co-Chair Stedman asked about the new fiscal note from the
Department of Military and Veterans Affairs (DMVA) showing
$750 thousand in general fund appropriations for site
planning and architectural design work. The funding reflects
an approximately $5 million federal match in FY11.
Senator Huggins explained that the legislation was a group
effort shared by Senator Thomas, Senator Therriault, and
himself. He stressed that the effort was to benefit the
community and to support veterans.
MCHUGH PIERRE, LIAISON, DEPARTMENT OF MILITARY AND VETERANS
AFFAIRS, discussed the fiscal note. The current plan is to
accumulate $750 thousand over three years, beginning in FY11
and ending in FY13, with the receipt of the federal money in
FY14. Currently, 34 cemeteries exist in the national queue
before Alaska. Eight cemeteries achieve funding each year.
The pre-application will be submitted next week and the
veterans' affairs administrator will review the application
with the federal veterans' administrator in DC, to
recommended changes.
Mr. Pierre explained that the fiscal note reflects the
bill's monetary requirement. The bill requires $750 thousand
in capital money. A land donation from the state is
necessary.
Co-Chair Stedman stated that the federal government might
produce funds for SB 45.
9:15:36 AM
Senator Huggins clarified that the $750 thousand is in the
Governor's budget. Mr. Pierre stated that the original
estimate for the project was $1 million, budgeted from 2010
to 2013, spanning four years, but the current low price of
oil led to removal of the first year.
Co-Chair Hoffman asked about the possibility of beginning
the first year with a smaller sum of money. Mr. Pierre
answered that there would not be official action by the
federal veteran's association until the $750 thousand was
appropriated.
Senator Thomas wanted greater understanding of the requested
funds. He understood the federal action fund contingency. He
asked about the federal government's time limits.
Mr. Pierre answered that the application period is July 2,
2008 to July 2 2009. He believed that date would remain
consistent as long as the legislature allocated the $750
thousand. The project will be delayed by one fiscal year if
the date is missed.
9:18:18 AM
Co-Chair Stedman emphasized that the committee requires
additional information from the administration about
removing $250 thousand from the FY10 capital budget. Mr.
Pierre explained that the expense spans four years. He
clarified that the fiscal note is not a request by the
administration or by DMVA. The $750 thousand appropriation
is necessary to receive federal funding in one year.
Senator Huggins intended to pursue additional information
regarding the Governor's budget items. He supposed that
there were substitute items that this legislation could
submit to enable this effort.
9:20:33 AM
Co-Chair Hoffman MOVED to ADOPT CSSB45 (STA) as the working
document.
Senator Thomas MOVED to ADOPT Amendment 1, 26-LS0277\P.2,
Bullock/Wayne:
Page 1, following line 7:
Insert a new bill section to read:
"* Section 1. The uncodified law of the State of
Alaska is amended by adding a new section to read:
LEGISLATIVE INTENT. It is the intent of the
legislature that, during fiscal year 2010, the
Department of Military and Veterans' Affairs, in
cooperation with federal authorities, begin the
planning and design of an Alaska veterans' cemetery,
authorized by AS 44.35.035, enacted by sec. 10 of this
Act, to be located in or near Fairbanks, and that the
Department of Military and Veterans' Affairs submit a
report on the status of the cemetery project to the
president of the senate and the speaker of the house of
representatives before December 15, 2009."
Page 1, line 8:
Delete "Section 1"
Insert "Sec. 2"
Co-Chair Stedman OBJECTED for discussion
Senator Thomas explained the amendment expresses the intent
that DMVA begin planning the design of the dedicated state
veterans' cemetery in the Interior during the coming year
and provide the legislature with a status report this
December. The amendment was constructed with the idea that
projects move forward quickly when information is adequately
provided. The status reports will keep the legislature
informed about the use of the $750 thousand while aiding
understanding of the cemetery's architectural design while
monitoring the federal process. He noted that construction
would not be included in the fiscal budget until FY11.
Senator Huggins supported the amendment because it brought
about accountability.
