HOUSE FINANCE COMMITTEE April 27, 1994 8:40 A.M. TAPE HFC 94 - 143, Side 1, #000 - end. TAPE HFC 94 - 143, Side 2, #000 - #53. CALL TO ORDER Co-Chair Larson called the House Finance Committee meeting to order at 8:40 A.M. PRESENT Co-Chair Larson Representative Martin Vice-Chair Hanley Representative Navarre Representative Brown Representative Parnell Representative Grussendorf Representative Therriault Representative Foster Representatives Hoffman and MacLean were not present for the meeting. ALSO PRESENT Nancy Bear Usera, Commissioner, Department of Administration; Connie Sipe, Director, Division of Senior Services, Department of Administration; Pat Denny, Director, Older Alaskans Commission, Department of Administration; Dave White, Division of Medical Services, Department of Health and Social Services. SUMMARY SB 248 An Act relating to services for and protection of vulnerable adults; and providing for an effective date. HCS CS SB 248 (FIN) was reported out of Committee with a "do pass" recommendation and with fiscal notes by the Department of Health and Social Services dated 1/14/94 and the Department of Administration dated 3/24/94 and zero fiscal notes by the Department of Public Safety dated 2/18/94 and the Department of Administration dated 3/24/94. SB 249 An Act relating to assisted living homes; repealing references to residential facilities for dependent adults; and providing for an effective date. 1 CS SB 249 (HES)am was reported out of Committee with fiscal notes by the Department of Health and Social Services dated 3/10/94 (2) & 1/14/94 (1) and zero fiscal notes by the Department of Administration dated 3/10/94. SB 250 An Act relating to the Older Alaskans Commission and staff of the commission; changing the name of the Older Alaskans Commission to the Alaska Commission on Aging and extending the termination date of the commission; relating to the Alaska Pioneers' Homes Advisory Board; relating to services and programs for older Alaskans; and providing for an effective date. HCS CS SB 250 (FIN) was reported out of Committee with a "do pass" recommendation and with a zero fiscal note by the Department of Administration dated 1/14/94. SENATE BILL 248 "An Act relating to services for and protection of vulnerable adults; and providing for an effective date." NANCY BEAR USERA, COMMISSIONER, DEPARTMENT OF ADMINISTRATION, explained that SB 248 (RLS)am was introduced by the Governor with the intent to make significant improvements in the way that protective services would be provided to vulnerable adults who are victims of abuse, neglect or exploitation. The bill would transfer the authority for adult protective services from the Department of Health and Social Services (Division of Family and Youth Services) to the Department of Administration (Division of Senior Services). She added that the legislation would define "vulnerable" adults and differentiate between "vulnerable" adults and "vulnerable" children. Commissioner Usera advised that the fiscal notes included with the legislation were transfers from the Department of Health and Social Services to the Department of Administration. Representative Martin MOVED to adopt Amendment #1 as proposed by the Christian Science churches in Alaska, explaining that Christian Scientists rely on spiritual treatment, based on prayer alone, for the healing of physical illnesses. Representative Brown expressed her support for adults being 2 able to select their own method of treatment, while adding that the issue becomes more complicated when applied to children. Representative Martin pointed out that it is important that people have freedom of faith where healing is involved. He added that the Christian Scientists want to ensure that senior citizens will not be subjected to health methods which they do not agree with. Commissioner Usera advised that the legislation will have no effect on children. Children are currently listed in the children's statutes, a separate category. Commissioner Usera recommended adding language to the end of the amendment stating: "Provided that the person consents to the treatment by spiritual means only", indicating that this language would create a consensual relationship. Representative Martin MOVED to adopt the additional language to Amendment #1. There being NO OBJECTION, the language change was adopted. Co-Chair Larson OBJECTED to adopting the amended Amendment A roll call vote was taken on the MOTION. IN FAVOR: Martin, Navarre, Brown, Foster, Grussendorf, Hanley. OPPOSED: Therriault, Larson. Representatives Parnell, Hoffman and MacLean were not present for the vote. The MOTION PASSED (6-2). Representative Navarre MOVED to report HCS CS SB 248 (FIN) out of Committee with individual recommendations and with the accompanying fiscal notes. There being NO OBJECTION, it was so ordered. HCS CS SB 248 (FIN) was reported out of Committee with a "do pass" recommendation and with fiscal notes by the Department of Health and Social Services dated 1/14/94, the Department of Administration dated 3/24/94, and zero fiscal notes by the Department of Public Safety dated 2/18/94 and the Department of Administration dated 3/24/94. SENATE BILL 249 "An Act relating to assisted living homes; repealing references to residential facilities for dependent adults; and providing for an effective date." 3 Commissioner Usera stated that the Governor introduced the proposed legislation for the purpose of promoting the operation of homes that help the elderly to "age in place", and disabled adults to reach their highest level of functioning by integration into the community. The legislation's reforms are summarized in three points: 1. Respect for residents as consumers. 