Legislature(2001 - 2002)

04/09/2001 01:35 PM HES

Audio Topic
* first hearing in first committee of referral
+ teleconferenced
= bill was previously heard/scheduled
                     ALASKA STATE LEGISLATURE                                                                                   
       SENATE HEALTH, EDUCATION & SOCIAL SERVICES COMMITTEE                                                                   
                           April 9, 2001                                                                                        
                             1:35 p.m.                                                                                          
                                                                                                                                
MEMBERS PRESENT                                                                                                               
Senator Lyda Green, Chair                                                                                                       
Senator Gary Wilken                                                                                                             
Senator Jerry Ward                                                                                                              
Senator Bettye Davis                                                                                                            
                                                                                                                                
MEMBERS ABSENT                                                                                                                
                                                                                                                                
Senator Loren Leman, Vice Chair                                                                                                 
                                                                                                                              
COMMITTEE CALENDAR                                                                                                            
                                                                                                                                
SENATE BILL NO. 86                                                                                                              
"An Act relating  to employment of teachers who have  subject-matter                                                            
expertise; and providing for an effective date."                                                                                
     MOVED CSSB 86(HES) OUT OF COMMITTEE                                                                                        
                                                                                                                                
SENATE BILL NO. 155                                                                                                             
"An  Act  relating   to  the  Alaska  Commission  on  Postsecondary                                                             
Education  and the  Alaska  Student  Loan Corporation;  relating  to                                                            
student financial aid programs  and the financing of those programs;                                                            
establishing  the  Alaska  Advantage  Loan Program  and  the  Alaska                                                            
Supplemental   Education  Loan  Program;   increasing  the   bonding                                                            
authorization of the Alaska  Student Loan Corporation; providing for                                                            
liens resulting from a  default under AS 14.43 or AS 14.44; relating                                                            
to the  duties of the recorder  regarding  those liens; relating  to                                                            
defaults  under  the  Western  Regional  Higher  Education  Compact;                                                            
relating  to the prohibition  on discrimination  regarding  programs                                                            
under  AS  14.43;  relating  to  fees  for  the  review  of  certain                                                            
postsecondary  institutions;   making  conforming  amendments;   and                                                            
providing for an effective date."                                                                                               
     MOVED SB 155 OUT OF COMMITTEE                                                                                              
                                                                                                                                
SENATE BILL NO. 135                                                                                                             
"An  Act relating  to mental  health  information  and records;  and                                                            
providing for an effective date."                                                                                               
     SCHEDULED BUT NOT HEARD                                                                                                    
                                                                                                                                
SENATE BILL NO. 116                                                                                                             
"An Act  relating to the  Alaska temporary  assistance program;  and                                                            
providing for an effective date."                                                                                               
     HEARD AND HELD                                                                                                             
                                                                                                                                
PREVIOUS COMMITTEE ACTION                                                                                                     
                                                                                                                                
SB 86 - See HESS minutes dated 3/16/01 and 3/19/01.                                                                             
                                                                                                                                
SB 116 - No previous Senate committee action.                                                                                   
                                                                                                                                
SB 155 - See HESS minutes dated 4/2/01.                                                                                         
                                                                                                                                
WITNESS REGISTER                                                                                                              
                                                                                                                                
Mr. Bob Labbe, Director                                                                                                         
Division of Medical Assistance                                                                                                  
Department of Health & Social Services                                                                                          
PO Box 110660                                                                                                                   
Juneau AK 99811-0660                                                                                                            
POSITION STATEMENT:  Participated in Medicaid presentation.                                                                   
                                                                                                                                
Mr. John Sherwood                                                                                                               
Division of Medical Assistance                                                                                                  
Department of Health & Social Services                                                                                          
PO Box 110660                                                                                                                   
Juneau AK 99811-0660                                                                                                            
POSITION STATEMENT:  Participated in Medicaid presentation.                                                                   
                                                                                                                                
Ms. Nancy Weller                                                                                                                
Division of Medical Assistance                                                                                                  
Department of Health & Social Services                                                                                          
PO Box 110660                                                                                                                   
Juneau AK 99811-0660                                                                                                            
POSITION STATEMENT:  Participated in Medicaid presentation.                                                                   
                                                                                                                                
Senator Pete Kelly                                                                                                              
Alaska State Capitol                                                                                                            
Juneau, AK  99801-1182                                                                                                          
POSITION STATEMENT:  Sponsor of SB 86.                                                                                        
                                                                                                                                
Dr. Bruce Johnson                                                                                                               
Deputy Commissioner                                                                                                             
Department of Education &                                                                                                       
 Early Development                                                                                                              
        th                                                                                                                      
801 W 10 St.                                                                                                                    
Juneau, AK  99801-1894                                                                                                          
POSITION STATEMENT:  Supports the concept of SB 86 but prefers that                                                           
new teachers be required to partake in a teacher certification                                                                  
program when employed.                                                                                                          
                                                                                                                                
Mr. Jim Nordlund, Director                                                                                                      
Division of Public Assistance                                                                                                   
Department of Health and Social Services                                                                                        
PO Box 110640                                                                                                                   
Juneau AK 99811-0640                                                                                                            
POSITION STATEMENT:  Testified in support of SB 116.                                                                          
                                                                                                                                
Kristen Bomengen                                                                                                                
Assistant Attorney General                                                                                                      
Department of Law                                                                                                               
PO Box 110300                                                                                                                   
Juneau AK 99811-0300                                                                                                            
POSITION STATEMENT:  Answered questions about SB 116.                                                                         
                                                                                                                                
ACTION NARRATIVE                                                                                                              
                                                                                                                                
TAPE 01-30, SIDE A                                                                                                            
Number 001                                                                                                                      
                                                                                                                                
                                                                                                                                
CHAIRWOMAN LYDA  GREEN called the Senate Health, Education  & Social                                                          
Services  Committee  meeting  to order  at  1:35 p.m.  Present  were                                                            
Senators Davis and Green.  Senator Wilken arrived shortly afterward.                                                            
Chairwoman  Green informed the committee  that representatives  from                                                            
the Department  of Health  and Social Services  (DHSS) would  give a                                                            
presentation  about the  Medicaid  program; a  very complex  program                                                            
that is a driver in the cost of doing business for DHSS.                                                                        
                                                                                                                                
