Legislature(2025 - 2026)DAVIS 106
03/25/2025 03:15 PM House HEALTH & SOCIAL SERVICES
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| Audio | Topic |
|---|---|
| Start | |
| HJR9 | |
| HB96 | |
| HB52 | |
| State Medical Board | |
| Adjourn |
* first hearing in first committee of referral
+ teleconferenced
= bill was previously heard/scheduled
+ teleconferenced
= bill was previously heard/scheduled
| + | TELECONFERENCED | ||
| *+ | HB 96 | TELECONFERENCED | |
| *+ | HB 52 | TELECONFERENCED | |
| + | TELECONFERENCED | ||
| += | HJR 9 | TELECONFERENCED | |
HB 96-HOME CARE EMPLOYMENT STANDARDS ADV BOARD
3:40:14 PM
CHAIR MINA announced that the next order of business would be
HOUSE BILL NO. 96, "An Act establishing the Home Care Employment
Standards Advisory Board; relating to payment for personal care
services; and providing for an effective date."
3:40:20 PM
REPRESENTATIVE MIKE PRAX, Alaska State Legislature, as prime
sponsor, presented HB 96. He read the sponsor statement
[included in the committee file], which read as follows
[original punctuation provided]:
Seniors are the fastest growing demographic in the
state of Alaska1 and are living longer lives. 2 The
state's 85+ population is expected to increase by 500%
between 2022 and 2050, of which, 1/3 will experience
Alzheimer's and Related Dementia. 3 The Alaska
Department of Labor and Workforce Development predicts
home care, a part of Alaska's continuum of care
services for seniors and people with disabilities, to
be one of the fastest growing and most in demand
occupations in the state.4
Alaska faces an acute shortage of direct care workers,
particularly outside of population centers. The
potential provider workforce demographic, those age 18
to 64, is in decline. Furthermore, low pay and lack of
benefits force many caregivers out of the profession
and make recruitment and retention increasingly more
difficult for agencies providing in-home care
services.56
We need to create strong and long-lasting home care
infrastructure in Alaska which will expand access to
quality, affordable home and community-based care for
seniors and people with disabilities, keep people in
their homes and out of costly facilities, and bolster
the creation of jobs. We also need to ensure that
Medicaid funding for personal care services is wisely
spent, with an adequate portion of the rate going to
pay and benefits for direct care workers, in order to
help address the workforce shortage. HB 96
accomplishes both of these objects by:
• Establishing a Home Care Employment Standards
Advisory Board that will investigate, advise, and
develop recommendations on Medicaid rates and other
policies to improve the wages, working conditions, and
recruitment and retention of direct care workers.
• Requiring that agencies providing personal care
services spend at least 70 percent of the total annual
funding they receive from the department for personal
care services on the pay and benefits of Personal Care
Assistants providing such services.
3:43:47 PM
RILEY NYE, Staff, Representative Mike Prax, on behalf of
Representative Prax, prime sponsor, read the sectional analysis
[included in the committee file], of HB 96, [original
punctuation provided]:
Section 1 amends AS 44.29 by adding new sections to it
and various aspects of the Home Care Employment
Standards Advisory Board. Thus,
Sec. 44.29.900. Home Care Employment Standards
Advisory Board. This section is added to establish the
advisory board on Home Care Employment Standards in
Alaska.
Sec. 44.29.905. Composition of the board. This section
elaborates on the composition of the board which will
consist of a chair, 6 voting, and 4 non-voting
members. The section clarifies how many members should
be sought from each represented group or institution.
The members will be appointed by the Commissioner of
Health after solicitation of applications. Thus,
• Commissioner of Health or commissioner's designee
(non-voting unless in the event of a
tie)
• Commissioner of Labor and workforce development (or
the commissioner's designee) (non-voting)
• Two members representing covered providers, (with
variance in terms of size, services provided and
geographical location) (voting)
• Two members who represent direct care workers
(voting)
• One member who is an enrollee or representative of
enrollees receiving covered services (voting)
• One member who represents the office of rate receive
(voting)
• A representative of the Alaska Commission on Aging
or another organization that represents seniors in the
state (non-voting)
• A representative of the Governor's Council on
Disabilities and Special Education another
organization that represents people with disabilities
in the state (non-voting)
Sec. 44.29.910. Term of office, vacancies, removal.
This section explains how the members of the board
appointed in AS 44.29.905(3) will serve and
establishes how long they shall serve, options for
reappointment and how vacancies will be filled.
Sec. 44.29.915. Meetings. The section establishes the
duty of the chair to call for meetings of the board
with regularity and as needed. It also establishes
that the board should meet at least three times each
year and hold additional meetings as often as
necessary to accomplish its duties. At every meeting,
the Board will provide space for public testimony.
Sec. 44.29.920. Quorum. The section clarifies that a
majority of the members of the Board constitute a
quorum in a meeting of the board for it to transact
its official business and to approve any
recommendations of the Board.
Sec. 44.29.925. Compensation. This section refers to
established rules under AS 39.20.180 to guide
compensation of members of the board through per diem
and expenses reimbursement. Other than that, members
of the Board will not receive compensation.
Sec. 44.29.930. Powers and duties. This section
establishes the duties and powers of the board which
include advising and consulting the department on
medical assistance program payment rates for covered
services and payment rate adequacy for covered
services, as well as investigating employment issues
and concerns including wages, working conditions and
workforce development and making recommendations. This
section also describes state compliance with
information requests and testimony, and ensures the
board will have access to data needed to fulfill its
responsibilities.