9:23:55 AM
Senator Olson wanted to know the department's position on
the legislation, and he understood that they were required
to coordinate with the Department of Natural Resources (DNR)
to acquire land for the cemetery. Mr. Pierre answered that
the department's intention was to move forward with all due
diligence to pursue this project. The project is a priority
to the veteran's community and the goal is to proceed
quickly in a responsible manner. The department supported
the amendment.
SENATOR GENE THERRIAULT, SPONSOR, commented that the
Fairbanks Borough government was in support of the effort,
and was willing to aid in locating land for the cemetery. He
expressed awareness about potential land. He supported the
amendment and felt that it lent focus and communication.
Co-Chair Stedman REMOVED his objection
Amendment 1 was ADOPTED
9:26:53 AM
Senator Huggins stated that one section of the bill deals
with hiring preferences. He noted that a representative from
the administration was present to speak. He expressed that
the bill does have a personnel hiring portion that deserves
consideration.
NICKI NEAL, DIRECTOR, DIVISION OF PERSONNEL AND LABOR
RELATIONS, DEPARTMENT OF ADMINISTRATION, stated that the
bill only clarifies the language as opposed to making
changes to the existing current preference.
Senator Huggins noted one change expanding the cemetery to
include the National Guard.
Ms. Neal noticed that the summery by Legislative Council
stated that National Guard Members already receive
preference.
9:28:44 AM AT EASE
9:28:56 AM RECONVENED
Ms. Neal discussed section 6 line 16 and the language on
Page 7 of the bill. The language deletes members of the
National Guard and moves it to section 7.
Senator Huggins asked if members of the National Guard were
denied preference. Ms. Neal could not recall an instance in
which veterans did not have preference. Veteran applicants
receive consideration and opportunities to interview, but
they must first meet the minimum qualifications for the job.
She wondered if the problem was that the person did not meet
the minimum qualifications and therefore, did not advance to
consideration or interview.
Senator Olson asked how the veteran's cemetery applies to
the Alaska territory or guard members when disputes exist as
to whether or not they are veterans.
Ms. Neal asked if the question was about the veteran
cemeteries. Senator Olson answered yes and asked if the
Alaska Guard members that were part of the Alaska
Territorial Guard (ATG) were eligible for burial in the
veteran cemeteries.
9:31:48 AM
Mr. Pierre answered that ATG members will be eligible for
burial in the veteran cemetery. Recognition as veterans
occurs once they receive official discharge from the Army.
Senator Olson asked how many veterans have completed the
paperwork establishing them as veterans. Mr. Pierre answered
that there are 1200 to 1500 applications pending with
approximately 700 certifications delivered. He explained
that the majority of buried veterans exist on record. The
remaining veterans are difficult to locate.
Senator Olson asked if living ATG members were not eligible
for burial in the veteran cemetery.
Mr. Pierre answered that the opposite was true, and stated
that the living ATG members who have received their official
discharge certificate are eligible for burial in a national
cemetery or a state veteran cemetery.
9:33:37 AM
PAT LUBY, ADVOCACY DIRECTOR, ALASKA ASSOCIATION OF RETIRED
PERSONS (AARP), ANCHORAGE (testified via teleconference). He
stated that AARP strongly supports SB45. He maintained that
SB 45 would offer many veterans and their families an
opportunity to have a closer burial.
JOSEPH FIELDS, SELF, FAIRBANKS (testified via
teleconference). He spoke in support of SB 45. He maintained
that Fairbanks was the appropriate location for such a
cemetery.
SB45 was HEARD and HELD in Committee for further
consideration.
9:38:36 AM
SENATE BILL NO. 13
"An Act relating to eligibility requirements for
medical assistance for certain children and pregnant
women; and providing for an effective date."
SENATOR BETTYE DAVIS, SPONSOR, noted that there had not been
opposition to this particular bill. She stated that the bill
had received support in the form of telephone calls,
letters, and e-mails with the goal of raising the
eligibility level for Denali Kid Care (DKC) from 150 percent
to 200 percent of the federal poverty level (FPL). She
requested that the committee refrain from amending the bill.