MR.  BOB LABBE,  Director  of the  Division of  Medical Assistance,                                                             
introduced  John Sherwood and  Nancy Weller  from the division.   He                                                            
referred  to a handout  entitled, "Medicaid  Directions," which  his                                                            
presentation would  be based on.  He explained the  Medicaid program                                                            
is part  of the Social  Security  Act (Title 19),  created in  1965.                                                            
The Medicare  program was established  at the same time.   The state                                                            
administers  Medicaid and  shares in the  funding while Medicare  is                                                            
administered  by  the federal  government.  States  were given  some                                                            
flexibility  with  the  Medicaid program  and  can  choose  options;                                                            
therefore each state's program is a little bit different.                                                                       
The Medicaid regulations are contained in 42 CFR.                                                                               
                                                                                                                                
CHAIRWOMAN GREEN  asked if 42 CFR contains the regulations  for both                                                            
Medicaid and Medicare.                                                                                                          
                                                                                                                                
MR. LABBE said it contains the regulations for both.                                                                            
                                                                                                                                
MR. LABBE continued.                                                                                                            
                                                                                                                                
The state plan  is Alaska's contract.   It is a preprinted  document                                                            
of several volumes.   The federal government requires  that a single                                                            
state agency  be designated  to run the program;  in Alaska  that is                                                            
DHSS. The  Division of  Medical Assistance  coordinates and  manages                                                            
the  program but  a  number of  other agencies  participate  in  it.                                                            
Clients  apply  through the  Division  of  Public Assistance.    The                                                            
program   was    traditionally   linked    to   welfare    payments.                                                            
Historically,  the old age,  blind and disabled  cash payments  were                                                            
also administered by the state until 1974.                                                                                      
                                                                                                                                
CHAIRWOMAN GREEN asked if eligibility could be moved.                                                                           
                                                                                                                                
MR. LABBE said the eligibility  determination has to be administered                                                            
either by the  agency that does the cash assistance  or the Medicaid                                                            
agency, but the state has a choice.                                                                                             
                                                                                                                                
MR. LABBE continued.   The federal  government requires there  be an                                                            
advisory  committee.  The  Alaska committee  meets quarterly  and is                                                            
comprised  equally of  a broad  array of providers,  consumers,  and                                                            
public members.                                                                                                                 
                                                                                                                                
SENATOR  WILKEN  asked  the  name  of  the  pediatric  dentist  from                                                            
Fairbanks.                                                                                                                      
                                                                                                                                
MR. LABBE  said that  is Greg  Johnson and  that he  was the  former                                                            
Chair.                                                                                                                          
                                                                                                                                
SENATOR WILKEN asked who the disability advocate is.                                                                            
                                                                                                                                
MR. LABBE said that is Sam Bush.                                                                                                
                                                                                                                                
MR.  LABBE  continued.   The  federal  government  has a  number  of                                                            
requirements  that must be  followed: the  program must be  operated                                                            
statewide;  it must cover  certain groups of  people; it must  cover                                                            
certain  services; benefits  must  be comparable  among groups;  the                                                            
program must provide enough  of a service to meet the purpose of the                                                            
service;  and  it must  offer  a freedom  of  choice  of  providers.                                                            
Medicaid  is  considered  the  payer  of  last  resort  with  a  few                                                            
exceptions.  The  program must be operated with certain  due process                                                            
considerations for the  client.  The division may request waivers of                                                            
some  of  the  rules;  the typical  one  is  freedom  of  choice  of                                                            
providers.   That type of  a waiver often  occurs with managed  care                                                            
arrangements.   The state joined the program in 1972  after enabling                                                            
legislation was enacted  and services were expanded in 1976.  A rate                                                            
advisory  commission  was  established  in 1983  and,  in 1988,  the                                                            
program began covering  pregnant women and children under age 5 with                                                            
household income  not exceeding 100  percent of the federal  poverty                                                            
level and  added case management  for nutrition  services.   Between                                                            
1990 and 1998, the following services were added:                                                                               
   · home and community based waiver services;                                                                                  
   · rehabilitation services for mental illness, alcoholism and                                                                 
     drug abuse;                                                                                                                
   · children in subsidized adoptions;                                                                                          
   · TEFRA;                                                                                                                     
   · coverage for pregnant women up to 200 percent of the poverty                                                               
     level;                                                                                                                     
   · continuous eligibility for children beyond five years of age.                                                              
                                                                                                                                
Number 720                                                                                                                      
                                                                                                                                
MR. LABBE  explained the  Tax Equity and  Fiscal Responsibility  Act                                                            
(TEFRA) option  is for children who  would be institutionalized  but                                                            
instead stay at  home with the parents.  Usually income  is a factor                                                            
in eligibility, but under  the TEFRA program, the parents' income is                                                            
not considered.   This option came  about during President  Reagan's                                                            
era and was based on an  individual case situation where the parents                                                            
wanted to bring  their child home who was on a ventilator.   If they                                                            
did so, they  would lose coverage  and could not provide  the needed                                                            
support on  their own.  From that  case, Congress enacted  the TEFRA                                                            
option in 1984, which the state picked up in 1993.                                                                              
                                                                                                                                
MR. LABBE informed  the committee that there are many  categories of                                                            
eligibility  under  the federal  rules; Alaska  covers  32, many  of                                                            
which are mandatory.                                                                                                            
                                                                                                                                
CHAIRWOMAN  GREEN asked  if  there are  18 other  optional  programs                                                            
offered through Medicaid  that the state could choose to participate                                                            
in.                                                                                                                             
                                                                                                                                
MR. LABBE  said that  is a rough  estimate and  that number  changes                                                            
every year.                                                                                                                     
                                                                                                                                
SENATOR  WILKEN asked if  Mr. Labbe  has a grid  of the 50  eligible                                                            
categories and which categories each state covers.                                                                              
                                                                                                                                
MR. LABBE said he does  not have one but could put one together.  He                                                            
noted he has  seen a grid that the  federal government has  produced                                                            
on  optional   services  by  state   but  he  is  not  aware   of  a                                                            
comprehensive  chart on eligibility.  He offered to  provide Senator                                                            
Wilken with the available material.                                                                                             
                                                                                                                                
MR. LABBE continued  with his presentation.  The mandated  groups of                                                            
eligible persons include:                                                                                                       
   · families and children;                                                                                                     
   · children in foster care;                                                                                                   
   · pregnant women and children under age 6 up to 133 percent of                                                               
     the federal poverty level;                                                                                                 
   · infants born to women on Medicaid;                                                                                         
   · children up to age 18 with family incomes up to 100 percent of                                                             
     the federal poverty level; and                                                                                             
   · certain aliens for emergency services only.                                                                                
                                                                                                                                
