SENATE HEALTH, EDUCATION AND SOCIAL SERVICES COMMITTEE March 8, 1999 1:36 p.m. MEMBERS PRESENT Senator Pete Kelly, Vice-Chairman Senator Gary Wilken Senator Drue Pearce Senator Kim Elton MEMBERS ABSENT Senator Mike Miller, Chairman COMMITTEE CALENDAR SENATE BILL NO. 56 "An Act allowing the disclosure of reports with regard to inspection and investigations of certain health care facilities, home health agencies, hospice programs, and assisted living homes; authorizing the Department of Health and Social Services to license home health agencies; and providing for an effective date." -HEARD AND HELD SENATE BILL NO. 57 "An Act relating to vulnerable adults; and providing for an effective date." -HEARD AND HELD SENATE BILL NO. 58 "An Act establishing an in-home and community-based services program for certain adults with long-term care needs; and providing for an effective date." -HEARD AND HELD SENATE BILL NO. 59 "An Act relating to the certificate of need program for nursing care facilities and other facilities; and providing for an effective date." -SCHEDULED BUT NOT HEARD PREVIOUS SENATE COMMITTEE ACTION SB 56 - See HESS minutes dated 3/3/99 SB 57 - See HESS minutes dated 3/3/99 SB 58 - See HESS minutes dated 3/3/99 SB 59 - See HESS minutes dated 3/3/99 WITNESS REGISTER Mr. Jay Livey, Deputy Commissioner Department of Health & Social Services PO Box 110601 Juneau, AK 99811-0601 POSITION STATEMENT: Commented on SB 56 Ms. Sonya Smith PO Box 23108 Juneau, AK 99802 POSITION STATEMENT: Commented on SB 57 & SB 58 Ms. Tiffany Shaquanie PO Box 35652 Juneau, AK 99803 POSITION STATEMENT: Commented on SB 57 Mr. Jonathan Smith PO Box 23108 Juneau, AK 99802 POSITION STATEMENT: Commented on SB 57 Mr. Donald Williams Sr. PO Box 22154 Juneau, AK 99802 POSITION STATEMENT: Commented on SB 58 ACTION NARRATIVE TAPE 99-09, SIDE A Number 001 VICE-CHAIRMAN KELLY called the Senate Health, Education and Social Services (HESS) Committee to order at 1:36 p.m. for Chairman Miller who was out of town. He announced the order of business would be the legislation resulting from the Long-Term Care Task Force - SB 56, SB 57, SB 58 and SB 59. SB 56 - HOME HEALTH AGENCIES/HOSPITALS/HOSPICES VICE-CHAIRMAN KELLY brought up the draft CS to SB 56 with changes recommended by Deputy Commissioner Lindstrom, and decided the committee wouldn't adopt the work draft today. Instead, HESS would take testimony on SB 56 and the other bills. Number 031 MR. JAY LIVEY, Deputy Commissioner of the Department of Health & Social Services, remarked that Shelby Larson is on-line to testify from Anchorage. He recalled the issue in the CS for SB 56 is whether or not the authority in the previous draft of the bill was in the proper section of the statute. The suggestion was to move the language to AS 18.18. Mr. Livey stated the CS does not change any of the bill's functions. VICE-CHAIRMAN KELLY asked if Mr. Livey wanted to testify on the bill, and he responded he would answer questions. Ms. Alison Elgee and Ms. Jane Demmert were present to answer questions along with two staff from the Division of Senior Services, Ms. Burrows and Mr. Dwight Becker, on-line in Anchorage. Number 067 SB 57-CARE FOR VULNERABLE ADULTS and SB 58-SERVICES FOR ADULTS WITH LONG-TERM NEEDS MS. SONYA SMITH introduced herself by her traditional Tlingit name, Shool Nik. She said she was speaking on behalf of her elder, Mr. Donald Williams Sr. with whom she has been working for the past 7 months. She expressed her views and beliefs as a traditional Native, and mentioned that her job is to teach the youngsters how to care properly for Mr. Williams. MS. SMITH said that Mr. Williams qualifies for long-term care but he has not received any medical services or compensation. She asked the amount of the appropriations at a state level for criminals and felons who have disabilities. She requested documentation from the committee by the date of the next hearing on the dollar amounts for the elderly and the disabled, including vulnerable adults. She questioned whether there is any support given to these individuals on a medical level, or any management of their medical care. She expressed alarm at the way these bills are written and enforced at a state level, and avowed there is no representation at all for people who have disabilities. Number 239 VICE-CHAIRMAN KELLY requested that Ms. Smith briefly explain what she would like the committee to do. MS. SMITH replied she would like to know the state appropriation numbers that were reached by consensus through