DON BURRELL, STAFF, SENATOR DAVIS, explained that SB
13 increases and restores the qualifying income
eligibility standard for the Denali Kid Care Program
to 200% of the Federal Poverty Line (FPL) to its
original levels 12 years ago. As you know, Alaska is
one of the nation's wealthiest states yet Alaska is
only one of five states that still fund our SCHIP
program below 200% FPL. SB 13 makes health insurance
accessible to approximately 1,277 uninsured children
and 225 pregnant women in Alaska.
Denali Kid Care is an "enhanced" reimbursement program
with Alaska currently receives about 66% under the
federal government's State Children's Health Insurance
Program (SCHIP), created in 1997. Congress
reauthorized the SCHIP program and President Obama
signed into law on February 4, 2009. This
reauthorization expanded the coverage to 4 million
additional children and is re-authorized through
2013.
Consider the following information from the Kaiser
Commission on Medicaid and the Uninsured, January,
2009:
· 45 states, including D.C., cover children in
families with incomes at 200% FPL or higher.
· 33 states cover children in families with
income between 200% and 250% FPL.
· 19 states including D.C., cover children in
families with income at 250% or higher. 10 of
these states cover children in families with
income at 300% FPL or higher.
· 35 states allow premiums or enrollment fees,
and 24 states have co-payments for selected
services in SCHIP programs on a sliding scale
of FPL.
· 46 states do not require asset tests.
Denali Kid Care serves an estimated 7,900 Alaska
children and remains one of the least costly medical
assistance programs in the state at about $1,700 per
child with full coverage, including dental, which is
about 20% of the cost of adult senior coverage.
It is estimated that uninsured children with a medical
need are five times as likely not to have a regular
doctor as insured children and four times more likely
to use emergency rooms at a much higher cost. Early
intervention and preventative care under SB 13 will
greatly increase Alaska children's health and yield
substantial savings to the state, public and private
sector hospitals, emergency rooms which are required
to admit indigent and uninsured patients for non-
emergency treatment.
There are still an estimated 18,000 uninsured children
in Alaska. This is about 9% of the children age 18 and
under. Private health care coverage for children has
declined over 30% in the last ten years, and the
deepening recession is pulling more children and
families into the uninsured ranks. Alaska should do
its share and take advantage of available federal
matching funds by insuring its low income children and
pregnant women up to and including 200% FPL under SB
13.
9:45:36 AM
Co-Chair Stedman asked for additional questions. He noted
three fiscal notes from the Department of Health and Social
Services (DHSS) showing an $886 thousand increase in the
general fund spending for FY10.
Senator Bettye Davis asked if the committee received the
updated fiscal notes.
9:46:32 AM AT EASE
9:46:42 AM RECONVENED
Co-Chair Stedman stated that the committee did not have the
updated fiscal notes.
Co-Chair Hoffman noted that approximately 7,900 children are
served today by Denali Kid Care (DKC) and 18,000 remain
uninsured. The proposed legislation would allow
approximately 1300 additional children into the program,
increasing the number served to 9,200. The change would drop
the number of uninsured children to 16,700. Senator Davis
agreed that Senator Hoffman's estimates were correct.
9:48:07 AM
CARLETTA MACK, DIRECTOR, COVENANT HOUSE ALASKA (testified
via teleconference). She spoke in support of SB 13. She
maintained that Covenant House seeks health care outside of
the emergency room for cost benefit purposes. Expanding the
number of youth eligible for health care coverage would lead
to greater health and decreased use of the emergency room
for medical care and long-term costs.
DAHNA GRAHAM, ANCHORAGE FAITH AND ACTION CONGREGATIONS
TOGETHER (AFACT), ANCHORAGE (testified via teleconference).
She spoke in support of SB 13. She opined that this
legislation was a bargain for the state, in light of the
federal contribution. She stated that a visit to the
emergency room fee would equal that of DKC's annual fee.
9:51:45 AM
ROD BETIT, PRESIDENT, ALASKA HOSPITAL ASSOCIATION (ASHNHA),
noted that his membership strongly supports SB13. He
believed that the legislation was the next logical step
considering the available economic stimulus funds. The
members of ASHNHA do not believe that the legislation would
preempt recommendations of the Health Care Commission.