SENATOR WILKEN  asked if  the federal poverty  level rate of  $1,475                                                            
per month for a family of three is based on net or gross income.                                                                
                                                                                                                                
MR. LABBE said it is based on gross income.                                                                                     
                                                                                                                                
MR. JOHN SHERWOOD,  Division of Medical  Assistance, explained  that                                                            
it is applied as a gross income test.                                                                                           
                                                                                                                                
SENATOR WILKEN  asked whether that number is adjusted  for different                                                            
areas of the state.                                                                                                             
                                                                                                                                
MR. LABBE  said it is statewide  but there  is a difference  between                                                            
Alaska and the Lower 48.                                                                                                        
                                                                                                                                
CHAIRWOMAN  GREEN  asked if  250 percent  of  the poverty  level  in                                                            
Alaska equals 275 percent elsewhere.                                                                                            
                                                                                                                                
MR. LABBE said  he is not sure.   He continued.  Two other mandatory                                                            
groups,  the  aged and  disabled,  are  tied  to those  who  receive                                                            
supplemental  security  income (SSI).   Some people  continue  to be                                                            
eligible for Medicaid who  would have lost their coverage because of                                                            
an increase  in  their social  security  benefits.   That group  was                                                            
"grandfathered" in by Congress.                                                                                                 
                                                                                                                                
CHAIRWOMAN GREEN asked if that eligibility applies for life.                                                                    
                                                                                                                                
MR.  LABBE said  it  does unless  something  else happens,  such  as                                                            
additional income from another source.                                                                                          
                                                                                                                                
MR.  LABBE   said  one  of  the  bigger   categories  of   qualified                                                            
individuals  is qualified  Medicare  beneficiaries.   Some of  those                                                            
clients are  eligible for both Medicaid  and Medicare, but  of those                                                            
clients  who only  have Medicare,  the Medicaid  program pays  their                                                            
premiums,  co-insurance,   and deductibles,   depending  on  certain                                                            
factors.  DHSS gets a federal match toward the premiums.                                                                        
                                                                                                                                
Regarding  the  optional  services,  Alaska  has  elected  to  cover                                                            
pregnant women  and children at a  higher income level of  up to 200                                                            
percent  of the  poverty level.   Alaska  also covers  services  for                                                            
children  who are not receiving  cash assistance.   Alaska  does not                                                            
cover the  people who would  fall in the  medically needy  category.                                                            
That category is for people  whose income is above the level for the                                                            
cash programs  but who have medical  expenses.  Those people  pay up                                                            
to a certain  level, above  which Medicaid  pays.  All of the  other                                                            
groups  are considered  to be categorically  needy.   The  medically                                                            
needy category  would cover people  who have catastrophic  costs due                                                            
to illness and prescription  costs for seniors and disabled clients.                                                            
                                                                                                                                
CHAIRWOMAN  GREEN  asked  if the  state  ever  opted to  cover  that                                                            
category.                                                                                                                       
                                                                                                                                
MR. LABBE said  not to his knowledge  but he thinks it was  analyzed                                                            
in the past.                                                                                                                    
                                                                                                                                
CHAIRWOMAN GREEN  asked Mr. Labbe to elaborate on  the higher income                                                            
level for that category.                                                                                                        
                                                                                                                                
MR. LABBE explained the  income of people in that category could not                                                            
be  more  than 133  percent  of  the  cash standard  for  a  welfare                                                            
recipient.   If their income,  minus medical  expenses, brings  them                                                            
below the 133 percent level,  they would be eligible.  Recently, the                                                            
Health Care  Financing Administration  reinterpreted its  policy and                                                            
decided  to allow  a higher  income for  the medically  needy.   The                                                            
income level was liberalized  so that those people would not have to                                                            
"spend down" so  far.  One of the problems with the  program is that                                                            
people have to almost impoverish themselves to be eligible.                                                                     
                                                                                                                                
CHAIRWOMAN GREEN asked if that is true of all categories.                                                                       
                                                                                                                                
MR. LABBE said  he was referring to  the medically needy  as that is                                                            
the group where a big "spend  down" occurs.  He pointed out that the                                                            
medically needy category was created by Congress in 1965.                                                                       
                                                                                                                                
MR. LABBE said  Alaska has an option  to use 300 percent  of the SSI                                                            
payment level,  which is about $1500  per month, as the eligibility                                                             
level for  individuals in  need of an institutional  level  of care.                                                            
That category  of people does not receive SSI cash  payments but has                                                            
a  higher  income.    A few  years  ago  the  Legislature  opted  to                                                            
participate in coverage for persons who are disabled but work.                                                                  
                                                                                                                                
CHAIRWOMAN GREEN asked if that option was done through a waiver.                                                                
                                                                                                                                
MR. LABBE said no, it was  a new option established by Congress that                                                            
states could elect to participate in.                                                                                           
                                                                                                                                
CHAIRWOMAN  GREEN said DHSS pays a  premium for some of its  clients                                                            
covered under  Medicare and asked if there is a similar  opportunity                                                            
to pay a premium under CHIA - comprehensive health insurance.                                                                   
                                                                                                                                
MR. LABBE said he was not  sure.  Under Medicaid, DHSS has an option                                                            
to pay health insurance premiums if payment is cost effective.                                                                  
                                                                                                                                
CHAIRWOMAN GREEN  asked Mr. Labbe to look into that  and report back                                                            
to the committee.   She commented  it may be a way to get  insurance                                                            
for people who would participate in the cost.                                                                                   
                                                                                                                                
MR. LABBE described  the income levels for the different  categories                                                            
of eligible groups.  He pointed out there is not much  comparability                                                            
between  the groups  regarding eligibility,  with  the exception  of                                                            
children,  because they  receive full  coverage  because of  federal                                                            
directives.   He stated that  persons ages  12-64 with no  children,                                                            
who  do not  meet the  disability  test, are  not  eligible for  any                                                            
services.                                                                                                                       
                                                                                                                                
CHAIRWOMAN GREEN  asked if a woman who needs prescreening  for early                                                            
detection for breast or  cervical cancer in that group would qualify                                                            
for that service.                                                                                                               
                                                                                                                                
MR.  LABBE   said   not  unless   she  was   in  another   category.                                                            
Historically,  there  has  been no  coverage  for the  middle  aged,                                                            
single  person but  under some  of the  new programs  there are  new                                                            
groups of eligible people.                                                                                                      
                                                                                                                                
