Legislature(1997 - 1998)
04/04/1997 10:04 AM Senate HES
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SENATE HEALTH, EDUCATION & SOCIAL SERVICES COMMITTEE
April 4, 1997
10:04 a.m.
MEMBERS PRESENT
Senator Gary Wilken, Chairman
Senator Loren Leman, Vice Chairman
Senator Lyda Green
Senator Jerry Ward
Senator Johnny Ellis
MEMBERS ABSENT
All members present.
COMMITTEE CALENDAR
SENATE BILL NO. 149
"An Act relating to reports and audits concerning health care
facilities; and providing for an effective date."
-MOVED SB 149 OUT OF COMMITTEE
SENATE BILL NO. 148
"An Act relating to libraries."
-MOVED SB 148 OUT OF COMMITTEE
SENATE BILL NO. 146
"An Act relating to the public school funding program; relating to
the definition of a school district, to the transportation of
students, to school district layoff plans, to the special education
service agency, to the child care grant program; imposing a school
tax in the unorganized borough; and providing for an effective
date."
-SCHEDULED BUT NOT HEARD
PREVIOUS SENATE COMMITTEE ACTION
SB 149 - No previous Senate action to record.
SB 148 - No previous Senate action to record.
SB 146 - See Senate Health, Education & Social Services minutes
dated 3/24/97.
WITNESS REGISTER
Jay Livey, Deputy Commissioner
Department of Health & Social Services
PO Box 110601
Juneau, Alaska 99811-0601
POSITION STATEMENT: Discussed SB 149.
Garrey Peska
Alaska State Hospital & Nursing Home Association (ASHNHA)
319 Seward Street
Juneau, Alaska 99801
POSITION STATEMENT: Discussed SB 149.
Mary Jackson, Staff
Senator Torgerson
State Capitol
Juneau, Alaska 99801-1182
POSITION STATEMENT: Discussed SB 148.
George Smith, Deputy Director
Division of Libraries, Archives & Museums
PO Box 110571
Juneau, Alaska 99811
POSITION STATEMENT: Discussed SB 148.
Moe McGee, Director
Anchorage Municipal Libraries
3600 Denali
Anchorage, Alaska 99503
POSITION STATEMENT: Supported SB 148.
Greg Hill
Fairbanks North Star Borough Library
555 Fairbanks Street
Fairbanks, Alaska 99709
POSITION STATEMENT: Urged passage of SB 148.
Paul Blair
Glennallen, Alaska
POSITION STATEMENT: Favored the general concept of SB 148.
Joyce Jenkins, Director
City of Petersburg Library
Petersburg, Alaska
POSITION STATEMENT: Encouraged support of SB 148.
ACTION NARRATIVE
TAPE 97-35, SIDE A
SB 149 HEALTH CARE FACILITY AUDITS & REPORTS
Number 001
CHAIRMAN WILKEN called the Senate Health, Education & Social
Services Committee (HES) to order at 10:04 a.m. and introduced
SB 149 as the first order of business before the committee.
JAY LIVEY , Deputy Commissioner for the Department of Health &
Social Services, noted that the committee packet contained a
position paper from the Alaska State Hospital & Nursing Home
Association (ASHNHA) which describes the four sections of SB 149.
SB 149 clarifies that the department has the ability to do audits
and other financial inspections of hospitals and nursing homes in
order to establish reimbursement rates for Medicaid. In the past,
there has been some ambiguity whether the department's statute
specifies that ability.
GARREY PESKA , ASHNHA, added that SB 149 would repeal a state filing
deadline that has been superseded by federal deadlines. Under
state law, facilities must file a year end report with the
department within 120 days of the end of the facility's fiscal
year. Due to changes in federal deadlines, facilities no longer
receive the documents necessary from federal payment intermediaries
until five months after the year end. SB 149 would allow the
department to set that deadline so as to coincide with the federal
deadlines. SB 149 includes language that acknowledges that the
department is not required to audit every hospital and nursing home
every year for Medicaid. Those facilities are all audited by
independent CPAs every year and therefore it would be appropriate
for Medicaid audits to be done less frequently.
CHAIRMAN WILKEN noted that Douglas Jones and Randal Schlapia from
DHSS were present to answer questions. Chairman Wilken said that
he intended to report SB 149 out of committee.
SENATOR ELLIS asked if there would be a review of the independent
CPAs' audit during the years the department does not perform an
audit. How many years could a small facility participate in
Medicaid without a state audit of the program? JAY LIVEY said that
a criteria had not yet been developed by which the department would
choose to do a facility audit every year. The department and
ASHNHA are contemplating changes to the rate setting system which
would eliminate the need for yearly audits. Therefore, the
department wanted to ensure that statute allowed the department the
discretion not to perform yearly audits.