2. Allowing access to health care in a homelike setting. 3. Transfer of the licensing responsibility of agencies with programmatic experience in independent living for the elderly or persons with disabilities. Representative Brown asked how the bill would affect the operations of the Pioneer Homes. Commissioner Usera replied that the legislation would have no impact on the Pioneer Homes, some of which are currently providing assisted living services. The legislation would intend to license members of private institutions to provide additional services. Representative Hanley questioned if it would be necessary for all the new homes to go through the certificate of need process. Commissioner Usera noted that the references here would be assisted living facilities and would not be subject to the certificate of need process. Representative Hanley questioned how these services would be paid for in the future. Discussion followed among Committee members regarding that concern. DAVE WHITE, DIVISION OF MEDICAL ASSISTANCE, DEPARTMENT OF HEALTH AND SOCIAL SERVICES, stressed that the proposed legislation would provide an alternative to the current nursing home situation and would provide a cost effective service operation short of institutionalization. Mr. White urged Committee members to pass the legislation in order that the assisted care institutions could be built and that this legislation would be able to grant provisions in order to license them. Representative Parnell MOVED to report CS SB 249 (HES)am out of Committee with individual recommendations and with the accompanying fiscal notes. There being NO OBJECTION, it was so ordered. CS SB 249 (HES)am was reported out of Committee with "no recommendations" and with fiscal notes by the Department of Health and Social Services dated 3/10/94 & 1/14/94 and the Department of Administration dated 3/10/94. SENATE BILL 250 4 "An Act relating to the Older Alaskans Commission and staff of the commission; changing the name of the Older Alaskans Commission to the Alaska Commission on Aging and extending the termination date of the commission; relating to the Alaska Pioneers' Homes Advisory Board; relating to services and programs for older Alaskans; and providing for an effective date." Commissioner Usera pointed out that SB 250 was one of the three pieces of legislation introduced by the Governor as part of a plan to improve and reorganize state services to Alaska's seniors. 1. Re-name the Older Alaskans Commission as the Alaska Commission on Aging. 2. Reduce the number of mandatory annual meetings for both the Commission and the Board in order to reflect current practices and fiscal resources. 3. Add the chairperson of the Commission on Aging to the Pioneers' Homes Board. 4. Establish 8 year maximum terms for Pioneers' Homes Board members, allow current members to serve up to 8 more years, and transition the board to staggered terms. 5. Clarify that the Commission on Aging administers programs through its executive director. 6. Clarify that the Commission sets policy for administration of its programs and selects recipients for grant awards. 7. Allows the Commission flexibility to reduce or waive local "match" requirements for grantees operating "pilot projects" when the waiver is in the public's interest. Commissioner Usera stated that the Department supports Amendment #1 which would provide a vote for the executive branch agencies who sit on the Boards as well as a vote for the Chairman of the Older Alaskan's Commission. PAT DENNY, EXECUTIVE DIRECTOR, OLDER ALASKAN'S COMMISSION, DEPARTMENT OF ADMINISTRATION, testified that the Older Alaskan's Commission was anxious to see that the Chairman of the Pioneer's Home Board and three members of the executive branch be given the opportunity to fully participate in the work of the Commission. CONNIE SIPE, DIRECTOR, DIVISION OF SENIOR SERVICES, DEPARTMENT OF ADMINISTRATION, summarized that there would be no amendments or changes to the Longevity Bonus through the proposed legislation. 