Legislature(2009 - 2010)SENATE FINANCE 532
03/11/2009 09:00 AM Senate FINANCE
| Audio | Topic |
|---|---|
| Start | |
| SB116 | |
| SB13 | |
| SB32 | |
| Adjourn |
* first hearing in first committee of referral
+ teleconferenced
= bill was previously heard/scheduled
+ teleconferenced
= bill was previously heard/scheduled
| += | SB 13 | TELECONFERENCED | |
| + | SB 32 | TELECONFERENCED | |
| + | TELECONFERENCED | ||
| = | SB 116 | ||
SENATE FINANCE COMMITTEE
March 11, 2009
9:04 a.m.
9:04:09 AM
CALL TO ORDER
Co-Chair Stedman called the Senate Finance Committee meeting
to order at 9:04 a.m.
MEMBERS PRESENT
Senator Lyman Hoffman, Co-Chair
Senator Bert Stedman, Co-Chair
Senator Charlie Huggins, Vice-Chair
Senator Johnny Ellis
Senator Donny Olson
Senator Joe Thomas
MEMBERS ABSENT
None
ALSO PRESENT
Senator Gene Therriault, Jay Livey, Staff, Senator Hoffman;
Ron Kreher Chief of Field Services, Division of Public
Assistance; Senator Bettye Davis, Sponsor; Lynne Koral,
Intern, Senator Bettye Davis; Ellie Fitzjarrald, Director,
Division of Public Assistance, Department of Health and
Social Services; Max Hensley, Staff, Senator Ellis; Jon
Sherwood, Director, Office of Program Review, Department of
Health and Social Services (DHSS); Denise Daniello,
Director, Alaska Commission on Aging; Tim Schuerch, Policy
Analyst, Alaska Native Health Board. Jon Sherwood, Director,
Office of Program Review, Department of Health and Social
Services (DHSS);
PRESENT VIA TELECONFERENCE
Pat Luby, Advocacy Director, Alaska Association of Retired
Persons (AARP), Anchorage; Marita Kaplan, Senior Citizens of
Kodiak; Jack Nielson, Department of Health and Social
Services; Steve Lesko, President of Key Coalition of Alaska;
Connie Sipe, Executive Director for Center for Communities;
Emily Ennis, Fairbanks Resource Agency; Don Cline,
Therapist, Bristol Bay Behavioral Health Corporation,
Dillingham; Rachel Green, Palmer Senior Center; Emma
Huntsman, self.
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 13 was REPORTED out of Committee with "no
recommendation" and with a new fiscal impact note
by the Department of Health and Social Services
and with two previously published fiscal impact
notes: FN1 (DHS) and FN2 (DHS).
SB 32 "An Act relating to medical assistance payments
for home and community-based services."
SB 32 was HEARD and HELD in Committee for further
consideration.
SB 116 "An Act making a special appropriation for energy
assistance for rural communities; and providing
for an effective date."
CSSB 116 (FIN) was REPORTED out of Committee with
a "do pass" recommendation.
SENATE BILL NO. 116
"An Act making a special appropriation for energy
assistance for rural communities; and providing for an
effective date."
9:04:29 AM
Co-Chair Hoffman MOVED to ADOPT work draft LS0600\R, Kane
3/3/09. There being NO OBJECTION, it was so ordered.
Co-Chair Hoffman stated that the initial approach to bring
energy relief to rural Alaskan communities was the
establishment of a separate entity under the title "Energy
Assistance for Rural Communities." A broad approach followed
a review with the administration for energy assistance
without the establishment of a second entity. The
legislation allows energy assistance through the Low Income
Home Energy Assistance Program (LIHEAP) and the Alaska
Heating Assistance Program (AKHAP). The funds were increased
from $5 million to $9 million in an effort to broaden the
program and to assist all Alaskans qualifying under the
LIHEAP program.