CHAIRWOMAN GREEN asked if that is a Medicaid program.                                                                           
                                                                                                                                
MS. NANCY WELLER, Division of Medical Assistance, said it is.                                                                   
                                                                                                                                
CHAIRWOMAN  GREEN asked if the Center  for Disease Control  (CDC) is                                                            
morphing into  a Medicaid program regarding treatment  of breast and                                                            
cervical cancer.                                                                                                                
                                                                                                                                
MS. WELLER  said the  CDC program  covers screening  only.   The new                                                            
eligibility option under  Medicaid is for people who are screened by                                                            
the CDC program  and diagnosed with cancer.  Eligibility  is tied to                                                            
screening by the CDC program.                                                                                                   
                                                                                                                                
MR.  LABBE  continued  his  presentation  by  reviewing   federally-                                                            
mandated services and the optional services.                                                                                    
                                                                                                                                
CHAIRWOMAN  GREEN asked if  the state receives  a federal match  for                                                            
the optional services it provides.                                                                                              
                                                                                                                                
MR. LABBE said  it does.  He finds it interesting  that prescription                                                            
drug coverage  is an optional service  that states can choose.   The                                                            
Medical  Rate  Advisory  Commission  (MRAC)  sets  a fair  rate  for                                                            
reasonable costs.  DHSS  recently changed its system to simplify it.                                                            
Over the years it became  very complicated and numerous appeals over                                                            
rates  were filed.   He  hopes the  simplified system  reduces  that                                                            
workload.                                                                                                                       
                                                                                                                                
CHAIRWOMAN GREEN  asked if the appeal process was  recently changed.                                                            
                                                                                                                                
MR. LABBE said  a bill was introduced  to change the appeal  process                                                            
but he does  not believe  it passed.  The  changes made to  the rate                                                            
setting system were a result  of that legislation.  DHSS worked well                                                            
with  the Alaska  Hospital  and  Nursing  Home Association  on  that                                                            
issue.   Regarding the  Disproportionate Share  Hospital program,  a                                                            
federal allotment  does require a state match but  it can be used to                                                            
pay certain  hospitals.   It  was designed  for  those teaching  and                                                            
public  hospitals in  the Lower  48 that  provide a  lot of  charity                                                            
care.    Most   states  with  state   institutions  directed   those                                                            
additional  allotments  as their financing  mechanism.   The  Alaska                                                            
Psychiatric  Institute  was funded  in this  way  until the  federal                                                            
government  restricted  the amount of  the allotment  that could  be                                                            
used  for API.  DHSS is  now looking  for  other things  to use  the                                                            
allotment for.                                                                                                                  
                                                                                                                                
CHAIRWOMAN  GREEN asked  Mr.  Labbe to  describe  the Medicaid  cost                                                            
report.                                                                                                                         
                                                                                                                                
MR. LABBE said  it is a cost report that facilities  are required to                                                            
submit to the Medicaid  program.  DHSS also requires that it receive                                                            
a  copy.    The  report  lists  the  facility's   cost  for  various                                                            
procedures, charges for patient days and other costs.                                                                           
                                                                                                                                
CHAIRWOMAN  GREEN asked if  the figures contained  in those  reports                                                            
are the published rate for the general public.                                                                                  
                                                                                                                                
MR. LABBE  said he thought  it contains total  annual costs  for the                                                            
different  aspect of  hospital  operations  and revenue.   When  the                                                            
rates are set, the MRAC looks at the costs and conducts audits.                                                                 
                                                                                                                                
CHAIRWOMAN GREEN  said she is trying to find out whether  the report                                                            
is based on what  the hospital charges everyone or  a Medicaid rate.                                                            
                                                                                                                                
MR. LABBE said  it should be based  on the hospital's general  rates                                                            
and  costs.   He informed  the  committee  that DHSS  implemented  a                                                            
Resource  Based   Relative  Value  Scale  (RBVS)  that   contains  a                                                            
conversion  factor for  each  unit.  Therefore,  if  a procedure  is                                                            
worth two units, the reimbursement  amount can easily be determined.                                                            
This scale is relatively  easy to adjust across the 10,000 physician                                                            
codes.   The initial implementation  was difficult  but it  has been                                                            
well  accepted.   It also  allows DHSS  to easily  compare  Alaska's                                                            
rates with other states' rates.                                                                                                 
                                                                                                                                
MR. LABBE explained the  calculation used to reimburse providers for                                                            
prescription   drugs.    Reimbursement   for  laboratory   services,                                                            
ambulatory surgery  and rural health clinics are based  on rates set                                                            
by Medicaid.   A function named Surveillance and Utilization  Review                                                            
(SURS) is used to review  program accountability.  User services and                                                            
claim  patterns of  providers are  reviewed and  random letters  are                                                            
sent to  recipients to  determine if services  billed were  actually                                                            
received.   In  addition,  DHSS uses  a  software program  to  audit                                                            
claims,  evaluate  billing  information  and  coding  accuracy,  and                                                            
review for  compliance.    He noted  that DHSS has a contractor  who                                                            
works on identifying other  payers and to make sure that third party                                                            
coverage is identified for billing.                                                                                             
                                                                                                                                
TAPE 01-30, SIDE B                                                                                                              
                                                                                                                                
DHSS also  has prior approval  records for  certain services  and it                                                            
refers cases  to the provider fraud  unit in the Department  of Law,                                                            
which  is federally  funded.   DHSS started  a pilot  project a  few                                                            
years ago  in which high  cost cases are  identified and  individual                                                            
case  management   takes  place  to   provide  for  more   efficient                                                            
management  of complex  medical cases.   DHSS would  like to  expand                                                            
that program.                                                                                                                   
                                                                                                                                
CHAIRWOMAN  GREEN announced  that the  committee  would recess  to a                                                            
call of the Chair  so that members could return to  the Senate floor                                                            
session.   The committee  would reconvene after  session to  take up                                                            
the bills  on its agenda.  She thanked  Mr. Labbe  and asked  him to                                                            
complete his presentation on Wednesday.                                                                                         
                                                                                                                                
TAPE 01-31, SIDE A                                                                                                              
                                                                                                                                
CHAIRWOMAN  GREEN called  the Senate  Health,  Education and  Social                                                            
Services  Committee  back  to order  at  4:37 p.m.     Present  were                                                            
Senators  Leman,  Davis,  Wilken and  Green.    The first  order  of                                                            
business to come before the committee was SB 155.                                                                               
                                                                                                                                