Senator Huggins asked about elements of the task force. Mr.
Betit answered that there were many recommendations, but he
could not report on the outcome. He believed that DHSS would
have the information regarding recommendations.
9:53:38 AM
JORDEN NIGRO, PRESIDENT OF THE ALASKA ASSOCIATION OF HOMES
FOR CHILDREN, approved of preventative care and supported
the bill in its entirety. She explained that raising the DKC
eligibility rate to 200 percent of the FPL would have a
drastic affect on behavioral health services, as it is the
primary funding source. Many children are unable to access
services because they are on the cusp of eligibility.
MARIE DARLIN, COORDINATOR, AARP CAPITOL CITY TASK FORCE,
spoke in favor of SB 13. She noted that AARP is one of the
nation's largest organizations of grandparents. Many
grandparents are responsible for raising children, while
dependent on Medicare themselves. She expressed support of
SB 13.
9:57:35 AM
LORIE MORRIS, EXECUTIVE DIRECTOR FOR AK BAPTIST FAMILY
SERVICES (testified via teleconference), She noted support
for SB 13.
JON SHERWOOD, DIRECTOR, OFFICE OF PROGRAM REVIEW, DEPARTMENT
OF HEALTH AND SOCIAL SERVICES, (DHSS) spoke in support of
increasing the eligibility limits to 200 percent of the FPL,
and expressed the administration's interest in cost sharing
provisions.
Senator Elton asked what the administration meant by cost
sharing. Mr. Sherwood answered that cost sharing can include
premiums or co-payments. He noted that there are federal
limits to cost sharing of 5 percent of a family's income.
The department prefers premiums because they are easier to
track, although there are also advantages to co-payments.
Senator Elton asked if support for the bill depends on
additional cost sharing provisions. Mr. Sherwood answered
that the department does not oppose an expansion to 200
percent of the FPL.
10:01:22 AM
Senator Huggins referred to a memorandum to Senator Bettye
Davis from Jennifer Saunders (Copy on File). He noted that
the second paragraph stated that under provisions of the
Deficit Reduction Act, states generally could not impose
cost sharing on children in families with an income below
150 percent of the federal poverty guidelines, except in
certain circumstances. He asked about the increase to 200
percent of the FPL given this information.
Mr. Sherwood answered that the department looked at imposing
cost sharing on income groups above 175 percent of the FPL.
Below 150 percent of the FPL, limitations on cost sharing
are cumbersome. A limited ability to cost share exists due
to the exclusion of children.
Senator Huggins agreed that all children deserve affordable
health insurance. He asked for an explanation of the
hesitation he noticed during Mr. Sherwood's testimony.
Mr. Sherwood expressed that his hesitation was due largely
to the fact that the department had proposed federal
regulations on cost sharing. The new administration withdrew
the regulations, and the department expects to see new ones.
He stated that he was reluctant to disclose specifics due to
the possibility that federal regulations may change. He
thought that above 150 percent of the FPL, co-payments for
emergency services, care for the terminally ill, and
preventative care remained acceptable. Above 150 percent of
the FPL, the rules are straightforward, yet are limited to
charging less than 5 percent of the family's income.
Tracking co-pays can prove cumbersome, but he believed that
there were reasonable methods available.
10:05:10 AM
Co-Chair Stedman asked if the cost and burden placed on the
department to track the co-pays above 150 percent of the FPL
equated to a net benefit for the state. Mr. Sherwood
answered that the administration does support some kind of
cost sharing. Premiums are easier to track against the five
percent cap.
Co-Chair Hoffman noted that the sponsor statement
illustrates that Alaska currently receives 66 percent
federal funds under this program, and will receive a 70
percent match. He asked if the 70 percent match was
contingent upon the passage of this legislation.
Mr. Sherwood believed that the 70 percent is the combination
of children served for which the current match rate is 66
percent. Services provided through tribal health providers
are included and claimed at 100 percent. The State
Children's Health Insurance Program (SCHIP) match rate is
currently under 66 percent and will move down to 65 percent
in the next few years. Co-pays or premiums may offset
expenditures.