9:07:21 AM
JAY LIVEY, STAFF, SENATOR HOFFMAN, explained the changes in
the bill. He referred to the PowerPoint presentation "Alaska
Heating Assistance Programs" (Copy on File):
Mr. Livey discussed Slide 3, "Program Participants":
• Program is statewide
• Directly serves 162 communities
• Through contracts with Native organizations serves 114
more communities
• Outside of tribal areas, 47% of households using the
program live in 6 communities - Anchorage, Wasilla,
Fairbanks, Palmer, North Pole, Homer
9:10:49 AM
Mr. Livey discussed Slide 4, "Eligibility":
• Resident of the State
• Living in the home in which the heating costs occur
• For LIHEAP have income (family of four) less than
$39,750
• For AkHAP have income (family of four) less than
$59,750
• For heating costs incurred from November 1st through
April 30
9:12:11 AM
Mr. Livey discussed Slide 5, "Program Mechanics":
• Individual must apply on behalf of a household
• Household is assigned points based on application
information
• Number of applications is estimated
• Based on state and federal appropriations and estimate
of the number of applications, a dollar amount is
assigned to each point
• Initial grant is made on behalf of household to vendor
in community
• Supplemental assistance is provided if available
9:13:38 AM
Mr. Livey discussed Slide 6, "Amounts of Assistance":
• Based on household points
• Fuel cost and climatic conditions
• Size and type of housing
• Household size and income
• If elderly, disabled or young children are in the
household
• Federal and state appropriations
9:15:27 AM
Mr. Livey explained Slide 7, "Sample Calculation":
• Based on application, household has 15 points.
• Based on available funds and estimate of total number
of applications - each point is worth $220.
• Applicant would receive $3300
• Based on heating oil prices of $6.50 per gallon user
could purchase 507 gallons or 84 gallons per month
• Assuming each household uses 150 gallons per month,
only 56 per cent of household's fuel needs are
recognized by the program
9:17:24 AM
Mr. Livey explained the document "Average Monthly
Temperatures for Bethel Alaska" (Copy on File). The document
intends to communicate that temperatures for March and April
are still quite low, illustrating the ongoing need for
heating assistance.
Mr. Livey addressed the document "Estimated Impact of $9
Million Appropriation for Heating Assistance Programs" (Copy
on File). The communities' average fuel oil cost determines
eligibility. The estimates illustrate the impacts on
households participating in the state-operated heating
assistance programs. The program does not discriminate
between fuel types, although natural gas is less expensive
than oil.
9:20:29 AM
Co-Chair Stedman reminded the public that the Senate Finance
Committee hearing followed a huge escalation in oil prices.
Some areas, particularly in Western Alaska do not have the
ability to benefit from the lower gas prices. The
legislation is an effort to help people around the state
afford to heat their homes this winter.
Co-Chair Hoffman stated that between November of 2005 and
November of 2008 a reduction in costs was calculated in many
regions of Alaska, excluding Western Alaska. He stated that
Western Alaska has yet to receive reductions although the
cost of living has increased.
Senator Huggins asked for a contrast between the $5 million
and the $9 million appropriation. Co-Chair Hoffman answered
that the original piece of legislation was targeted at
Western Alaska. The new legislation addresses the entire
state including Anchorage, Fairbanks, Homer, and the Matsu
valley. The expansion of the program requires an increase in
funds.
9:23:26 AM
Senator Huggins asked how many people currently participate
in the program. Mr. Livey answered that there are 14,000
Alaska households participating in LIHEAP and AKHAP
combined. An additional 4500 members receive services from
tribal organizations. The expectation is 19,000 Alaskan
households participating in the two programs by the end of
the year.
9:24:32 AM
RON KREHER CHIEF OF FIELD SERVICES, DIVISION OF PUBLIC
ASSISTANCE, responded that the number of households served
is only an estimate. Currently the Division of Public
Assistance has received approximately 13,000 applications,
which is 30 percent more than the year prior. Only 6,000
applications have been processed. He informed that 200-300
applications are received each week.
Mr. Livey discussed a planned supplemental check run. The
appropriation would be attached to the run. The vendor will
have a credit account established on the behalf of an
individual. The appropriation would ensure that the vendor
is paid later. The individual could then extend their credit
line with the vendor, knowing that money will be available
to pay for the oil.
9:27:07 AM
Senator Huggins asked if heating oil for senior housing was
eligible for assistance within the program. Mr. Kreher
answered that individuals living in residential housing are
not eligible for heating assistance. Individual residences
are covered by the program, but citizens living in shelters
or residential housing do not qualify for heating
assistance. Senator Huggins encouraged a mechanism to
accommodate senior citizens who face the same demographic
challenges as individuals qualifying for the program.