         SB 155-STUDENT LOANS/ COMN. ON POSTSECONDARY ED.                                                                   
                                                                                                                              
CHAIRWOMAN  GREEN reminded committee  members that SB 155  was heard                                                            
in committee  for the purpose  of providing  committee members  with                                                            
time to  prepare amendments,  if desired.   No amendments have  been                                                            
proposed  and no  further  concerns have  been expressed  about  the                                                            
legislation.                                                                                                                    
                                                                                                                                
SENATOR  LEMAN   moved  SB  155  from   committee  with   individual                                                            
recommendations  and its accompanying fiscal notes.   There being no                                                            
objection, the motion carried.                                                                                                  
                                                                                                                                
                                                                                                                                
          SB  86-TEACHER EMPLOYMENT &  SUBJECT EXPERTISE                                                                    
                                                                                                                                
CHAIRWOMAN GREEN asked  Senator Pete Kelly, sponsor of SB 86, if the                                                            
amendment  before  the  committee  has been  incorporated  into  the                                                            
proposed committee substitute.                                                                                                  
                                                                                                                                
SENATOR KELLY said it was not.                                                                                                  
                                                                                                                                
CHAIRWOMAN GREEN  asked if, regarding the provision  that allows the                                                            
substitution  of  five  years  of work  experience  in  the  subject                                                            
matter,  any type of  experience in  that subject  that is not  work                                                            
related would apply.                                                                                                            
                                                                                                                                
SENATOR KELLY  said he would not object to deleting  the word "work"                                                            
on page  2, line 19,  so that five  years of  any experience  in the                                                            
subject matter is required.                                                                                                     
                                                                                                                                
CHAIRWOMAN  GREEN referred to Sec.  3(d) and asked if Senator  Kelly                                                            
would object to  using the term "experienced educator"  instead of a                                                            
"tenured teacher" (page 3, line 10).                                                                                            
                                                                                                                                
SENATOR KELLY  said the idea of the mentor, although  he agrees with                                                            
it, did not come  from him.  The idea of a tenured  teacher may have                                                            
been used because it assumes a certain level of experience.                                                                     
                                                                                                                                
CHAIRWOMAN GREEN pointed  out that an experienced teacher may not be                                                            
tenured in  a certain district.    She said  the sectional  analysis                                                            
says that Section  5 pertains to teachers coming off  retirement and                                                            
lay off status and requires  them to have practiced within the prior                                                            
five years.  She asked for an explanation.                                                                                      
                                                                                                                                
SENATOR KELLY said he thought that provision is in existing law.                                                                
                                                                                                                                
DR.  BRUCE  JOHNSON,  Deputy  Commissioner   of  the  Department  of                                                            
Education and Early Development  (DOEED), said the only thing he can                                                            
think of is that teachers  are required, when renewing certificates,                                                            
to have  six additional credit  hours over  a five-year period.   He                                                            
said he is not sure whether that provision refers to the mentor.                                                                
                                                                                                                                
CHAIRWOMAN  GREEN indicated  that an explanation  of that  provision                                                            
was included in  the sectional analysis, even though  that provision                                                            
is in current  law.  She moved to  remove the word "work"  from page                                                            
2, line 19 (Amendment  1), and to substitute on page  3, line 9, the                                                            
word "tenured"  with the  word "experienced"  (Amendment 2).   There                                                            
being no objection, the  motion to adopt Amendments 1 and 2 carried.                                                            
                                                                                                                                
SENATOR LEMAN  stated that he has  two minor amendments to  propose.                                                            
The first (Amendment 3)  is on page 2, line 16, and is to insert the                                                            
words "or  national" after  "regional".   He informed the  committee                                                            
that while most  colleges are accredited by a regional  association,                                                            
some  are  accredited  by a  national  association  and  the  Alaska                                                            
Commission   on  Postsecondary  Education   (ACPE)  considers   both                                                            
associations to be comparable.                                                                                                  
                                                                                                                                
CHAIRWOMAN GREEN asked if there was objection to Amendment 3.                                                                   
                                                                                                                                
SENATOR DAVIS asked Senator Leman to explain his intent.                                                                        
                                                                                                                                
SENATOR LEMAN said that  inserting that language will make sure that                                                            
all qualified  institutions are covered  and that both associations                                                             
have comparable standards.                                                                                                      
                                                                                                                                
There being no further objection, Amendment 3 was adopted.                                                                      
                                                                                                                                
SENATOR  LEMAN moved to  adopt Amendment  4, in  which the word  "or                                                            
minored" would be inserted  after the word "majored" on page 2, line                                                            
18.   He  said that  a person  could  minor in  a subject  and  have                                                            
considerably  more expertise  in  an area  than he or  she may  have                                                            
under a typical education degree.                                                                                               
                                                                                                                                
CHAIRWOMAN GREEN  asked if a minor requires 18 hours  of coursework.                                                            
                                                                                                                                
Number 178                                                                                                                      
                                                                                                                                
DR. JOHNSON  said that a minor usually  consists of a minimum  of 18                                                            
hours of coursework.                                                                                                            
                                                                                                                                
SENATOR DAVIS  asked Dr.  Johnson his opinion  of Amendment  4.  She                                                            
noted that many  teachers already teach in their minor  area but the                                                            
focus was toward teaching in the area they majored in.                                                                          
                                                                                                                                
DR.  JOHNSON said  DOEED  has  concerns about  this  bill  regarding                                                            
having individuals  in the  classroom who are  not making a  general                                                            
commitment  to  teacher education.    DOEED  would prefer  that  the                                                            
individual  be enrolled in a teacher  education program at  the same                                                            
time the individual  is teaching for many reasons,  not the least of                                                            
which  is that  evidence  in  other states  strongly  suggests  that                                                            
teacher  education  preparation   programs  really  help  support  a                                                            
subject matter  specialist capacity  to be successful over  the long                                                            
term.   Those teachers  tend to  stay in their  assignments  longer.                                                            
Knowing content  is an important ingredient of teaching  but knowing                                                            
how to work with students  is also important.  DOEED does not object                                                            
to allowing  these people to enter  as teachers but it would  prefer                                                            
that they  immediately be  enrolled in a  teacher education  program                                                            
that is similar  to the Masters in Art of Teaching  so that they can                                                            
receive  a  teaching  credential  in  a one  year  period  of  time.                                                            
Regarding the  question of whether teachers should  be able to teach                                                            
in a field  they minored  in, he doesn't think  that would be  a big                                                            
problem for  DOEED. Again, DOEED would  rather have the focus  be on                                                            
supporting  the credential  aspect.   He  pointed  out the  district                                                            
would be  making the decision  on whether a  person with a  minor is                                                            
qualified.                                                                                                                      
                                                                                                                                
