Legislature(1999 - 2000)
02/02/1999 03:37 PM Senate HES
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SENATE HEALTH, EDUCATION AND SOCIAL SERVICES COMMITTEE
February 2, 1999
3:37 p.m.
MEMBERS PRESENT
Senator Mike Miller, Chairman
Senator Pete Kelly, Vice-Chairman
Senator Gary Wilken
Senator Drue Pearce
MEMBERS ABSENT
Senator Kim Elton
COMMITTEE CALENDAR
Briefing on Long-Term Health Care
PREVIOUS SENATE COMMITTEE ACTION
None
WITNESS REGISTER
Representative Con Bunde
Alaska State Capitol
Juneau, Alaska 99801-1182
Senator Gary Wilken
Alaska State Capitol
Juneau, Alaska 99801-1182
ACTION NARRATIVE
TAPE 99-02, SIDE A
Number 001
CHAIRMAN MILLER called the Senate Health, Education and Social
Services (HESS) Committee to order at 3:37 p.m. and announced that
Representative Bunde would begin the presentation on long-term
health care.
REPRESENTATIVE BUNDE stated that he and Co-Chair Wilken appreciated
the opportunity to present the findings and recommendations of the
Task Force on Long-Term Health Care. The task force was
established by SCR 11 and charged with developing an equitable plan
for providing an actuarially sound and affordable long-term care
option for seniors. Long-term care should be expanded to cover
everyone in the disabled community and not just seniors. Between
1990 and 1996, Alaska experienced a 42% increase in the 65-and-
older age group, exceeding all expectations. In 1996, the State
provided long-term care at a cost of $73 million. By the year
2,015, long-term care would cost the State $372 million, and with
the budget crisis we're currently facing, this is not a tenable
situation. Our senior population will quadruple in the next 16
years. The number of wage earners are decreasing at the same time
the number of retirees are increasing, adding to our challenge.
Long-term care is very expensive, costing from $100 to $300 per
day. For example, the down-payment for a colleague's mother to get
in the door of a retirement home was %50,000.
REPRESENTATIVE BUNDE asked who should pay for long-term health
care: the federal government, the state government, private
individuals, or a combination of these? Medicare doesn't pay for
long-term care. Medicaid will pay 80% of long-term care but it
requires people to impoverish themselves to qualify, disinherit
their children and disenfranchise their spouse. This is not a
viable option. There is public denial of long-term health care
needs, and fewer than 50% of state retirees are buying the long-
term care option on their medical insurance. The long-term option
is easy and not very expensive if it's spread out over a large
group of people, or if it begins early. New York Life has told us
that if everyone in the state age 25 were involved in a long-term
health care plan, it would probably cost only $25 a month per
person. We don't want a system like social security where the
youth are paying for the long-term care of the elderly, with no
hope that when they become elderly there will be anyone there to
pay for them.
REPRESENTATIVE BUNDE stated the task force's recommendations will
not solve the problem, but will slow its growth and its impact on
the state's budget. That's why the task force is here briefing the
committee and asking for its help with more extensive research and
analysis to come up with a single funding plan or a group of
funding alternatives to address this problem. The task force was
created by resolution, and "is sunsetted out" of existence as of
this moment. He concluded by recommending the creation of a
legislative oversight committee to continue working on the issue,
thanking the public members of the task force, and acknowledging
the work of Senator Wilken, Ms. Sheila Peterson, and Ms. Joyanna
Geisler, a task force member present at the briefing.
SENATOR WILKEN expressed his commitment to continue working with
the long-term health care issue because the discussions and report
findings brought to light the tremendous problem this will be if
Alaskans don't address the problem of aging for this generation and
those that follow. He commended the report to the committee, and
briefly discussed its format. The table of contents includes five
different sections and 31 specific recommendations. The task force
tried to bring forth the concept that we are responsible for our
own actions, and we don't have a State "fix" for this.
SENATOR WILKEN emphasized that one recommendation (Request No. 13)
would provide for long-term care services for the elderly in the
home and the community for as long as possible before it becomes
necessary to institutionalize. REPRESENTATIVE BUNDE interjected
that this would be the most humane, least expensive, and most
productive way to deal with long-term health care.
SENATOR WILKEN referred the committee to the purple tab on page 75
of the report that highlights three pages of requests. Numbers 3,
7, 13 and 21 all speak to legislation that he would like the HESS
Committee to consider and introduce. Chairman Miller has a sponsor
statement for each of the four pieces of legislation. These speak
to the disclosure of licensing reports to the public, protecting
vulnerable adults, certificate of need for nursing homes, and the
establishment of community-based services.
SENATOR WILKEN emphasized the need to implement Request No. 31,
which would create a new task force to continue the review and
monitoring of long-term care in Alaska. The task force would
function as an oversight committee to ensure that these issues and
others have been carried out. SENATOR WILKEN remarked, "This
report shouldn't sit on the shelf, we need follow-through."
REPRESENTATIVE BUNDE commented that he'd like the Division of
Insurance to address the long-term health care insurance options
that are currently available. Whatever is available to state
retirees should be available to all citizens. We need the entire
Legislature's help in creating an actuarially-sound plan, or
combination of plans that encourage, allow or force participation.
We may need to pay for it long before we need long-term health
care. He mentioned the issue of the Pioneer Home public policy
change from a retirement community to an intensive care unit for
Alzheimer patients. REPRESENTATIVE BUNDE noted in Anchorage there's
dissension as to whether the Pioneer Home residents are receiving
adequate service.
CHAIRMAN MILLER asked Representative Bunde to clarify the age 25,
$25 per month insurance he mentioned earlier, asking if that refers
to term insurance. REPRESENTATIVE BUNDE replied his understanding
is that at age 65, you'd still be paying $25 per month.
SENATOR WILKEN stated that he was surprised by the level of
interest in the issue by the public, as well as nonprofits and the
Department of Administration and the Alaska Commission on Aging.
The interest gave Senator Sharp the original impetus to introduce
the joint resolution. SENATOR WILKEN concluded by offering to
continue with the effort, and to answer questions.
SENATOR PEARCE asked if the task force will draft the requested
legislation and ask the Rules Committee to put it in. SENATOR
WILKEN replied that the legislation has been drafted and the
sponsor statement is essentially done. He asked the HESS Committee
to sponsor and introduce it.
CHAIRMAN MILLER stated that the Assisted Living Homes study will be
released soon. The issues for Assisted Living Homes, though
different, can be dovetailed with the long-term health care issues
and recommendations. He looks forward to working on both issues.
CHAIRMAN MILLER stated he will be happy to introduce legislation on
behalf of the long-term task force, through the HESS Committee.
SENATOR WILKEN shared that he asked for a quote from his insurance
agent for himself, a 53-year-old with relatively good health. A
"Cadillac plan" of $200/day, inflation-proofed, would cost $2470
per year if he entered a retirement home tomorrow and remained for
30 years. As a frame of reference, SENATOR WILKEN stated that you
can project what it might cost 20 years from now for an average
Alaskan looking for long-term care.
REPRESENTATIVE BUNDE brought up other concerns. Personal care
attendants who provide essential services are paid low wages and
have no career ladder. We need to continue to address the issue of
the moratorium on nursing homes because of the cost problems, and
decide if it is now time to authorize more nursing homes, and in
what proportion to home-based care.
CHAIRMAN MILLER thanked the members of the task force for their
work. He stated that long-term health care is not always a
pleasant situation but one that we have to address as a state, and
an issue that affects everyone, including himself and his aging
parent. With no further business to come before the committee,
CHAIRMAN MILLER adjourned at 4:03 p.m.
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