Co-Chair Hoffman stated that he would like to modify the
LIHEAP program with separate legislation. Mr. Kreher stated
that the elderly and disabled are a priority population for
AKHAP, however, individuals in residential or subsidized
housing have minimal heating costs.
Co-Chair Stedman asked if the administration supports SB
116. Mr. Kreher stated that the administration does not
oppose SB 116. Co-Chair Stedman asked if Mr. Kreher is
stating that the administration supports SB 116. Mr. Kreher
stated that he was informed only briefly by the
administration and has not had the opportunity to consult
about the position, but his understanding was that the
administration does not oppose SB 116.
9:29:17 AM
Co-Chair Stedman asked how many Alaskan citizens were
considered in the Emergency Relief Appropriation Bill. Mr.
Livey estimated between 15,000 or 18,000 Alaskan households.
Co-Chair Hoffman concluded that he wanted to approach the
issue earlier, but he felt that the new approach allows
broader assistance to many low income households. The
fairness of the bill is amplified by the increased cost.
Senator Huggins highlighted that when rent is raised due to
increased fuel cost, some senior citizens are forced out of
their housing arrangements. He did not want to see senior
citizens excluded.
Co-Chair Hoffman MOVED to report CSSB 116 (FIN) out of
Committee with individual recommendations. There being NO
OBJECTION, it was so ordered.
CSSB 116 (FIN) was REPORTED out of Committee with a "do
pass" recommendation.
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, introduced the bill and her
staff member.
LYNNE KORAL, INTERN, SENATOR BETTYE DAVIS, discussed the
legislation, which increases eligibility limits for Denali
Kid Care (DKC) from 175 to 200 percent of the federal
poverty level (FPL). She explained that SB 13 restores the
original level of the qualifying income eligibility standard
for the DKC program to 200 percent of the FPL. She explained
that DKC is considered an enhanced reimbursement program
with up to 70 percent matching funds from the federal
government's State Children's Health Insurance Program
(SCHIP), created in 1997.
Ms. Koral stated that uninsured children with a medical need
are four times more likely to use emergency rooms at a much
higher cost because they tend not to receive care from a
regular care provider. Alaska is one of five states who fund
its SCHIP program below 200 percent of the FPL. Private
health care coverage for children has declined over 30
percent in the last 10 years and the deepening recession is
pulling more children and families into the uninsured ranks.
SB 13 makes insurance eligibility accessible to an estimated
1,277 additional children and 225 additional pregnant women
in Alaska.
9:36:34 AM
Co-Chair Hoffman commented that the administration does
support CSSB 116.
Senator Huggins asked if the administration supports SB 13.
Senator Bettye Davis stated that she had not been informed
about a lack of support from the administration. The
department stated that they indeed support an increase in
eligibility limits to 200 percent of the FPL in the last
Senate Finance Committee meeting of 2/25/09.
9:38:06 AM
JON SHERWOOD, DIRECTOR, OFFICE OF PROGRAM REVIEW, DEPARTMENT
OF HEALTH AND SOCIAL SERVICES (DHSS), explained that the
Governor publically supported expanding income eligibility
levels to 200 percent of the FPL. The Governor expressed
interest in provisions such as premiums. He stated that the
administration does not have a position in opposition to SB
13.
Senator Huggins asked for the contrast between a similar
bill addressing the increase of eligibility limits for DKC.
Mr. Sherwood answered that there were four different
proposals on the table to expand the DKC program. Two of the
bills expand beyond 200 percent of the FPL with some degree
of cost sharing in the form of premiums and or co-pays. One
bill expands from 175 to 250 percent of the FPL with cost
sharing in the form of premiums beginning at 175 percent of
the FPL and expanding for children only.
Senator Huggins assumed that the specialists in the
department favor one bill that best supports children and
remains cost effective.
9:40:43 AM
Mr. Sherwood stated that he had disclosed all of the
information that was available to him. He did not feel that
he could answer the question further.
Senator Huggins encouraged an effective means of helping
Alaskans with healthcare costs and he asked the
administration to come forward with a position.
Senator Bettye Davis stated that the cost of the various
bills remains the same, however, SB 13 allows children to
obtain coverage as soon as possible. She emphasized that the
proper action was to bring as many children onto DKC as soon
as possible. She maintained that cost sharing was still a
possibility with another bill. She stressed that the
solitary goal of SB 13 was raising income eligibility limits
to 200 percent of the FPL.
