04/05/1993 08:35 AM House FIN

  HOUSE BILL NO. 3                                                             
                                                                               
       "An Act  relating to  public home  care providers;  and                 
       providing for an effective date."                                       
                                                                               
  REPRESENTATIVE MACKIE  noted that HB  3, An Act  relating to                 
  public home care providers, restricts the  ability of a home                 
  care  provider  to  assume power  of  attorney  and requires                 
  criminal background checks on  any individual providing home                 
  care services paid  for by  public funds for  an elderly  or                 
  disabled person.                                                             
                                                                               
  Representative Mackie stressed  that HB 3 will  provide some                 
  protection  to  elderly  and  disabled  persons  from  those                 
  responsible for their  care.  He asserted  that these groups                 
  are  particularly  vulnerable  to   abuse  because  of  age,                 
  illness,  disability  and the  isolation  of being  alone in                 
  their home with a care giver.                                                
                                                                               
                                                                               
  Representative Mackie  emphasized  that it  is important  to                 
  take  these steps now,  while Alaska is  on the brink  of an                 
  explosion  in  home care  services.   He  stressed  that the                 
  state's senior  citizen population is rapidly  expanding and                 
  the state has  just received approval for  a Medicaid Waiver                 
  to  provide  home   and  community  based  services   as  an                 
  alternative  to institutionalization.    He maintained  that                 
  once  the  Medicaid Waiver  is  effective,  and  there is  a                 
  payment system  available for expanded home  based services,                 
  the home care services industry will  see rapid growth.  The                 
  bill also requires background checks  on home care providers                 
  paid through Older  Alaskans Commission grants,  and respite                 
  care providers paid through the Division of Family and Youth                 
  Services.                                                                    
                                                                               
  Representative Mackie  noted that  the Department  of Health                 
  and  Social Services  is  required to  implement regulations                 
  identifying actions to  be taken upon  reports of harm by  a                 
  home care provider; it also  protects the due process rights                 
  of the provider.   The companion  bill, HB 4, provides  that                 
  conviction of a person licensed, certified or regulated by a                 
  board or the Department of Commerce, for abuse of an elderly                 
  or disabled person may be considered ground for disciplinary                 
  proceedings or sanctions.                                                    
                                                                               
  Representative Mackie pointed  out that  30 percent of  back                 
  ground checks made by the Department of Public Safety have a                 
  criminal history.  He provided  members with a letter citing                 
  abuses of elderly nursing patients (Attachment 1).                           
                                                                               
  Representative  Parnell asked  if a  family member can  be a                 
  home care provider under state contract.                                     
                                                                               
  PAT O'BRIEN, FAMILY AND YOUTH SERVICES, DEPARTMENT OF HEALTH                 
  AND SOCIAL SERVICES clarified that it would be unusual for a                 
  family member to be a contract care provider.                                
                                                                               
  Representative  Hanley asked  if  "held jointly"  means that                 
  both   powers   of   attorney   would   have   to   execute.                 
  Representative    Mackie    replied    that   they    would.                 
  Representative Hanley noted  that the spouse of  the primary                 
  power of attorney could be the second power of attorney.  He                 
  asserted that it  would be easy  for couples to abuse  their                 
  charge.  He suggested that the  second power of attorney not                 
  be the spouse.                                                               
                                                                               
  Representative  Martin  expressed  concern with  the  fiscal                 
  cost.  Representative Mackie clarified  that no new programs                 
  would be created.   He pointed out that the  current program                 
  is funded through federal Medicaid funds.  He noted that the                 
  legislation    only    changes    employment   requirements.                 
  Representative Martin stresssed that background checks would                 
  be  mandated.  The  funding source of  background checks was                 
                                                                               
                                                                               
  not specified.                                                               
                                                                               
  Representative Parnell MOVED to report HB 3 out of Committee                 
  with individual  recommendations and  with the  accompanying                 
  fiscal notes.  There being NO OBJECTION, it was so ordered.                  
                                                                               
  HB  3  was  reported  out  of  Committee with  a  "do  pass"                 
  recommendation and with a zero fiscal note by the Department                 
  of Administration, dated  3/10/93 and  with a fiscal  impact                 
  note by  the Department  of Health  and Social Services  and                 
  with a  zero fiscal  note by  the Department  of Health  and                 
  Social Services.