CHAIRWOMAN  GREEN  noted  that  a  person  might  have  a  major  in                                                            
chemistry  and a minor in  physics, in which  case teaching  physics                                                            
would not be foreign.                                                                                                           
                                                                                                                                
There being  no further objection  to Amendment 4, CHAIRWOMAN  GREEN                                                            
announced it was adopted.                                                                                                       
                                                                                                                                
SENATOR WILKEN  moved Amendment 5, by Senator Kelly,  which reads as                                                            
follows.                                                                                                                        
                                                                                                                                
                       A M E N D M E N T  5                                                                                 
                                                                                                                                
                                                                                                                                
OFFERED IN THE SENATE                            BY SENATOR KELLY                                                               
     TO:  CSSB 86(   ), Draft Version "L"                                                                                       
                                                                                                                                
Page 2, line 23:                                                                                                                
     Delete "and"                                                                                                               
                                                                                                                                
Page 2, line 26, following "certificate":                                                                                       
     Insert "; and                                                                                                              
                (4)  completed, within the two years before                                                                     
     beginning  to teach  as a  subject-matter  expert teacher,  the                                                            
     six-week  introductory course to prepare subject-matter  expert                                                            
     teachers for the classroom"                                                                                                
                                                                                                                                
Page 2, following line 30:                                                                                                      
     Insert a new subsection to read:                                                                                           
          "(c)  The department shall establish the requirements for                                                             
     a  six-week   introduction  to  teaching  course   for  persons                                                            
     interested  in  becoming  subject-matter  expert  teachers.   A                                                            
     school  district or  regional educational  attendance area  may                                                            
     not employ  a person as a subject-matter  expert teacher  under                                                            
     this section  unless the person has successfully  completed the                                                            
     course within the  two years immediately preceding the person's                                                            
     initial  hire by the  school district  or regional educational                                                             
     attendance  area or unless  the person  has been employed  as a                                                            
     subject-matter  expert  teacher in another  school district  or                                                            
     regional  educational  attendance  area  immediately  preceding                                                            
     employment  in  the school  district  or  regional educational                                                             
     attendance area."                                                                                                          
                                                                                                                                
Reletter the following subsections accordingly.                                                                                 
                                                                                                                                
Page 3, line 11, following ".":                                                                                                 
     Insert "At the end of the subject-matter expert teacher's                                                                  
first year of  teaching, the mentor, the teacher,  and the principal                                                            
of  the  school  in  which  the subject-matter   expert  teacher  is                                                            
teaching  shall  meet  for  an  evaluation   of  the  strengths  and                                                            
weaknesses  of the  teacher's performance  as a  teacher during  the                                                            
past year."                                                                                                                     
                                                                                                                                
                                                                                                                                
SENATOR  KELLY explained  that Amendment  5 incorporates,  into  the                                                            
qualifications for a subject  matter teacher, a six-week pre-course.                                                            
                                                                                                                                
CHAIRWOMAN  GREEN asked if the pre-course  would be required  before                                                            
the person begins.                                                                                                              
                                                                                                                                
SENATOR  KELLY said  it would take  place before  the person  begins                                                            
teaching.                                                                                                                       
                                                                                                                                
SENATOR  LEMAN  asked   if  the  name  "six-week  introduction"   is                                                            
something that  has already been developed by the  University and is                                                            
known or whether that is the expected length of the class.                                                                      
                                                                                                                                
SENATOR KELLY said it is not something that has been developed.                                                                 
                                                                                                                                
SENATOR LEMAN asked if  a person could compress that course and take                                                            
it in half the time if need be.                                                                                                 
                                                                                                                                
SENATOR KELLY said he had  the same thought.  He asked, because four                                                            
of the  members are also  on the Senate  Finance Committee,  whether                                                            
this amendment  could be addressed  by the Senate Finance  Committee                                                            
to give him more time to work on it.                                                                                            
                                                                                                                                
SENATOR WILKEN asked for  unanimous consent to withdraw Amendment 5.                                                            
There being no objection, Amendment 5 was withdrawn.                                                                            
                                                                                                                                
There being no further  discussion or questions, SENATOR LEMAN moved                                                            
CSSB 86(HES) from committee  with individual recommendations and its                                                            
accompanying  fiscal note.   There  being no  objection, the  motion                                                            
carried.                                                                                                                        
                                                                                                                                
                                                                                                                                
           SB 116-AK TEMP. ASSISTANCE PROGRAM AMENDMENTS                                                                    
                                                                                                                                
CHAIRWOMAN  GREEN noted that a proposed  committee substitute  to SB                                                            
116 was before the committee.                                                                                                   
                                                                                                                                
SENATOR LEMAN  moved to adopt Version F as the working  draft of the                                                            
committee.  There being no objection, the motion carried.                                                                       
                                                                                                                                
MR. JIM  NORDLUND, Director  of the Division  of Public Assistance,                                                             
said SB  116 makes  amendments  to the Alaska  Temporary  Assistance                                                            
Program (ATAP),  which was created when Alaska's welfare  reform act                                                            
was  enacted in  1996 [SB  98 by  Senator Green].  SB  98 is a  very                                                            
robust law that has enabled  the division to reform Alaska's welfare                                                            
system  and to successfully  move  welfare recipients  from  welfare                                                            
into  the workforce.    SB 116  is the  first  attempt  to make  any                                                            
amendments  to that law.   One section of  SB 116 is important;  the                                                            
others are minor modifications.                                                                                                 
                                                                                                                                
MR. NORDLUND  said the section that  was in SB 116 that was  removed                                                            
from Version F  dealt with the 60 month lifetime limit  on benefits.                                                            
Both the federal and state  laws allow 20 percent of the caseload to                                                            
be exempt from  the five-year limit.   Congress and the Legislature                                                             
recognized  that, inevitably, some  welfare recipients will  have to                                                            
receive  benefits  beyond  60  months  because  certain   conditions                                                            
prevent  them from  working  and providing  for their  families.  He                                                            
pointed out the 20 percent  waiver applied to the original caseload,                                                            
which amounted to about  12,000 families at the time, before welfare                                                            
reform was instituted.   The division has projected that when the 60                                                            
month limit hits  in July of 2002, the caseload will  be below 6,000                                                            
so the 20 percent waiver  will only apply to about 1200 clients.  He                                                            
explained that  if 20 percent originally applied to  the 12,000, one                                                            
can assume  those families  have severe  problems  that will  not go                                                            
away.  The  division predicts that  in future years (2003  and 2004)                                                            
it will have to  cut people off of the caseload who  all would agree                                                            
should continue to receive assistance.                                                                                          
                                                                                                                                