Senator Huggins stated that he preferred an omnibus bill
that combines the best methods within the available means.
9:43:33 AM
Senator Bettye Davis stated that SB 13 could pass while work
occurs with the other bills providing the accomplishment of
many good ideas.
Co-Chair Stedman asked if additional employees were
necessary to process the paperwork. Mr. Sherwood answered
that the program's caseload will increase by 1500 additional
individuals. He informed that given the current caseload
averages, two additional employees are necessary. Co-Chair
Stedman asked if the positions were eliminated when
eligibility was reduced in 2003.
9:45:43 AM
ELLIE FITZJARRALD, DIRECTOR, DIVISION OF PUBLIC ASSISTANCE,
DEPARTMENT OF HEALTH AND SOCIAL SERVICES, commented on the
elimination of positions with eligibility reductions. The
two positions requested for SB 13 are due to changes in
Medicaid requirements surrounding citizenship verification
and the emphasis on payment accuracy to ensure that
applicants are eligible for the program. When income scales
are increased, more time is needed to ensure eligibility.
The request for additional employees serves the increased
number of applicants.
9:47:58 AM
Co-Chair Stedman spoke to the three fiscal notes increasing
the general fund spending $861,000 in FY09 and $940,000 in
FY10.
Senator Bettye Davis stated that she wished for the bill to
pass out during the current hearing.
Co-Chair Hoffman MOVED to report SB 13 out of Committee with
individual recommendations and the accompanying fiscal
notes. There being NO OBJECTION, it was so ordered.
SB 13 was REPORTED out of Committee with "no recommendation"
and with a new fiscal impact note by the Department of
Health and Social Services and with two previously published
fiscal impact notes: FN1 (DHS) and FN2 (DHS).
SENATE BILL NO. 32
"An Act relating to medical assistance payments for
home and community-based services."
9:50:14 AM
Senator Ellis presented SB 32.
Senate Bill 32 creates a mechanism for regular Medicaid
rate review for providers of home- and community-based
services to Alaska's elderly and developmentally
disabled citizens. Institutional service providers
receive regular reviews in order to bring rates in line
with costs.
However, home and community-based services (HCBS) have
been conclusively proven to lower overall long-term
Medicaid costs. One recent study in the academic
journal Health Affairs found that states with long-
established high proportions of HCBS spending saw a 3%
overall decrease in long-term care spending between
1995 and 2005 as opposed to a 14.5% increase in low-
HCBS states. The study concluded:
"Justifications based on financial
constraints can no longer be credibly
offered as reasons for forcing such people
[seniors and persons with developmental
disabilities] into nursing homes and other
institutions. HCBS programs may be one
instance in which offering people greater
1
choice also helps reduce costs."
Over the last few years, however, rates for home- and
community-based services have been frozen. During that
time, not only have costs increased, the medical
environment - including regulations, technology, and
client expectations - has shifted dramatically. These
shifts threaten the continued viability of the hundreds
of HCBS providers, primarily private businesses that
employ thousands of Alaskans in every region of the
state.
Home and community based services are the key to
helping our seniors and those living with developmental
disabilities live their lives as productive members of
our communities while controlling the growth of health
care costs. Without the regular review process in
Senate Bill 32, many providers will be forced out of
1
Health Affairs 28, no. 1 (2009): 262-272.
business and HCBS services will be taken away from
thousands of Alaskans across the state.
9:58:25 AM
Senator Ellis noted that most providers have not seen
increases in ten years. He pointed to problems with
contractor's assessments precluding testimony from smaller
providers. He explained that SB 32 gives the Department of
Health and Social Services (DHSS) the flexibility to devise
a cost based system, while repairing the disparity between
home and community based services and institutional care
rates. Hospitals and nursing homes require regular rate
reviews. Home and community based services deserve the same
treatment from the state.
10:00:19 AM
Co-Chair Hoffman asked for a list of home and community
based providers. He asked how the fiscal notes would affect
their earnings.
Senator Ellis noted that new and possibly reduced fiscal
notes would be provided to the committee. He emphasized that
the legislation is not a rate increase, but a mechanism for
rate review. He believed that work in the finance committee
could further reduce the cost. He informed that DHSS could
provide the requested provider information.