Senator Olson asked if Mr. Sherwood referred to 5 percent
per family or 5 percent per child. Mr. Sherwood understood
that the 5 percent limit exists for the individual versus
the whole family, and pregnant women are not subject to cost
sharing provisions.
10:08:43 AM
Senator Thomas asked when the administration would be able
to present information regarding cost sharing within the
federal regulations. Mr. Sherwood answered that he was
hesitant to set a target date. He planned to address the
subject later. He hoped to revisit the committee in a
reasonable amount of time.
Senator Thomas opined that the payment of premiums would
encourage individuals to seek lesser plans that may or may
not include preventative care.
10:11:05 AM
Mr. Sherwood stated that the department intended to offer
all enrolled recipients of Medicaid full benefits, which
includes preventative care. Federal law does not allow a
program to offer health care to children that does not
include preventative care.
Senator Davis wrapped up by repeating her initial statement.
She stated that she had an opportunity to address cost
sharing, and had consulted with the National Conference of
State Legislatures (NCSL), and she understood that the
administration's intention was to cost share. She stated
that she had not found evidence of administrative action
regarding cost sharing. She recommended against waiting for
the administration to create a plan including federal
regulations. She understood that the money is present in the
current budget to cover the increase. She asked that the
bill pass out in a timely manner. There is not opposition to
this bill. She maintained that her goal was to bring
eligibility requirements for DKC up to 200 percent of the
FPL.
Co-Chair Stedman appreciated the volume of Senator Davis'
voice as it made it easy to understand her position.
SB 13 was HEARD and HELD in Committee for further
consideration.
10:15:14 AM
SENATE BILL NO. 87
"An Act expanding medical assistance coverage for
eligible children and pregnant women; relating to cost
sharing for certain recipients of medical assistance;
and providing for an effective date."
SENATOR BILL WIELECHOWSKI, SPONSOR, explained that the goal
of SB 87 is to increase the eligibility requirements for DKC
to 200 percent. He stated that 80 percent of children
without health insurance are from working families. Private
insurance for children can cost thousands of dollars, with a
large deductable and co-pay. This bill would allow families
with incomes up to 300 percent of the FPL to buy into DKC
using a sliding fee scale for premiums and a 20 percent co-
pay. Those with the greatest means would reimburse the state
roughly 90 percent of its costs. An opportunity exists to
take advantage of millions of federal dollars and provide
the opportunity to allow all children access to health
insurance.
10:19:53 AM
Mr. Wielechowski opined that the bill would save the state
money. He stated that Providence and Alaska Regional
Hospitals in Anchorage report providing $89 million in
uncompensated care in 2006. All premiums are increased when
hospital care is uncompensated. In 2005, the total cost of
health care in Alaska for the uninsured (excluding costs
paid out-of-pocket by the uninsured) was $125 million
(Families USA). He estimated that every Alaskan family would
pay $2248 in 2010 for increased premiums. The opportunity
exists to spend millions of federal dollars resulting in
significant cost savings for all Alaskans including the
state's 14,000 employees. Providing health insurance to
multiple families will ultimately save millions of dollars.
He noted that there was not an increment in the HESS budget
for DKC, which leads him to believe that the administration
is not anticipating increase costs due to raising the
eligibility limits.
10:22:38 AM
Co-Chair Stedman stated that the fiscal note included
language regarding staff increases. Senator Wielechowski
answered that he had been working with the administration to
seek efficiencies in the administration of the bill.
Co-Chair Hoffman stated that even though the money for the
expanded program is not in the operating budget, the fiscal
note is a method of accommodating the increases, if the
legislation passes.
10:24:13 AM
MICHELLE SYDEMAN, STAFF, SENATOR WEILECHOWSKI, mentioned the
original fiscal note. She noted that there had been numerous
meetings with the department to review the overall costs in
terms of the general fund as well as the number of required
positions. She stated that there is a revised fiscal note
based on new understanding about available federal funds.
She assured that the amount was substantially less than the
one listed before the committee. The assumption is that
there would be some changes in the bill with regard to the
co-pay amount. The new fiscal note shows significantly fewer
staff.