Number 120
SENATOR ELLIS inquired as to the length of time SB 149 allows for
the department not to audit. JAY LIVEY said that SB 149 does not
specify a schedule. SENATOR ELLIS believed that under SB 149 the
department could choose not to perform an audit on a facility with
a Medicaid program. JAY LIVEY acknowledged that possibility under
SB 149, but said that the department had no intention of doing
such. Unless a change occurred in the current rate setting system,
the department would intend to audit every year. GARREY PESKA
noted that federal law requires that the department have an audit
program. Mr. Peska suggested that for a small facility an audit
every other year would be appropriate. Such a facility could have
a contract based on the number of encounters rather than actual
cost or a contract based on a quarterly lump sum of the previous
year's reimbursement could be utilized.
SENATOR ELLIS asked how small an operation would be before the
program would be considered as a program not materially
participating in Medicaid. JAY LIVEY pointed out that the problem
with Medicaid is that it is a $350 million program. Even a
facility with a relatively small share of that budget could be
receiving $2 or $3 million in state expenditures which would be a
large portion in another context. Mr. Livey said that the
materiality would need review and the department has not begun
regulations describing that materiality.
Hearing no further discussion, CHAIRMAN WILKEN said that he would
entertain a motion.
SENATOR GREEN moved to report SB 149 out of committee with
individual recommendations and accompanying fiscal notes. Without
objection, it was so ordered.
SB 148 PUBLIC LIBRARIES
Number 200
CHAIRMAN WILKEN noted that SB 146 would not be taken up today, but
would be before the committee on Wednesday. Chairman Wilken
announced that SB 148 was the last order of business before the
committee.
MARY JACKSON , Staff to Senator Torgerson, informed the committee
that SB 148 is a companion to HB 197. SB 148 establishes a
definition of public library in order to provide a criteria for
funding libraries under existing grant programs.
GEORGE SMITH , Deputy Director of the Division of Libraries,
Archives & Museums, discussed the history of Alaska's support of
public libraries. Mr. Smith noted that the $1 to $1 match of the
grant program has not been possible for a number of years, every
library receives the basic $5,000 grant. The match has been
prorated and in recent years, no more than $2,000 match has been
provided. In the last three or four years, no library has received
more than $7,000. Mr. Smith explained that about five years ago,
a number of libraries requested that a law defining a public
library be developed. SB 148 was developed through the work of
Public Library Directors of the 19 largest libraries in Alaska.
The legislation was also reviewed by the Education Subcommittee of
the Alaska Municipal League who would like to see SB 148 move
forward.
Number 285
SB 148 addresses two major issues. Firstly, SB 148 addresses some
administrative issues found in the following sections. Section 6
specifies the minimum levels of service that a public library
should provide to be eligible for a grant. Section 5 provides a
structure for Library Boards if the community decides to have such.
Mr. Smith noted that many cities do not have such a board, rather
the city council acts in that capacity. Section 2 requires
nonprofit corporations that run public libraries to conduct board
meetings in public. Of Alaska's 85 public libraries, 22 are
operated by nonprofit corporations. Section 6 allows nonprofits in
unorganized boroughs, outside of cities to qualify as a community
per the Department of Community & Regional Affairs definition of
community.
Secondly, SB 148 radically restructures the nature of the grant
program which is located in Section 3. Currently, a community can
receive a $5,000 grant without any local effort. There is a
matching portion that does require local effort. SB 148 specifies
that a library would not be eligible for a grant without local
effort at a minimum of $5,000. The current law requires that the
match be in money, but SB 148 would allow in-kind service which
recognizes the efforts of volunteer services. This would stabilize
many of the small libraries. Mr. Smith acknowledged that a few
libraries at the lower end who have never contributed locally will
have to decide whether to contribute or close. Based on libraries'
annual reports, between five and ten libraries will face a
difficult question regarding whether to provide local effort. On
the other hand, 15-20 libraries will fair better because of the in-
kind service. Under SB 148 if there is ever more money for this
program, any amount available above $7,000 per library would be
distributed on a per capita basis.
Mr. Smith pointed out that Section 7 sunsets two public library
construction grant programs which no longer exist. Mr. Smith noted
that the state library has been giving public library grants,
interlibrary cooperation grants, and regional services grants. The
regional services grants never appeared in law, although those
grants have been functioning since the 1970s. Sections 1 and 2
clarify that situation by recognizing regional services grants
which provides books by mail service.