10:01:55 AM
Co-Chair Stedman observed that the fiscal notes are $4.4
million for FY10 and $8 million for FY11. A committee
substitute (CS) bill is in the works, but information for
committee members is today's goal. Senator Ellis stressed
that the fiscal impact could be reduced.
Senator Olson asked how non-Medicaid eligible individuals
would be impacted by the mandatory rate review. Senator
Ellis explained that SB 32 addresses providers that are
reimbursed through Medicaid. Senator Olson stated that he
had not witnessed a component of the fiscal note for
providers ineligible for Medicaid.
10:03:32 AM
MAX HENSLEY, STAFF, SENATOR ELLIS, responded to questions.
He informed that there are approximately 350 home and
community based providers, who receive approximately $140
million in Medicaid funding per year.
Mr. Hensley informed that Section 1 of SB 32 creates a rate
review process for home and community based services as well
as assisted living homes, which are outside of the Medicaid
arena. Section 1 adds personal care services and assisted
living homes for needy and vulnerable adults to the services
receiving the rate review process. As drafted, the bill only
covered home and community based services provided though a
Medicaid waiver.
Mr. Hensley reviewed Sections 2 and 3, which are conforming
language for the assisted living homes for needy and
vulnerable adults. Section 4 creates an annual report to the
legislature detailing trends in rates based on the review
process in the bill, and sunset that reports in 2014. He
stressed that the legislation is designed as a management
tool.
10:06:15 AM
Mr. Hensley explained that Section 6 delays the
implementation of the program for two years to allow DHSS to
create the methodology to set the rates.
10:07:25 AM
JON SHERWOOD, DIRECTOR, OFFICE OF PROGRAM REVIEW, DEPARTMENT
OF HEALTH AND SOCIAL SERVICES (DHSS), observed that the
process has been collaborative. The department hired a
consultant to review the program. The department is
committed to moving forward with a rate setting system, but
is still seeking compromise, including adequate direction
without restriction in the rate setting process of larger
hospitals and nursing homes. The department supports the
process of accountability.
10:09:21 AM
Senator Olson questioned how the legislation would affect
residents of the Mary Conrad center in Anchorage. Mr.
Sherwood observed that they would not be affected by SB 32.
Senator Olson asked if semi-private home services providers
were affected. Mr. Sherwood answered that the legislation
requires the department to change rates reflecting costs
incurred by providers. Senator Olson asked if the
legislation would affect health care corporations in rural
Alaska.
10:10:51 AM
Senator Ellis acknowledged that there are home and community
based providers, especially in rural Alaska, who would
benefit from the legislation. The intent of the legislation
is to find the proper balance. Rural providers are
struggling and the state is in danger of losing a cross
section of service providers.
10:12:19 AM
Senator Huggins requested clarification regarding the two
year delay in the implementation of SB 32. Mr. Sherwood
agreed that the department requested the two year delay.
Senator Huggins asked if the department has concerns for
home and community service organizations that might not
survive two years. He felt concern about the attrition of
these services.
Mr. Sherwood answered that two years was an ambitious goal
for implementing a cost based rate system. He explained the
difficulty in creating the system.
Senator Huggins asked when the five year repealer would
begin. Mr. Hensley explained that the repealer addresses the
report from the department and takes effect June 30, 2014,
meaning that the report would occur during the first three
years of the program.
10:14:27 AM
DENISE DANIELLO, DIRECTOR, ALASKA COMMISSION ON AGING
testified in favor of SB 32.
Good Morning. My name is Denise Daniello and I am the
executive director of the Alaska Commission on Aging. I
am here to testify in support of CSSB 32, a bill to
allow for regular rate reviews of home- and community-
based services for Medicaid-eligible persons similar to
the process used by hospitals and nursing homes. We
believe that this proposed legislation addresses the
need for a fair and consistent process to maintain the
systems of care for vulnerable Alaskans and promotes
sounds fiscal planning for providers and the State.
The Governor's Council on Disabilities and Special
Education, the Alaska Mental Health Board, Advisory
Board on Alcoholism and Drug Abuse along with the
Alaska Mental Health Trust Authority, the Suicide
Prevention Council, the Alaska Brain Injury Network and
the Alaska Commission on Aging have jointly identified
the establishment of a regular and periodic schedule of
rate reviews for home and community based services as
one of our four legislative priorities for 2009. The
provisions that address our legislative priority are
included in SB 32 sponsored by Senator Ellis.