MR. NORDLUND  said the  bill as  introduced by  the Governor  simply                                                            
repeals  the  20 percent  cap.   Instead  of  using  that  arbitrary                                                            
figure,  the  division  suggested  establishing   objective,  strict                                                            
criteria by  which families would  be allowed to receive  assistance                                                            
beyond 60 months.  The  families that fit the criteria would receive                                                            
an extension  rather than a lifelong  exemption.  He explained  that                                                            
section 2 would have repealed that cap [AS 47.27.015(f)].                                                                       
                                                                                                                                
MR. NORDLUND  said he discussed alternative  solutions with  Senator                                                            
Green and Representative  Dyson.   Senator Green was concerned  that                                                            
putting the  criteria in  regulation was too  loose of an  approach.                                                            
On proposal  was to  put the  criteria in statute.   Representative                                                             
Dyson  suggested applying  the  20 percent  waiver  to the  original                                                            
number of recipients,  which would give the division  enough room to                                                            
cover the number of families  that need continual assistance.  After                                                            
further  discussions with  Senator Green,  she decided  to pursue  a                                                            
solution  to  that  problem  next  year so  Section  2  was  removed                                                            
altogether.   Because  that section  was the heart  of the bill,  it                                                            
will have to be dealt with at some point.                                                                                       
                                                                                                                                
CHAIRWOMAN  GREEN asked  Mr. Nordlund  to review  the provisions  of                                                            
Version F.                                                                                                                      
                                                                                                                                
MR.  NORDLUND  said that  Section  1 of  Version  F deals  with  the                                                            
conformity  issue with  federal law.   Under  federal law,  families                                                            
that  live  in Native  villages  with  unemployment  rates  over  50                                                            
percent, as determined  by state data, are exempt  from the 60 month                                                            
limit.  Alaska  law does not contain a similar provision  so Section                                                            
1 will bring Alaska's statute  into conformity with the federal law.                                                            
It was not  in the original version  of SB 116 because removing  the                                                            
20 percent cap would have taken care of the problem.                                                                            
                                                                                                                                
SENATOR WARD asked what qualifies as a Native village.                                                                          
                                                                                                                                
MR. NORDLUND said  that definition comes from the  list of federally                                                            
recognized villages.                                                                                                            
                                                                                                                                
SENATOR WARD  asked if this applies  to the 226 villages  recognized                                                            
by the Ada Deere case.                                                                                                          
                                                                                                                                
MR. NORDLUND said he believes so.                                                                                               
                                                                                                                                
SENATOR WARD asked if it  applies to the federally recognized tribes                                                            
or whether it applies to a place like Egegik.                                                                                   
                                                                                                                                
MR. NORDLUND offered to get an answer for the committee.                                                                        
                                                                                                                                
CHAIRWOMAN GREEN  said she did not realize this bill  applied to the                                                            
federally recognized tribes.                                                                                                    
                                                                                                                                
Number 428                                                                                                                      
                                                                                                                                
MS. KRISTEN  BOMENGEN,  assistant  attorney general,  Department  of                                                            
Law,  said she  does  not believe  the  federal welfare  reform  law                                                            
referred  to  the  federally  recognized  tribes.   She  offered  to                                                            
provide the definition to the committee at a later date.                                                                        
                                                                                                                                
CHAIRWOMAN  GREEN  asked if  that  originally  applied  to a  Native                                                            
village or a rural village.                                                                                                     
                                                                                                                                
MR. NORDLUND  said the federal law  uses the word "reservations"  so                                                            
it was trying to replicate  that in Alaska.  He again offered to get                                                            
the specific language for the committee.                                                                                        
                                                                                                                                
CHAIRWOMAN  GREEN commented  that  the economy  of  the village  was                                                            
supposed to trigger the waiver.                                                                                                 
                                                                                                                                
MS. BOMENGEN  said she believes Alaska's  statutory language  simply                                                            
refers to that provision in the federal law.                                                                                    
                                                                                                                                
CHAIRWOMAN  GREEN asked  if Section  1, as written,  addresses  that                                                            
concern.                                                                                                                        
                                                                                                                                
MS. BOMENGEN said it does.                                                                                                      
                                                                                                                                
MR. NORDLUND  said Section 2 is in  response to a lawsuit  that DHSS                                                            
lost.                                                                                                                           
                                                                                                                                
MS. BOMENGEN explained  the case was a challenge to DHSS regulations                                                            
that were  generated under  the statute as  it formerly read.  Under                                                            
those regulations,  the basis  for the 50  percent reduction  was an                                                            
evaluation of the employment  of the family's principal wage earner.                                                            
That language  was borrowed from the Aid to Families  with Dependent                                                            
Children  (AFDC) statute  in effect  at the time.  That program  had                                                            
three different categories  based on deprivation. The third category                                                            
was created  for two-parent families  that had an attachment  to the                                                            
workforce.   If the  wage earner  was unemployed,  the family  could                                                            
qualify  for  the  AFDC benefit.    That  terminology  was  borrowed                                                            
because  the AFDC  statute was  in effect  when this  law was  being                                                            
written. DHSS  then made, in regulation,  an attempt to distinguish                                                             
two-parent families  in which one of the parents was  incapacitated.                                                            
The  court  determined  that  the plain  language  of  this  statute                                                            
indicated a different  kind of evaluation than the  one used by DHSS                                                            
and overruled the regulation.                                                                                                   
                                                                                                                                
MR.  NORDLUND  said  when  he  researched  why  this  provision  was                                                            
originally chosen, he found  that language was chosen before federal                                                            
welfare  reform  was on  the horizon.    DHSS took  two approaches:                                                             
Senator Green's  waiver approach,  which assumed that law  would not                                                            
pass and the Governor's  approach, which assumed that it would.  The                                                            
language had to  be consistent with AFDC if it was  to be in effect,                                                            
assuming  federal  welfare  reform  didn't occur.    Borrowing  that                                                            
language  made sense at the  time, but the  problem now is  that the                                                            
court interpreted  that language literally when the  law intended it                                                            
to apply to two-parent  families despite the unemployment  status or                                                            
who was the principal  wage earner.  The danger is,  if this part of                                                            
the law is not changed,  DHSS might have to go back and pay benefits                                                            
to two-parent  families in the summer,  which he does not  think was                                                            
the Legislature's intent.                                                                                                       
                                                                                                                                