5 Representative Martin MOVED to adopt Amendment #1. (Tape Change, HFC 94-143, Side 2). There being NO OBJECTION, it was adopted. Representative Martin MOVED to report HCS CS SB 250 (FIN) out of Committee with individual recommendations and with the accompanying fiscal note. There being NO OBJECTION, it was so ordered. HCS CS SB 250 (FIN) was reported out of Committee with a "do pass" recommendation and with a zero fiscal note by the Department of Administration dated 1/14/94. ADJOURNMENT The meeting adjourned at 9:25 A.M. HOUSE FINANCE COMMITTEE April 27, 1994 8:40 A.M. TAPE HFC 94 - 143, Side 1, #000 - end. TAPE HFC 94 - 143, Side 2, #000 - #53. CALL TO ORDER Co-Chair Larson called the House Finance Committee meeting to order at 8:40 A.M. PRESENT Co-Chair Larson Representative Martin Vice-Chair Hanley Representative Navarre Representative Brown Representative Parnell Representative Grussendorf Representative Therriault Representative Foster Representatives Hoffman and MacLean were not present for the meeting. ALSO PRESENT Nancy Bear Usera, Commissioner, Department of Administration; Connie Sipe, Director, Division of Senior Services, Department of Administration; Pat Denny, Director, Older Alaskans Commission, Department of Administration; Dave White, Division of Medical Services, Department of Health and Social Services. SUMMARY 6 SB 248 An Act relating to services for and protection of vulnerable adults; and providing for an effective date. HCS CS SB 248 (FIN) was reported out of Committee with a "do pass" recommendation and with fiscal notes by the Department of Health and Social Services dated 1/14/94 and the Department of Administration dated 3/24/94 and zero fiscal notes by the Department of Public Safety dated 2/18/94 and the Department of Administration dated 3/24/94. SB 249 An Act relating to assisted living homes; repealing references to residential facilities for dependent adults; and providing for an effective date. CS SB 249 (HES)am was reported out of Committee with fiscal notes by the Department of Health and Social Services dated 3/10/94 (2) & 1/14/94 (1) and zero fiscal notes by the Department of Administration dated 3/10/94. SB 250 An Act relating to the Older Alaskans Commission and staff of the commission; changing the name of the Older Alaskans Commission to the Alaska Commission on Aging and extending the termination date of the commission; relating to the Alaska Pioneers' Homes Advisory Board; relating to services and programs for older Alaskans; and providing for an effective date. HCS CS SB 250 (FIN) was reported out of Committee with a "do pass" recommendation and with a zero fiscal note by the Department of Administration dated 1/14/94. SENATE BILL 248 "An Act relating to services for and protection of vulnerable adults; and providing for an effective date." NANCY BEAR USERA, COMMISSIONER, DEPARTMENT OF ADMINISTRATION, explained that SB 248 (RLS)am was introduced by the Governor with the intent to make significant improvements in the way that protective services would be provided to vulnerable adults who are victims of abuse, neglect or exploitation. The bill would transfer the authority for adult protective services from the Department 7 of Health and Social Services (Division of Family and Youth Services) to the Department of Administration (Division of Senior Services). She added that the legislation would define "vulnerable" adults and differentiate between "vulnerable" adults and "vulnerable" children. Commissioner Usera advised that the fiscal notes included with the legislation were transfers from the Department of Health and Social Services to the Department of Administration. Representative Martin MOVED to adopt Amendment #1 as proposed by the Christian Science churches in Alaska, explaining that Christian Scientists rely on spiritual treatment, based on prayer alone, for the healing of physical illnesses. Representative Brown expressed her support for adults being able to select their own method of treatment, while adding that the issue becomes more complicated when applied to children. Representative Martin pointed out that it is important that people have freedom of faith where healing is involved. He added that the Christian Scientists want to ensure that senior citizens will not be subjected to health methods which they do not agree with. Commissioner Usera advised that the legislation will have no effect on children. Children are currently listed in the children's statutes, a separate category. Commissioner Usera recommended adding language to the end of the amendment stating: "Provided that the person consents to the treatment by spiritual means only", indicating that this language would create a consensual relationship. Representative Martin MOVED to adopt the additional language to Amendment #1. There being NO OBJECTION, the language change was adopted. Co-Chair Larson OBJECTED to adopting the amended Amendment A roll call vote was taken on the MOTION. IN FAVOR: Martin, Navarre, Brown, Foster, Grussendorf, Hanley. OPPOSED: Therriault, Larson. Representatives Parnell, Hoffman and MacLean were not present for the vote. The MOTION PASSED (6-2). 