the recommendations of the Alaska Federation of Natives and the Indian Health Service. She asserted there are two separate laws for vulnerable adults and persons with disabilities, with no distinction of what defines a "vulnerable adult." SENATOR ELTON asked Ms. Smith which department she has been working with, and she responded Adult Protective Services. VICE-CHAIRMAN KELLY asked Ms. Smith to leave a copy of her testimony with the committee aide, Sharon Clark. Number 273 MS. SMITH said she would not be comfortable leaving her written testimony unless she could continue a dialogue with the committee after today. VICE-CHAIRMAN KELLY explained that it would help Ms. Clark and Senator Miller's office to compile her requests, with assistance from Senator Wilken who helped to draft the task force recommendations. MS. SMITH agreed to leave her statement. She mentioned she has begun working with Senator Miller's office. Number 282 SENATOR ELTON pointed out to Ms. Smith that one of the elements of SB 58 is more money for community-based care, an appropriation of $425.0 that will increase to $800.0 in the future. He allowed that there might be some provisions in the bill that don't work. SENATOR WILKEN suggested that Ms. Smith might visit with Representative Kookesh who was a member of the Long-Term Care Task force and may have commonality with her issue. MS. SMITH said she was aware of Representative Kookesh's participation. She urged the creation of a new task force to do further work on long-term care issues. Number 310 MS. TIFFANY SHAQUANIE introduced herself by her Tlingit name. She then requested that the committee provide "actual funding figures based on consensus as it relates to persons with disabilities." She explained that in her Tlingit relationship to Mr. Donald Williams she is recognized as a child to the elder man's moiety of the Eagle/Killer Whale Clan. She thanked the committee for the opportunity to testify on behalf of Mr. Williams, and then she described his health. She discussed the new language in SB 57 on Page 2, beginning on line 24, "The department may not disclose..." and the existing language beginning on line 28 of Page 2, "The department shall upon request disclose the number of verified reports..." She asked whether this means that people can do their own investigation at a federal level. She concluded that the way SB 57 reads, Mr. Williams could be taken from his people at any time. Number 397 MR. JONATHAN SMITH introduced himself by his Tlingit name and his clan, the Raven/Dog Salmon. He spoke of his observations of racial discrimination against his Native people. He said Mr. Williams needs the care of his mother, Sonya Smith, and that he worries Mr. Williams could be taken away from the family at any time if those services aren't good enough. Number 482 MR. DONALD WILLIAMS SR. explained that Dr. Susan Hunter-Joerns, a local neurologist, recommended continuation of the medical services he has been receiving after reviewing his condition and examining his skull. He told the committee he has four skull fractures and he takes 600 mg of Dilantin around the clock. He had worked as a grants specialist for the federal government for fifteen years until he had an accident in Hobart Bay. He has had several surgeries. MR. WILLIAMS said he's aware of SB 58, and he asked for the committee's help in its passage. Number 518 SENATOR WILKEN explained to those who testified that the purpose of the vulnerable adult legislation (SB 57) is to provide assistance, if needed, for a person who has diminished capacity to make a decision in their own best interest. He stated he doesn't think the legislation delineates disability by age or by injury, and certainly not by race. It is simply meant to help those who could be taken advantage of by someone who is directly or implicitly charged to look out for their best interests. That is the intent of SB 57, and SENATOR WILKEN said that nothing in the testimony today would indicate to him that the bill isn't doing that. He invited the witnesses to share specifics with the committee so that it can be proactive and make sure the bill doesn't hurt the citizens of the state. VICE-CHAIRMAN KELLY asked for the written testimony of Mr. Smith and Mr. Williams. He announced that on Monday, March 15 the committee would again hear SB 56, 57, 58 and 59, with participation by teleconference. The assisted living bill, SB 73, will be taken up on March 17. With no further business before the committee, he adjourned at 2:20 p.m.