Alaska's most vulnerable populations depend heavily on
a network of community nonprofit provider agencies.
Before last year's rebasing for FY09, many home and
community-based service providers had been over a
decade without a rate review receiving the same level
of reimbursement while their costs continued to climb
along with demand for more services.
Home- and community-based services are an effective and
efficient means of providing care for nearly 57,000
Alaskans who would otherwise need to be served by more
costly institutions. Investment in the foundation of
home- and community-based services is prudent to assure
that services meet the needs of all vulnerable Alaskans
to maintain their quality of life and to hold down the
costs of higher level health care.
According to 2006 estimates provided by Senior and
Disabilities Services, the average annual cost of a
semi-private room in a nursing facility was $172,685
compared to $21,436 for the Medicaid waiver.
It should also be kept in mind that as more individuals
are able to receive home- and community-based services,
fewer of them will need to enter much more costly
institutions such as nursing homes. Thus, it is quite
possible that by adequately funding these critical
pieces of the continuum of care may result in an
ultimate cost savings for the State.
Older Alaskans depend on home- and community-based
services which help them to continue living in their
home communities for as long as possible close to
family, friends, and cultural tradition. For seniors,
these services may include home-delivered meals,
transportation, chore services, care coordination,
assisted living homes, and other services. Thirty-six
percent of the 3,498 individuals served by Medicaid
waivers are older Alaskans - the majority of whom are
elders in their 80's on the Older Alaskans waiver.
This bill has broad support from a coalition of
providers who have also signed on to our joint Trust
and Advisory Boards' position paper. They include
· Alaska Association on Developmental Disabilities,
serving 2,636 Alaskans
· AgeNet, serving 18,953 Alaskans
· Personal Care Attendant Providers' Association,
serving 3,807 Alaskans
· Assisted Living Association of Alaska, serving
1,500 Alaskans
· Alaska Behavioral Health Association, serving
26,285 Alaskans
10:19:24 AM
TIM SCHUERCH, POLICY ANALYST, ALASKA NATIVE HEALTH BOARD
represented the state's Native Health Organizations. He
stressed that providing basic services in outlying areas has
grown expensive. The medical inflation index and employer's
health insurance increase every year. The rates for home and
community based services have been frozen for nine years. A
rate freeze for cost effective services does save money
overall by preventing and intervening up front. The Alaska
Native Health Board supports SB 32. Concerns include
gathering the necessary data. He stated that the two year
delay was crucial to work with the department to create a
rate establishing methodology.
10:22:16 AM
PAT LUBY, ADVOCACY DIRECTOR, ALASKA ASSOCIATION OF RETIRED
PERSONS (AARP), ANCHORAGE (testified via teleconference), in
favor of the legislation. The goal of home and community
based services is to avoid premature institutionalization
for individuals. Rates must undergo review ensuring that
providers are accurately reimbursed. Older citizens have
fewer options without the help of home and community based
services.
MARITA KAPLAN, SENIOR CITIZENS OF KODIAK (testified via
teleconference). She urged the committee to allow the annual
rate review. The Senior Citizens are challenged with keeping
services alive and having trained staff available. Home
based services are essential for families striving to keep
elders at home.
JACK NIELSON, DEPARTMENT OF HEALTH AND SOCIAL SERVICES
(testified via teleconference). He stated that he works in
the office of rate review, which works directly with cost
reporting and rate setting proposed under SB 32.
Co-Chair Hoffman asked if the department believes that the
rate review must occur annually or is a less frequent review
prudent.
10:27:26 AM
Mr. Nielson replied that his work was involved with statutes
and regulations. Requirements outlined in federal statutes
outline the requirements for rate setting in the Medicaid
program. The department must provide access to services for
clients with rates that are consistent with economy and
efficiency, which has an element of cost. The current laws
do not require a cost review each year.
STEVE LESKO, PRESIDENT OF KEY COALITION OF ALASKA (testified
via teleconference) in favor of the legislation. He asked
that the impact on families be considered. This governs
rebasing, which accounts for mandatory pass through costs on
a periodic basis. Community and home based programs do not
have access to such a process. This fiscal year marks the
fifth year of the rate freeze. These factors have
devastating consequences on the community. He mentioned a
few of the ways impacts are perceived. Families receive
fewer and fewer services. Care for so many is not an option
it is a matter of life and death.