CHAIRWOMAN  GREEN asked if the language  in Section 2 addresses  the                                                            
crux of the problem.                                                                                                            
                                                                                                                                
MR. NORDLUND said  the language does address the court  case but the                                                            
language in the committee  substitute does not contain language from                                                            
the original bill that  exempts a two-parent family from the benefit                                                            
cut  if  one parent  is  incapacitated.    ATAP  has  exempted  such                                                            
families for the  last four years so the committee  substitute would                                                            
make a  policy change. He  was not sure  that was the Legislature's                                                             
intent.                                                                                                                         
                                                                                                                                
CHAIRWOMAN GREEN  asked if the committee substitute  would treat the                                                            
two-parent family  of which one parent is incapacitated  the same as                                                            
a "whole" two-parent family.                                                                                                    
                                                                                                                                
MR. NORDLUND said that is correct.                                                                                              
                                                                                                                                
CHAIRWOMAN GREEN asked  Mr. Nordlund what the court directed DHSS to                                                            
do and whether the original bill contains the minimum language.                                                                 
                                                                                                                                
MS. BOMENGEN said  the language proposed in the original  bill would                                                            
maintain  the status quo.   It provides for  the fourth category  of                                                            
eligibility that is provided  for in ATAP with one exception for the                                                            
incapacitated  parent.   The language  in the  committee  substitute                                                            
sets a clear line that  establishes that all two-parent families are                                                            
subject to the reduction and DHSS could not change that.                                                                        
                                                                                                                                
CHAIRWOMAN GREEN asked  if DHSS prefers the language in the original                                                            
bill regarding the provision.                                                                                                   
                                                                                                                                
MS. BOMENGEN said it does.                                                                                                      
                                                                                                                                
CHAIRWOMAN GREEN  asked if anything in that language  is superfluous                                                            
and is not required for DHSS's needs.                                                                                           
                                                                                                                                
MS. BOMENGEN said no.                                                                                                           
                                                                                                                                
CHAIRWOMAN GREEN  asked what has been added to address  the lawsuit.                                                            
                                                                                                                                
MS. BOMENGEN explained the question is what has been subtracted.                                                                
                                                                                                                                
CHAIRWOMEN  GREEN asked  if she  was speaking  of  the phrase,  "the                                                            
unemployment of the family's principal wage earner."                                                                            
                                                                                                                                
MS. BOMENGEN said that  term is no longer examined by the department                                                            
and is no longer  useful because it  doesn't really give  the public                                                            
fair notice  of what is  being established.   She thought the  court                                                            
felt that the  law contained plain  language while DHSS was  telling                                                            
the court it  did not have to look  at unemployment because  it does                                                            
not use that as an eligibility factor any longer.                                                                               
                                                                                                                                
Number 599                                                                                                                      
                                                                                                                                
SENATOR  WARD asked  if the  committee  substitute as  is would  not                                                            
satisfy the court.                                                                                                              
                                                                                                                                
MS. BOMENGEN  said, "This  language is beside  the fact.  The  court                                                            
didn't  address this.   What  the court  addressed was  that we  had                                                            
language  that  didn't  clearly state  what  we  were doing  in  the                                                            
language  that we've  extracted.   It's  good  to extract  it.   The                                                            
language here  is a policy change.  It does not keep  the program at                                                            
the  status quo,  it  instead changes  so  that more  families  will                                                            
receive  the two-parent  -  the 50  percent reduction  during  those                                                            
summer months because it ...                                                                                                    
                                                                                                                                
TAPE 01-31, SIDE B                                                                                                              
                                                                                                                                
[MS BOMENGEN  continued.]  ... the exception  that the division  was                                                            
able to  recognize because  it was borrowed  from the AFDC  concept.                                                            
The court doesn't  have an opinion about what the  policy is that is                                                            
adopted here.   If that is the policy  that this committee  chooses,                                                            
that's beside the point for the court."                                                                                         
                                                                                                                                
SENATOR WARD  asked what, in Ms. Bomengen's  opinion, the  court has                                                            
asked the legislature to do, if anything.                                                                                       
                                                                                                                                
MS. BOMENGEN said  the court has asked DHSS, as long  as the statute                                                            
contains the language  "unemployment of the family's  principal wage                                                            
earner"  to make  an  evaluation of  the  employment  status of  the                                                            
principal wage  earner.  The court has not asked the  legislature to                                                            
change the  law, it has only  said this is  what DHSS must  do under                                                            
the existing law.                                                                                                               
                                                                                                                                
SENATOR WARD  commented that DHSS  must write new regulations  then.                                                            
                                                                                                                                
MS. BOMENGEN said it will  and it will have to analyze each family's                                                            
relative unemployment status.                                                                                                   
                                                                                                                                
CHAIRWOMAN GREEN asked  Mr. Nordlund and Ms. Bomengen to provide the                                                            
committee with  a definition of Native villages and  she asked for a                                                            
side-by-side  comparison  of  the two  versions  of the  bill.   She                                                            
commented  that  the less  language  that must  be added  to  create                                                            
additional  exceptions  the better,  and that  it is  her intent  to                                                            
perfect that language.                                                                                                          
                                                                                                                                
SENATOR WARD asked,  regarding the people who will  never be able to                                                            
get off of public  assistance, at what point in time  they should be                                                            
transferred  to another  program.  He  asked if  there has been  any                                                            
discussion about other  possible programs that might be addressed in                                                            
this bill.                                                                                                                      
                                                                                                                                
MR. NORDLUND  said a  number of states  have done  that.  Some  ATAP                                                            
clients  have  disabilities  or incapacities   that are  not  severe                                                            
enough to  qualify for social  security income  but they are  severe                                                            
enough to prevent those  clients from holding a job.  He agrees that                                                            
finding a way to transfer  those clients to a different program is a                                                            
good idea that  needs to be explored  as DHSS learns more  about how                                                            
many  clients  will  fall in  this  category.    For now,  they  can                                                            
continue to be served under  ATAP as long as there is room under the                                                            
cap but  as more people  hit the  60 month limit,  that cap  will be                                                            
reached.                                                                                                                        
                                                                                                                                
There  being no  further  business  to come  before  the  committee,                                                            
CHAIRWOMAN GREEN adjourned the meeting at 5:32 p.m.                                                                             
                                                                                                                                

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