8 Representative Navarre MOVED to report HCS CS SB 248 (FIN) out of Committee with individual recommendations and with the accompanying fiscal notes. There being NO OBJECTION, it was so ordered. HCS CS SB 248 (FIN) was reported out of Committee with a "do pass" recommendation and with fiscal notes by the Department of Health and Social Services dated 1/14/94, the Department of Administration dated 3/24/94, and zero fiscal notes by the Department of Public Safety dated 2/18/94 and the Department of Administration dated 3/24/94. SENATE BILL 249 "An Act relating to assisted living homes; repealing references to residential facilities for dependent adults; and providing for an effective date." Commissioner Usera stated that the Governor introduced the proposed legislation for the purpose of promoting the operation of homes that help the elderly to "age in place", and disabled adults to reach their highest level of functioning by integration into the community. The legislation's reforms are summarized in three points: 1. Respect for residents as consumers. 2. Allowing access to health care in a homelike setting. 3. Transfer of the licensing responsibility of agencies with programmatic experience in independent living for the elderly or persons with disabilities. Representative Brown asked how the bill would affect the operations of the Pioneer Homes. Commissioner Usera replied that the legislation would have no impact on the Pioneer Homes, some of which are currently providing assisted living services. The legislation would intend to license members of private institutions to provide additional services. Representative Hanley questioned if it would be necessary for all the new homes to go through the certificate of need process. Commissioner Usera noted that the references here would be assisted living facilities and would not be subject to the certificate of need process. Representative Hanley questioned how these services would be paid for in the future. Discussion followed among Committee members regarding that concern. DAVE WHITE, DIVISION OF MEDICAL ASSISTANCE, DEPARTMENT OF HEALTH AND SOCIAL SERVICES, stressed that the proposed legislation would provide an alternative to the current 9 nursing home situation and would provide a cost effective service operation short of institutionalization. Mr. White urged Committee members to pass the legislation in order that the assisted care institutions could be built and that this legislation would be able to grant provisions in order to license them. Representative Parnell MOVED to report CS SB 249 (HES)am out of Committee with individual recommendations and with the accompanying fiscal notes. There being NO OBJECTION, it was so ordered. CS SB 249 (HES)am was reported out of Committee with "no recommendations" and with fiscal notes by the Department of Health and Social Services dated 3/10/94 & 1/14/94 and the Department of Administration dated 3/10/94. SENATE BILL 250 "An Act relating to the Older Alaskans Commission and staff of the commission; changing the name of the Older Alaskans Commission to the Alaska Commission on Aging and extending the termination date of the commission; relating to the Alaska Pioneers' Homes Advisory Board; relating to services and programs for older Alaskans; and providing for an effective date." Commissioner Usera pointed out that SB 250 was one of the three pieces of legislation introduced by the Governor as part of a plan to improve and reorganize state services to Alaska's seniors. 1. Re-name the Older Alaskans Commission as the Alaska Commission on Aging. 2. Reduce the number of mandatory annual meetings for both the Commission and the Board in order to reflect current practices and fiscal resources. 3. Add the chairperson of the Commission on Aging to the Pioneers' Homes Board. 4. Establish 8 year maximum terms for Pioneers' Homes Board members, allow current members to serve up to 8 more years, and transition the board to staggered terms. 5. Clarify that the Commission on Aging administers programs through its executive director. 6. Clarify that the Commission sets policy for administration of its programs and selects recipients for grant awards. 7. Allows the Commission flexibility to reduce or waive local "match" requirements for grantees operating "pilot projects" when the waiver is in the public's interest. 10 Commissioner Usera stated that the Department supports Amendment #1 which would provide a vote for the executive branch agencies who sit on the Boards as well as a vote for the Chairman of the Older Alaskan's Commission. PAT DENNY, EXECUTIVE DIRECTOR, OLDER ALASKAN'S COMMISSION, DEPARTMENT OF ADMINISTRATION, testified that the Older Alaskan's Commission was anxious to see that the Chairman of the Pioneer's Home Board and three members of the executive branch be given the opportunity to fully participate in the work of the Commission. CONNIE SIPE, DIRECTOR, DIVISION OF SENIOR SERVICES, DEPARTMENT OF ADMINISTRATION, summarized that there would be no amendments or changes to the Longevity Bonus through the proposed legislation. Representative Martin MOVED to adopt Amendment #1. (Tape Change, HFC 94-143, Side 2). There being NO OBJECTION, it was adopted. Representative Martin MOVED to report HCS CS SB 250 (FIN) out of Committee with individual recommendations and with the accompanying fiscal note. There being NO OBJECTION, it was so ordered. HCS CS SB 250 (FIN) was reported out of Committee with a "do pass" recommendation and with a zero fiscal note by the Department of Administration dated 1/14/94. ADJOURNMENT The meeting adjourned at 9:25 A.M. 11