Co-Chair Stedman asked for the number of staff listed on the
new fiscal note. Ms. Sydeman understood that there were
eleven staff listed on the most current fiscal note. She
stated that she had not seen the note.
Senator Huggins asked how many staff are employed.
Senator Thomas asked how many full time positions would be
required for the changes in the bill.
Senator Wielechowski answered that the number of additional
children in SB 13 is roughly 1500, and the number of
additional children in SB 87 is roughly 1500.
Co-Chair Stedman stated that he would like to wait until he
had updated information on SB 13.
10:27:13 AM
Senator Elton questioned the point that there was not a
requested increment for DKC, even with the eligibility
increase from 175 percent of the FPL to 200 percent of the
FPL. He suggested that there might not be a requested
increment because there is anticipation by the department of
a co-pay/premium structure in place by the next fiscal year.
Senator Wielechowski answered that the Health and Social
Services(HSS) committee had not addressed the increment
increase. The co-pay and premium system would require
additional staff.
Senator Elton suggested that new staff would be necessary
with a co-pay system. He asked for the additional increment
of positions needed if the program increased from 200 to 300
percent of the FPL.
Senator Wielechowski stated that SB 87 does include a co-pay
system from 200 to 300 percent of the FPL.
Senator Elton asked that if additional staff are required to
implement a co-pay system for a program serving 150 to 200
percent of the FPL, could the same level of staff handle a
co-pay system between 200 and 300 percent of the FPL?
Senator Wielechowski answered that he would rather see the
co-pay begin at 200 percent of the FPL and extend to 300
percent of the FPL. He felt concern about dropping the co-
pay system down to 150 percent of the FPL.
Senator Elton explained that he was not suggesting that the
co-pay drop to serve 150 percent of the FPL. He wanted to
know what the number of additional staff required to
implement the increase to 200-300 percent of the FPL.
10:31:02 AM
Senator Olson asked how the same number of staff needed to
serve 200 percent of the FPL could also serve 300 percent of
the FPL. Senator Wielechowski answered that the increase
from 175 percent to 200 percent adds an additional 1579
people. To extend from 200 percent of the FPL to 300 percent
of the FPL with the co-pay system adds an additional
estimated 1500 children and pregnant women to the program.
10:31:52 AM
DAHNA GRAHAM ANCHORAGE FAITH AND ACTION CONGREGATIONS
TOGETHER (AFACT) (testified via teleconference). She spoke
in favor of income limits for DKC at 200 percent of poverty
level. Above 200 percent of the FPL, she maintained that a
co-pay or premium system would be appropriate.
PAT SENNER, ALASKA NURSES ASSOCIATION (testified via
teleconference) She requested the exploration of cost
sharing methods. She did not agree with cost sharing for
people below 200 percent of the FPL. She spoke in favor of
exploring all options to allow an increase of children
covered above 200 percent of the FPL.
10:35:38 AM
ROD BETIT, PRESIDENT, ALASKA HOSPITAL ASSOCIATION, spoke in
support of SB 87. He agreed with sharing financial
responsibility as income increases. He agreed with language
in SB 87 discouraging a shift of people currently covered by
private plans to a public plan. The approach in SB 87 is
similar to that of other countries' successful health plans.
JORDEN NIGRO, PRESIDENT, ALASKA ASSOCIATION OF HOMES FOR
CHILDREN, stated that the Alaska Association of Homes for
Children would like to see a co-pay established for families
over 200 percent of the FPL only.
MARIE DARLIN, PRESIDENT, AARP CAPITAL CITY TASK FORCE, spoke
in support of SB 87. She agreed that raising the floor to
200 percent was the most important factor.
10:41:06 AM
Co-Chair Stedman asked for the administration's view of the
program expansion. Mr. Sherwood stated that the
administration supports expanding the program and cost
sharing. He stated that he could not provide a position on
the bill.
Senator Elton asked if additional staff would be required to
implement cost sharing for 200 to 300 percent of the FPL.
Mr. Sherwood answered that the administration's position is
not to implement cost sharing for groups currently served.
Pregnant women are exempt from cost sharing. The
administration does not have plans to administer new staff
to collect premiums or administer the co-pay provisions.