Number 391
SENATOR LEMAN referred to page 2, line 6 when asking if that
language would prevent libraries from charging shipping fees.
GEORGE SMITH said that the language would not prevent the charge of
transportation fees. Across the country, a sizable interlibrary
loan fee has evolved and in addition there is a shipping cost.
SB 148 would merely eliminate the interlibrary loan fee and charge
only the shipping fee which all libraries in Alaska have done for
many years.
SENATOR LEMAN asked if there was a standard methodology regarding
how in-kind services are valued. GEORGE SMITH said that this would
need to be addressed in regulation. Mr. Smith believed that in-
kind service should be valued slightly under the level of a city
clerk in that particular region, but not less than $10 per hour.
SENATOR LEMAN suggested that Mr. Smith consider a minimal cash
contribution from the community in order to help establish the
community's ownership of the library. Senator Leman referred to
page 4, line 3 which refers to the items the library would provide
free of charge. Senator Leman assumed that the library could
charge fees for fines, copying, etc. GEORGE SMITH said that there
is no charge for a resident of the community to check out a book.
Mr. Smith noted that libraries with a data base service would be
allowed to charge a fee.
Number 459
MOE MCGEE , Director of Anchorage Municipal Libraries, supported
SB 148. Ms. McGee discussed the meetings that took place between
various library directors with state library staff in order to
draft public library law for Alaska. This process resulted in a
closeness between the directors which will benefit future
endeavors. From the Anchorage perspective, Ms. McGee was pleased
with the per capita provisions beyond the basic grant. Ms. McGee
appreciated the support of the state library in this process.
GREG HILL , Fairbanks North Star Borough Library, informed the
committee of a report from the National Center for Education
Statistics which reports that 44 percent of all U.S. households
used a public library last month. The report also found that 65
percent of all U.S. households used a public library in the last
year. Alaska ranks even higher; 56 percent of Alaskans used a
public library last month and 76 percent of Alaskans used a public
library last year. Mr. Hill believed it time for legislation to
define public libraries to be used to lay the foundation for the
future. SB 148 requires local commitment and provides an incentive
with the recognition of in-kind service. Mr. Hill urged the
passage of SB 148.
PAUL BLAIR , testifying from Glennallen, informed the committee that
the Glennallen library was in an unincorporated borough with a
minimum of $5,000 grant. Mr. Blair said that either way, the
Glennallen library would be hurt. Mr. Blair referred to the
language in Section 2, subsection (b) stating " Only one library in
a city or unincorporated community is eligible for a public library
assistance grant during a fiscal year. " Does that language apply
to an unincorporated borough with nine libraries or does that not
apply to an unincorporated borough?
GEORGE SMITH explained that there could be any number of recognized
libraries within an unincorporated borough, the language only
refers to within one community as defined by Community & Regional
Affairs. If Community & Regional Affairs recognizes a community as
eligible for state grants, SB 148 would as well.
PAUL BLAIR indicated the need for more specific language on that
matter. GEORGE SMITH pointed out that the Community & Regional
Affairs law specifies that each viable community is separate and
eligible, although that is not mentioned in SB 148.
Number 527
PAUL BLAIR believed that the specified range of $5,000 to $7,000
for matching grants would hurt the small libraries such as in
Glennallen. Mr. Blair cited a case in Glennallen in which there
was a small in-kind base to draw from as well as greater utility
expenses; that would create difficulties matching grants greater
than $7,000. Mr. Blair suggested that the low end of the range be
lowered and the high end be raised so as to consider the smaller
libraries. GEORGE SMITH noted that Glennallen is one of the more
stable smaller libraries which has had the maximum matching amount
for years. SB 148 could actually help Glennallen, especially with
the in-kind matching allowed. Mr. Smith agreed that a maximum of
more than $7,000 would be nice, but the reality is that there is a
limited amount of money available.
PAUL BLAIR said that he was in favor of the general content of
SB 148.
JOYCE JENKINS , Director of the Petersburg Library, echoed the
comments regarding the time spent on this legislation. The
increased accountability for libraries through the definition are
important and need to be in law. Ms. Jenkins commented that the
greatest difficulty was balancing the needs of the small and large
libraries which SB 148 achieves. Ms. Jenkins encouraged the
committee's support of SB 148.
SENATOR WARD moved to report SB 148 out of committee with
individual recommendations and accompanying fiscal notes. Without
objection, it was so ordered.
CHAIRMAN WILKEN asked if there was anything else to come before the
committee.
SENATOR ELLIS inquired as to the progress of the sex offender
registration bill. CHAIRMAN WILKEN said that he would work on
that. There being no further business before the committee, the
meeting was adjourned at 10:50 a.m.
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