HB 288-MED. ASSISTANCE ELIGIBILITY: PRISONERS  3:04:04 PM CHAIR KELLER announced that the first order of business would be HOUSE BILL NO. 288, "An Act prohibiting denial or withholding of medical assistance eligibility or coverage for a prisoner." 3:04:32 PM JIM POUND, Staff, Representative Wes Keller, Alaska State Legislature, introduced HB 288, on behalf of the prime sponsor, Representative Keller. He read from a prepared statement: House Bill 288 is based on the fact that if an individual is convicted of a crime, he's sentenced to jail. The State of Alaska assumes custody ... but we also assume the medical costs. Some of these can be extremely expensive, and under our current regulatory process, we cannot share that cost with anyone, including Medicaid. Medicaid sharing by inmates is forbidden by state regulation, not state law. The regulation is based on a federal understanding of the rules; in fact there is no federal law that requires it, either. It's a grey area that says inmates under state custody cannot receive Medicaid, but the interpretation of that is rapidly changing in that several states already seek Medicaid funds for inmates. For those inmates in facilities in an infirmary, the rule is essentially the same as in state custody. Where the condition places the inmate under the care of a hospital, the rules are different. Medicaid may be used for that type of care. For the State of Alaska, up to 50 percent of that money is federal money. The state needs to look at ways to save money. This is a golden opportunity for us to look at a $32 million budget for this coming up fiscal year. How much we can save will depend on the number of inmates who qualify. Potential changes in the U.S. health care laws may also greatly increase that amount in 2014. We urge your support of this bill; it moves us in the right direction. CHAIR KELLER asked the committee if there were any questions. 3:06:41 PM JON SHERWOOD, Medicaid Special Projects, Office of the Commissioner, Department of Health and Social Services (DHSS), explained that, although the area of coverage by Medicaid for inmates was "somewhat ambiguous," states were able "to cover inmates when they are staying overnight in in-patient medical institutions." He expressed a need to move carefully, as this issue had "a good deal of federal oversight." He commented that, as Medicaid billing was monthly, the billing of Medicaid coverage solely for an in-patient setting outside the correctional facility would be a challenge for the DHSS, requiring some structural adjustments to the billing system. 3:08:40 PM CHAIR KELLER reflected on the irony for his introduction of a bill to expand Medicaid, but, as it was balanced against general fund funding, he declared "it just seemed like something that just is the right thing to do." 3:09:18 PM REPRESENTATIVE MILLER asked for a definition of prisoner, and when there would be [Medicaid] coverage. LESLIE HOUSTON, Director, Central Office, Division of Administrative Services, Department of Corrections (DOC), in response, stated that the focus was to those people incarcerated in the state correctional facilities. She admitted that the proposed bill could include people with electronic monitoring, as well as those in community residential centers (CRCs). REPRESENTATIVE SEATON asked for clarification about a person who was in the custody of the state. MS. HOUSTON explained that the proposed bill would include people under electronic monitoring, supervised probation, residents of half way houses (CRCs), as well as those in DOC facilities. 3:11:35 PM REPRESENTATIVE SEATON, noting a difference between her testimony and the proposed bill, asked to clarify whether, initially, the state was only going to claim coverage for prisoners in a correctional institution, and not claim coverage for everyone in custody. MS. HOUSTON, in response, said that it would begin the process with those incarcerated in facilities, as this was an easier point to assess eligibility. She agreed that it would be expanded "to reach every single area possible." 3:12:53 PM REPRESENTATIVE SEATON asked to clarify that proposed HB 288 allowed DOC and DHSS to narrow or broaden the coverage. MS. HOUSTON expressed her agreement. 3:13:12 PM CHAIR KELLER, directing attention to the formula on page 2 of the memorandum from Legislative Research Services [Included in members' packets], stated that the savings to the state general fund would be a minimum of $3 million. He allowed that this savings did not calculate any cost for administering the program. 3:15:42 PM CHAIR KELLER closed public testimony. 3:16:24 PM REPRESENTATIVE DICK moved to report HB 288 out of committee with individual recommendations and the accompanying fiscal notes. There being no objection, HB 288 was reported from the House Health and Social Services Standing Committee.