10:33:37 AM
CONNIE SIPE, EXECUTIVE DIRECTOR FOR CENTER FOR COMMUNITIES,
SITKA (testified via teleconference) representing a non-
profit based in Sitka. She spoke in favor of the
legislation. She explained that the budget is made up of 50
percent Medicaid reimbursements. She stated that the center
does not receive grants. She spoke of the areas served in
Southeast Alaska. She stated that the center had 113 clients
in Sitka, Kake, and Ketchikan. Medicaid pays for the
services. She felt that her organization had been unfairly
treated in the Medicaid arena for home and community based
services leading to many position cuts. SB 32 is necessary
to keep home and community based services stable.
10:38:38 AM
EMILY ENNIS, EXECUTIVE DIRECTOR, FAIRBANKS RESOURCE AGENCY
(testified via teleconference), in support of SB 32.
Medicaid supported home and community services enable the
care of people who are not able to independently care for
themselves. She believed that the Medicaid community
services along with hospitals and nursing homes represent
Alaska's long term healthcare system in the community.
10:42:32 AM
DON CLINE, THERAPIST, BRISTOL BAY BEHAVIORAL HEALTH
COORPORATION, DILLINGHAM (testified via teleconference),
spoke in support of SB32. He mentioned the recent
termination of the crisis center, "Our House," which served
as respite for the chronically mentally ill. The center was
closed and the service is missed by both the families and
the mentally ill individuals.
10:46:05 AM
RACHEL GREEN, REPRESENTATIVE FROM THE PALMER SENIOR CENTER
(testified via teleconference), in support of SB 32. She
supported the bill due to the regular rate review of state
services. The senior citizen population is increasing, and
senior citizen services have been underfunded for many
years. This bill allows the necessary tools to provide
educated funding decisions for home and community based
services now and in the future.
10:48:19 AM
EMMA HUNTSMAN, SELF, BARROW (testified via teleconference),
in support of SB 32. She spoke in support of the North Slope
area. She spoke in support of Medicaid and annual rate
reviews. She relayed appreciation for the benefits of
Medicaid utilized by her disabled son.
10:51:14 AM
ADJOURNMENT
The meeting was adjourned at 10:50 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 |
| Alaska Heating Assistance Programs.ppt |
SFIN 3/11/2009 9:00:00 AM |
SB 116 |
| sectional.pdf |
SFIN 2/25/2009 9:00:00 AM SFIN 3/11/2009 9:00:00 AM |
SB 13 |
| 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 |
| Background of SCHIP.pdf |
SFIN 2/25/2009 9:00:00 AM SFIN 3/11/2009 9:00:00 AM |
SB 13 |
| ANHB Support Letter.pdf |
SFIN 3/11/2009 9:00:00 AM |
SB 116 |
| AVERAGE MONTHLY TEMPERATURES FOR BETHEL ALASKA.doc |
SFIN 3/11/2009 9:00:00 AM |
SB 116 |
| SB 116 - gallons by comunity.xls |
SFIN 3/11/2009 9:00:00 AM |
SB 116 |
| SFIN letters of support addendum.pdf |
SFIN 3/11/2009 9:00:00 AM |
SB 32 |
| SFIN explanation of changes.pdf |
SFIN 3/11/2009 9:00:00 AM |
SB 32 |
| sb13_2009 summary 3-9-09.pdf |
SFIN 3/11/2009 9:00:00 AM |
SB 13 |
| SFIN letters of support.pdf |
SFIN 3/11/2009 9:00:00 AM |
SB 32 |
| SFIN sponsor statement.pdf |
SFIN 3/11/2009 9:00:00 AM |
SB 32 |
| SFIN supporting information.pdf |
SFIN 3/11/2009 9:00:00 AM |
SB 32 |
| sponsor statement.pdf |
SFIN 2/25/2009 9:00:00 AM SFIN 3/11/2009 9:00:00 AM |
SB 13 |
| Work Draft CS for SB116(Fin) 031109.pdf |
SFIN 3/11/2009 9:00:00 AM |
SB 116 |