Legislature(2023 - 2024)ADAMS 519
04/20/2023 01:30 PM House FINANCE
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| Audio | Topic |
|---|---|
| Start | |
| HB58 | |
| HB59 | |
| Adjourn |
* first hearing in first committee of referral
+ teleconferenced
= bill was previously heard/scheduled
+ teleconferenced
= bill was previously heard/scheduled
| += | HB 58 | TELECONFERENCED | |
| += | HB 59 | TELECONFERENCED | |
| + | TELECONFERENCED |
HOUSE BILL NO. 58
"An Act relating to medical assistance for recipients
of Medicaid waivers; establishing an adult care home
license and procedures; providing for the transition
of individuals from foster care to adult home care
settings; and providing for an effective date."
1:35:16 PM
Co-Chair Foster asked staff from the Department of Health
(DOH) to review the fiscal notes.
TONY NEWMAN, DIRECTOR, DIVISION OF SENIOR AND DISABILITIES
SERVICES, DEPARTMENT OF HEALTH, thanked the committee for
hearing the bill again. He briefly explained that the bill
would provide elderly Alaskans and adults with disabilities
enrolled in the Medicaid home and community based waivers
with a new living option called adult home care. The bill
established a new licensed residential setting type and a
new certified service that would be overseen by DOH. He
offered to take questions or provide an overview of the
fiscal notes.
Co-Chair Foster asked for a review of the fiscal notes.
Mr. Newman reviewed the first fiscal note, OMB component
number 2663, control code fpGii. The fiscal note primarily
funded one position to begin in FY 25, which would
implement and operationalize the adult home care service.
The work would entail developing the organizational
procedures around certifying and monitoring providers who
offer the service, in addition to certifying and monitoring
the providers. The position was new, and it would involve
setting up the program, providing training, and making it
clear to families and providers how the service was
different from existing service options. The note included
the salary of $119,100 for one health program manager II
with $2,300 for some minimal travel, $14,000 for services
(i.e., core service costs for an employee including IT,
lease costs, HR, and fiscal management services costs), and
$4,000 for commodities. The costs would be funded with 50
percent federal Medicaid funds and 50 percent state general
Medicaid funds.
1:38:28 PM
Mr. Newman reviewed the second fiscal note OMB component
number 3234, control code boKBB. The note was zero and had
been compiled by the department to demonstrate to the
legislature that it had considered what it would cost to
add a new service. The department had determined it would
have a net zero impact on the Medicaid Services budget. He
reminded the committee that the service was for people who
were already eligible for Medicaid home and community based
waiver services. He explained it would be a more expensive
service in some cases and a less expensive service in other
cases, leading to a net zero estimate.
1:39:32 PM
RENEE GAYHART, DIRECTOR, DIVISION OF HEALTH CARE SERVICES,
DEPARTMENT OF HEALTH, reviewed the last fiscal note, OMB
component number 245, control code Pvlvr. The department
was requesting one PCN [position control number] beginning
in FY 25 for $105,000 with $10,000 in travel, $14,000 in
services, and $1,000 in commodities. The department was
looking at licensing approximately 40 new homes in the
first year and the position would be responsible for
regulations drafting, policies and procedures, training,
and outreach to the new provider types. The department was
requesting an additional PCN in FY 29 to reflect doubled
cost. She explained there was an uptick any time a new
license provider type came on board and the department
assumed it would continue to see additional facilities
wanting to be licensed under the program; therefore, the
department was projecting 40 new homes in the first year
and a similar amount in the outyears. The department would
also have to do recertifications or relicensing in the
fifth year. She explained the original licensed providers
would be relicensed as new licenses were coming on board as
well. She relayed that if the funding was approved, the
department would be able to submit a path for the position
in FY 29 and attach the approval of HB 58. The department
would still have to go through the budget and the Office of
Management and Budget (OMB) to get a PCN through
classification.