Sec. 44.29.935 Biennial report. The section requires
the board to submit a written report biennially to the
Commissioner. The Commissioner is mandated to review
with the aim of accepting or rejecting findings and
recommendations and to give guidance and a way forward
depending on circumstances.
Sec. 44.29.940. Publication of reports. This section
mandates the publication of the reports on July 1 each
year and the reports must be publicly accessible. The
section also elaborates on what shall be included in
the published reports.
Sec. 44.29.945. Definitions. This section specifies
the definitions of all the terms used in the sections
above i.e. AS 44.29.900 - 44.29.945 including those
that relate to Section 1915(c) of the Social Security
Act (42 U.S.C. § 1396n(c))
Section 2 amends AS 47.07.045 by adding new
subsections that require an agency providing personal
care services to pay as compensation and benefits to
employees providing personal care services at least 70
percent of total annual funding received by the agency
for the purposes of providing personal care services,
increasing to 80 percent by July 1, 2030, unless the
agency receives a hardship exemption from the
department. This section also requires the department
to establish procedures and objective criteria for
granting a hardship exemption, and sets alternative
minimum requirements for an agency that qualifies for
such an exemption.
Section 3 amends the uncodified law of the State of
Alaska by adding a new section establishing when the
board should be appointed, that the first meeting
should be held on or before October 1, 2025, and the
issues to be investigated for the preliminary report
which will be presented at the first meeting.
Section 4 amends the uncodified law of the State of
Alaska by adding a new section establishing the date
for preliminary internet website publication of the
publication to be no later than July 1, 2026.
Section 5 amends the uncodified law of the State of
Alaska by adding a new section instructing the
Department of Health to amend the state plan under AS
47.07.045 and submit for approval to the United States
Department of Health and Human Services, to the extent
necessary.
Section 6 amends the uncodified law of the State of
Alaska by adding a new section that makes this Act
conditional on the United States Department of Health
and Human Services approving amendments submitted in
accordance with section 5, or determines that approval
is not necessary.
Section 7 sets the day after the date on which the
United States Department of Health and Human Services
approves amendments to the state plan or determines
that approval is not necessary under section 6 of this
act, as the date section 2 of this Act takes effect.
Section 8 sets July 1, 2025 as the date the Act takes
effect, except as provided in section 7.
3:50:43 PM
REPRESENTATIVE GRAY asked what percentage of funding to agencies
under the Department of Health is currently going to personal
care services.
MR. NYE responded that the breakdown is currently 50/50.
REPRESENTATIVE GRAY asked if other states have implemented
similar legislation to HB 96 and what their experience has been
like.
REPRESENTATIVE PRAX responded that he does not know if other
states have passed similar legislation.
3:52:58 PM
TONY NEWMAN, Director, Division of Senior and Disabilities
Services, Department of Health, said that the state would need
to apply for a state plan amendment, which can take a few
months. He said that other states have created boards of this
kind and have found it to be helpful.
3:54:30 PM
REPRESENTATIVE SCHWANKE asked if this board would require an
executive director.
MR. NEWMAN responded that there is no requirement under HB 96
for an executive director and that his division has submitted a
fiscal note asking for two staff to assist with the work
required by HB 96. In response to Representative Schwanke, he
explained the workload that would require two staff members.
3:55:47 PM
CHAIR MINA asked if the Home Care Employment Standards Advisory
Board would focus only on Medicaid rates or if it would be
looking at grants and other funding from the Department of
Health.
REPRESENTATIVE PRAX responded that the board would have to
comply with Medicaid rates.
MR. NEWMAN said that HB 96 would ensure that the Division of
Senior and Disabilities Services is in compliance with the
federal Medicaid Ensuring Access Rule.
CHAIR MINA asked what types of providers would be under the
purview of this board.
MR. NEWMAN said that both the federal rule and HB 96 would have
two requirements: wage transparency for a range of professional
services and wage adequacy provisions.
CHAIR MINA asked if the board is narrowed to specific types of
caregivers because of the federal Medicaid Ensuring Access Rule.
MR. NEWMAN responded that he believes that is true.
REPRESENTATIVE PRAX emphasized that the federal Medicaid
Ensuring Access Rule is quite extensive.
4:00:26 PM
CHAIR MINA announced invited testimony.
4:00:43 PM
ALEXIS RODICH, Director of Policy & Research, SEIU 775,
described the recent increase in the senior population of Alaska
and the increased need for care services. She said that HB 96
would help reduce the "workforce crisis" in direct care services
by creating a labor rate for personal care services and
increasing rate transparency. She emphasized the importance of
a workforce standard advisory board, which would be created
under HB 96.
4:08:01 PM
ROSE CHILDS, Caregiver, representing self, testified in support
of HB 96. She described her personal and work experience as a
caregiver. She said that there has been a decline in the direct
service provider profession, but emphasized the need for it.
4:13:30 PM
BETTY REDD-MENDEZ, Caregiver, representing self, described her
experience as a caregiver to her family members. She emphasized
the challenges she faces due to her profession, including no
health insurance and low pay. She explained how an advisory
board would allow caregivers to advocate for better pay, health
insurance, and other critical needs.
4:17:13 PM
ESSIE FRANK, Caregiver, representing self, described her
experience as a caregiver. She said that many caregivers
struggle financially due to low wages. She said that HB 96
would allow her voice and the voices of her clients to be heard.
4:20:13 PM
CHAIR MINA opened public testimony on HB 96. After ascertaining
that there was no one who wished to testify, she closed public
testimony.