HB 384 PIONEERS' HOME - INABILITY TO PAY TAPE 96-31, SIDE A Number 001 CHAIRMAN SHARP called the Senate State Affairs Committee to order at 3:43 p.m. and brought up HB 384 as the first order of business before the committee. He called the prime sponsor to testify. REPRESENTATIVE NORMAN ROKEBERG, prime sponsor of HB 384, stated the bill would make statutory what has been standard policy since the beginning of the Pioneers' Homes in Alaska: that residents who cannot pay are not evicted. Representative Rokeberg read the sponsor statement for HB 384. He drew committee members' attention to the new rate schedule contained in their bill packets. That rate schedule will take effect for residents of pioneers' homes on July 1, 1996. It will increase the cost pioneers' home residents pay over a seven year period, after which, rates paid would be equal to the cost of care. Rates will increase 50% in FY 97. If residents do not have enough money to pay the fees, they need the protection that HB 384 will provide. The Ombudsman issued a memo to the Speaker of the House and the President of the Senate this year which asked the legislature to put into statute or regulation every department policy that has not been set in statute or regulation. This issue is one of a number of unwritten policies of the State of Alaska. HB 384 would not result in any additional cost to the State of Alaska. The department supports the bill. Right now, the Governor's budget calls for $2,500,000.00 in increased revenues this year from the pioneers' home fee schedule increases, while it is estimated that only $1,500,000.00 will not be provided from people who cannot pay. REPRESENTATIVE ROKEBERG stated two primary issues were brought up in the House relating to HB 384. One was the spending down phenomenon, or what would happen if a person going into a pioneers' home attempted to avoid payments by dispersal of their assets. Currently there are regulations and statutes requiring that the department look back for two years at a new resident's total asset picture to ensure there was no giving away or selling at less than market value of assets. The department is looking at extending that picture to three years. So that concern is addressed. The second issue came up in the House State Affairs Committee. That issue was perhaps holding harmless existing residents, but giving no protection to future residents. Representative Rokeberg stated there is a legal opinion in members' bill packets stating a provision like that would be unconstitutional. Other people have asked how we could do that with the longevity bonus in that case, but Representative Rokeberg thinks that's probably unconstitutional also. He asked for support of HB 384. Number 155 SENATOR RANDY PHILLIPS asked how much money the pioneers' homes get in fees from residents. REPRESENTATIVE ROKEBERG replied he doesn't have that figure. CHAIRMAN SHARP offered that it is about $4,500,000.00 to $5,000,000.00. SENATOR RANDY PHILLIPS stated the homes are not paying for themselves through residents. We are also spending another $73,000,000.00 on the longevity bonus program. REPRESENTATIVE ROKEBERG thinks that an empty-nest couple in this state probably has benefits in excess of $11,000.00 per year. SENATOR RANDY PHILLIPS stated that oil revenues are declining, and we want to reduce the budget. So there is a dilemma that we are spending this money. REPRESENTATIVE ROKEBERG agreed with Senator Phillips that we need to look at all of these programs, and that we need to make reductions. But the Governor, in raising the fee schedule, answers that question. Certainly, the long-range financial projections are such that the residents will be making a greater contribution to the cost of those homes. But we all recognize that many of these people do not have the financial capabilities to do that. One alternative that's been discussed is to make the pioneers' homes eligible for medicaid payments in the state. We could easily do that, however, there is the phenomenon of medi-grants. Representative Rokeberg predicts that within one year the State of Alaska will be faced with a block grant for medicaid money. Therefore, we would simply be taking that money out of one pocket and putting it in another. That really wouldn't help the state financially. He thinks it would end up hurting the state, because we would be putting more of our assets into senior services and the pioneer homes than we would for other eligible medicaid requirements. Raising the fees is a good long-range proposition. REPRESENTATIVE ROKEBERG stated that in law is the term "promissory estoppel" is applicable to this situation. SENATOR RANDY PHILLIPS asked if fees at pioneers' homes include food. REPRESENTATIVE ROKEBERG responded the fees include room and board. Over 80% of residents are in assisted living or other levels of care. Number 255 SENATOR LEMAN disagreed that the changes made to the longevity bonus program were unconstitutional; that was not the advice received from the Department of Law. REPRESENTATIVE ROKEBERG replied he meant to say that may be unconstitutional. CHAIRMAN SHARP stated he has heard concern voiced by people in the Fairbanks Pioneers' Home over the fee increases also. HB 384 would resolve a lot of doubt that residents and their families have. He asked if there were any other comments on the bill. Hearing none, he asked the pleasure of the committee. Number 300 SENATOR LEMAN made a motion to discharge HB 384 from the Senate State Affairs Committee with individual recommendations. Number 310 CHAIRMAN SHARP, hearing no objection, stated HB 384 was discharged from the Senate State Affairs Committee.