1:41:55 PM
Co-Chair Foster OPENED public testimony.
MARGE STONEKING, ADVOCACY DIRECTOR, AARP ALASKA, ANCHORAGE
(via teleconference), read from prepared remarks:
AARP strongly supports continued expansion and
improvement of home and community based waiver
services to better serve our fast growing senior
population, including offering a range of residential
settings. The vast majority of us want to remain in
our own homes and communities as we age and prefer a
home setting over a nursing home or other
institutional settings. Of course, as you know, home
and community based services (HCBS) cost a fraction of
what otherwise required nursing home care would cost.
In the home care workforce crisis combined with our
rapidly aging population, its threatening access to
HCBS for private pay and state pay alike and that is
already driving people into assisted living
facilities. This could additionally drive elders into
institutional care and because few can afford nursing
home care, could ultimately increase the Medicaid
rolls. That's why we need to use all tools in the
toolbox to expand home and community based service
options using proven service models from across the
nation to offer choices to appeal to waiver
participants and perspective workers alike.
Adult home care is one such solution and AARP welcomes
the administration proposing adult home care as an
additional service option and adult care homes as a
new residential setting for [inaudible] residents. It
is our understanding that HB 58 will provide a pathway
to creating a lower administrative burden for
operators than group assisted living homes and the
intent is to offer elders and others the option of
more homelike settings with lower level services and
fewer residents. For these reasons, AARP supports HB
58 and looks forward to working with the department on
regulations required in the bill. We also urge the
Department of Health, with the support of the
legislature, to stand up additional initiatives that
directly support the aging in place component of the
governor's Healthy Families Initiative, including
participant directed care. Aging in place is what the
vast majority of older Alaskans want to do and home
care services and support cost the state a fraction of
what institutional care does.
Co-Chair Foster noted that Representative Coulombe had
joined the meeting.
1:45:52 PM
ROBERT TASSO, HEALTH AND SOCIAL SERVICES PLANNER,
GOVERNOR'S COUNCIL ON DISABILITIES AND SPECIAL EDUCATION,
ANCHORAGE (via teleconference), spoke in support of the
legislation and the companion bill SB 57. The legislation
would expand home and community based services and
establish a new residential setting category for adult home
care. The bill would establish several main goals for
stakeholders, particularly allowing legally responsible
individuals including family members to care for seniors
and individuals with disabilities and to receive financial
support for the service. The bill would also allow for
continuity of care for individuals to provide the necessary
support for the family providing care and would lower cost
and decrease the administrative burden normally required
for an adult assisted living home. The bill provided an
opportunity for enhanced support for caregivers of
individuals with disabilities or individuals aging out of
the foster care system. He highlighted the current
workforce crisis and relayed that the bill would help
address the issue that many providers had been struggling
with. The governor's council supported the passage of the
bill.
Co-Chair Foster CLOSED public testimony.
Representative Galvin asked if the fiscal notes included
receipts for licenses. She wondered if it was not a part of
the overall consideration.
Ms. Gayhart replied that it would not be taken into
consideration until DOH drafted the regulations. Currently
the license fee was quite low at about $25 per bed. The
department had not factored it into account because it did
not yet know how many beds would come online. She explained
it would be included in the outyears. She stated there
would be limited receipts, but not to begin with.
Representative Galvin wondered if it was common to have a
placeholder in future years for accounting purposes. She
suggested making note of the issue in the drafting.
HB 58 was HEARD and HELD in committee for further
consideration.
Co-Chair Foster noted he intended to schedule the bill the
following week. His staff would work with committee members
regarding an amendment deadline.
| Document Name | Date/Time | Subjects |
|---|---|---|
| HB 59 Public Testimony Rec'd by 4-17-23.pdf |
HFIN 4/20/2023 1:30:00 PM |
HB 59 |
| HB 59 HFIN Response questions 041823.pdf |
HFIN 4/20/2023 1:30:00 PM |
HB 59 |