Senator Elton asked if the department was exempting
expansion. He asked if the department was considering cost
sharing from 175 to 200 percent of the FPL if SB 13 passes.
Mr. Sherwood stated that the administration's response to
cost sharing has not been determined in regard to SB 13. The
department will not implement cost sharing with SB 13. He
assumed that the department would respect legislative
intent.
10:44:59 AM
SB87 was HEARD and HELD in Committee for further
consideration.
10:46:08 AM
ADJOURNMENT
The meeting was adjourned at 10:45 AM.
| Document Name | Date/Time | Subjects |
|---|---|---|
| 2009-02-25 Denali KidCare, CHIP.PDF |
SFIN 2/25/2009 9:00:00 AM SFIN 3/11/2009 9:00:00 AM |
SB 13 |
| 2009-02-25 Denali KidCare, CHIP.PDF |
SFIN 2/25/2009 9:00:00 AM |
SB 87 |
| Prese Release.doc |
SFIN 2/25/2009 9:00:00 AM |
SB 45 |
| SB 45 Changes in CS vs.P.doc |
SFIN 2/25/2009 9:00:00 AM |
SB 45 |
| SB 45 Sponsor Stmt.doc |
SFIN 2/25/2009 9:00:00 AM |
SB 45 |
| SB 45 Support. Am Legion,VFW,DAV.pdf |
SFIN 2/25/2009 9:00:00 AM |
SB 45 |
| Repercussions.pdf |
SFIN 2/25/2009 9:00:00 AM SFIN 3/11/2009 9:00:00 AM |
SB 13 |
| Poverty Guidelines.pdf |
SFIN 2/25/2009 9:00:00 AM SFIN 3/11/2009 9:00:00 AM |
SB 13 |
| Kaiser Report.pdf |
SFIN 2/25/2009 9:00:00 AM |
SB 13 |
| Background of SCHIP.pdf |
SFIN 2/25/2009 9:00:00 AM SFIN 3/11/2009 9:00:00 AM |
SB 13 |
| SB 45 Support Ak Com on Aging022309.pdf |
SFIN 2/25/2009 9:00:00 AM |
SB 45 |
| Amendment 1 Thonmas.pdf |
SFIN 2/25/2009 9:00:00 AM |
SB 45 |
| SB 45 Support. US Sen Begich 022009.pdf |
SFIN 2/25/2009 9:00:00 AM |
SB 45 |
| SB 45 Support.AARP to SFIN co Chairs.pdf |
SFIN 2/25/2009 9:00:00 AM |
SB 45 |
| SB 45 vs E sectional.pdf |
SFIN 2/25/2009 9:00:00 AM |
SB 45 |
| SB013-DHSS-PAFS-02-24-09.pdf |
SFIN 2/25/2009 9:00:00 AM |
SB 13 |
| SB013-DHSS-PAFS-02-24-09.pdf |
SFIN 2/25/2009 9:00:00 AM |
SB 13 |
| SCHIP Cost Sharing Rules.pdf |
SFIN 2/25/2009 9:00:00 AM |
SB 13 |
| SB45-DMVA-VS-2-23-09.pdf |
SFIN 2/25/2009 9:00:00 AM |
SB 45 |
| sectional.pdf |
SFIN 2/25/2009 9:00:00 AM SFIN 3/11/2009 9:00:00 AM |
SB 13 |
| Sponsor statement 4 - No Child Left Uninsured.doc |
SFIN 2/25/2009 9:00:00 AM |
SB 87 |
| sponsor statement.pdf |
SFIN 2/25/2009 9:00:00 AM SFIN 3/11/2009 9:00:00 AM |
SB 13 |
| Wielechowski kid's health care facts 2.doc |
SFIN 2/25/2009 9:00:00 AM |
SB 87 |
| Wielechowski kid's health care facts 3.doc |
SFIN 2/25/2009 9:00:00 AM |
SB 87 |
| Wielechowski kid's health care facts 4.doc |
SFIN 2/25/2009 9:00:00 AM |
SB 87 |
| Wielechowski kid's health care facts.doc |
SFIN 2/25/2009 9:00:00 AM |
SB 87 |