Legislature(2025 - 2026)DAVIS 106
02/06/2025 03:15 PM House HEALTH & SOCIAL SERVICES
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| Audio | Topic |
|---|---|
| Start | |
| HB73 | |
| HB68 | |
| Adjourn |
* first hearing in first committee of referral
+ teleconferenced
= bill was previously heard/scheduled
+ teleconferenced
= bill was previously heard/scheduled
| + | SB 15 | TELECONFERENCED | |
| + | HB 68 | TELECONFERENCED | |
| *+ | HB 73 | TELECONFERENCED | |
HB 73-COMPLEX CARE RESIDENTIAL HOMES
3:18:27 PM
CHAIR MINA announced that the first order of business would be
HOUSE BILL NO. 73, "An Act relating to complex care residential
homes; and providing for an effective date."
3:19:07 PM
HEIDI HEDBERG, Commissioner, Department of Health (DOH), co-
presented HB 73 on behalf of the bill sponsor, House Rules by
request of the governor. She thanked the committee for hearing
HB 73. She said the bill is the result of collaborative work
between the Department of Family and Community Services (DFCS)
and DOH "to address gaps in the Alaska system of care for
individuals with complex behavioral health and co-occurring
needs." She explained that Alaska currently lacks a place where
individuals can get the care they need while remaining "in home-
like community settings." The new license proposed under HB 73
would fill the gap in options. She introduced Deputy
Commissioners Ricci and Lasley.
3:20:19 PM
EMILY RICCI, Deputy Commissioner, Office of the Commissioner,
Department of Health, co-presented HB 73 on behalf of the bill
sponsor, House Rules by request of the governor. She said one
key effort of the department is to strengthen the behavioral
health system, a key aspect of which is to address complex care
needs both at an individual and system level. She said the
proposed legislation represents the outcome of that work within
the department and with DFCS.
3:21:20 PM
CLINTON LASLEY, Deputy Commissioner, Department of Family and
Community Services (DFCS), co-presented HB 73 on behalf of the
bill sponsor, House Rules by request of the governor. He talked
about the recent split of the former Department of Health and
Social Services into the two departments represented today and
getting people the care they need in the most effective way. He
said a case response team was created to look at individual
cases, as well as a Complex Care Committee (CCC), which looked
at finding appropriate care settings.
MR. LASLEY began a PowerPoint presentation [hard copy included
in the committee file], on slides 3 and 4, "What Is Complex
Care?," which read as follows [original punctuation provided]:
club Definition: Co-occurring behavioral, medical, or
disability-related needs requiring a multi-
disciplinary team and multiple programs.
club Vision: A coordinated system that delivers
compassionate, timely, and person-centered care for
the most vulnerable and complex Alaskans.
Behavioral health conditions
Public safety encounters
Disruptive behaviors
1:1+ staffing required
Co-occurring medical conditions
Extensive inpatient hospital visits
Carceral system involvement
Out of state treatment
Frequent emergency department visits
Harm to self or others
Psychiatric hospitalization
MR. LASLEY talked about group home settings that can provide
individuals and focused groups the care they need. He said this
is why the bill is important; the complex care residential
license type would allow Alaskans to live their best life in the
least restrictive environment.
3:26:15 PM
MS. RICCI picked up the presentation on slide 5, "What Does HB
73 Do?," which read as follows:
HB 73 creates the necessary statutory framework to
allow the Department of Health to license and regulate
a new setting:
Complex Care Residential Homes (CCRHs)
MS. RICCI covered the factors of how CCCRHs would fill a gap in
the care continuum, as shown on slide 6, which depicts a CCRH as
being in the middle of a continuum from that which requires
lower acuity care: foster homes, private residences, assisted
living homes, and home and community based waiver services; and
that which requires higher acuity care: residential psychiatric
treatment centers, inpatient psychiatric hospitals, skilled
nursing facilities, and general acute hospitals. She explained
that the gap exists for people that do not meet the criteria of
having an intellectual and developmental disability diagnosis,
which is critical to them accessing most of the home and
community-based waiver services; further, their needs are not
critical enough to be appropriate to care for them in an in-
patient setting.
MS. RICCI brought focus to slide 7, which showed four steps in
establishing a new residential setting, with HB 73 being the
second step. The four steps are: identify needs and define
scope; create new license type; determine services to be
provided; and establish reimbursement mechanisms.
3:30:08 PM
ROBERT LAWRENCE, MD, Chief Medical Officer, Department of
Health, co-presented HB 73 on behalf of the bill sponsor, House
Rules by request of the governor. He showed a list on slide 8
of those that would benefit from a homelike setting of CCRHs and
mentioned youth ages 8-12, with mental illness with multiple
behavioral health diagnoses; adults with mental health disorders
and other issues; and seniors with dementia, for example.
DR. LAWRENCE brought attention to slide 9, "Key Features of a
CCRH," which read as follows [original punctuation provided]:
CCRHs will offer a new residential care setting in
Alaska.
Fewer than 15 residents
24/7 care from a multi-disciplinary team
More supportive than assisted living homes and less
restrictive than a psychiatric hospital
Specialized monitoring, intervention, and/or treatment
to meet the needs of residents
DR. LAWRENCE turned to slide 10, "Benefits of a CCRH," which
read as follows [original punctuation provided]:
Improves care for Alaskans with complex needs
Adds a license type for home-like settings that offer
care in the most clinically appropriate environment
Allows for service specialization and for specific
requirements to be set forth in regulations
Promotes community safety by offering a new service
setting for individuals with complex behavioral health
needs
3:34:32 PM
MS. RICCI offered a sectional analysis of HB 73, as shown on
slides 11-13, which read as follows [original punctuation
provided]:
Section 1. Amends AS 47.32.010(b) to add "complex care
residential homes" to the list of entities regulated
by the Department of Health.
Section 2. Amends AS 47.32.900(2) to update the
definition of "assisted living home" to exclude
complex care residential homes.
Section 3. Adds AS 47.32.900(11) to modify the
definition of "hospital" to clarify that it does not
include complex care residential homes.
Section 4. Adds AS 47.32.900(22) to introduce a new
definition for "complex care residential home." It is
defined as a residential setting that provides 24-
hour multi-disciplinary care on a continuing basis for
up to 15 individuals with mental, behavioral, medical,
or disability-related needs requiring specialized
care, services and monitoring.
Section 5. Amends the uncodified law by adding a new
section that requires the Department of Health to
submit for approval by the United States Department of
Health and Human Services amendments to the state
Medicaid plan or apply for waivers necessary to
implement the provisions of Sections 1-4.
Section 6. Amends the uncodified law by adding a new
section specifying that sections 1-4 of the bill will
only take effect if the United States Department of
Health and Human Services approves the required
Medicaid waivers or amendments by July 1, 2031. The
commissioner of health is required to notify the
revisor of statutes within 30 days once the necessary
approvals are received.
Section 7. Provides that sections 1-4 take effect the
day after the United States Department of Health and
Human Services approves amendments to the state plan
or waivers submitted under Section 5.
3:36:35 PM
MS. RICCI, in response to Representative Prax, explained that
the vision is for a homelike setting rather than an
institutional one, while allowing for services typically
provided in an institution. Size could change via regulation
based on need. She explained that the cap of 15 individuals has
to do with aligning with federal requirements.
3:40:39 PM
CHAIR MINA announced that HB 73 was held over.