Legislature(2019 - 2020)GRUENBERG 120
03/28/2019 03:00 PM House STATE AFFAIRS
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| Audio | Topic |
|---|---|
| Start | |
| HB96 | |
| HB71 | |
| HB82 | |
| Adjourn |
* first hearing in first committee of referral
+ teleconferenced
= bill was previously heard/scheduled
+ teleconferenced
= bill was previously heard/scheduled
| += | HB 96 | TELECONFERENCED | |
| += | HB 71 | TELECONFERENCED | |
| *+ | HB 82 | TELECONFERENCED | |
| + | TELECONFERENCED | ||
| + | TELECONFERENCED |
HB 96-PIONEERS' HOME AND VETERANS' HOME RATES
3:08:12 PM
CO-CHAIR KREISS-TOMKINS announced that the first order of
business would be HOUSE BILL NO. 96, "An Act relating to Alaska
Pioneers' Home and Alaska Veterans' Home rates and services."
3:08:41 PM
REPRESENTATIVE SHAW moved to adopt the committee substitute (CS)
for HB 96, [Version 31-LS0646\U, Marx, 3/27/19], as the working
document. There being no objection, Version U was before the
committee.
3:08:59 PM
CO-CHAIR FIELDS, as prime sponsor of HB 96, Version U, remarked
that there were a few substantive changes in Version U. He said
that the cost of the Alaska Pioneer Homes (APH) failed to keep
pace with inflation going back to 2004; therefore, in Version U,
the rates for Levels I-III align with what 2004 rates would have
been if they had kept pace with inflation. He stated that
because the population of APH has changed, under Version U, the
current three tiers of care would be expanded to five tiers of
care. This change is consistent with the current direction of
the management of APH and with the Agnew::Beck [Consulting]
study ["Staffing Plan and Cost Impact Analysis for the Alaska
Pioneer Homes," 11/29/18, document not provided]. He explained
that having complex behavior neighborhoods within APH allows
residents to be moved from Alaska Psychiatric Institute (API) to
APH, thus, saving the state money. He relayed that under
Version U, the Consumer Price Index (CPI) would be replaced with
the Social Security [Administration] (SSA) cost-of-living
adjustment, which is preferred by the Department of Health and
Social Services (DHSS).
CO-CHAIR FIELDS maintained that the proposed legislation would
still provide certainty to residents that rate increases would
be capped and indexed annually to inflation. He expressed his
hope that under Version U, APH rates would keep pace with
inflation and provide a balance between capturing a fair share
of the revenue yet protecting consumers by ensuring
accessibility.
CO-CHAIR FIELDS related that through research, his staff
confirmed that under Version U, the state would capture the full
value of long-term care insurance. He clarified that with the
value of standard long-term care insurance and the average
tenure of residents in APH, the rates under Version U would
capture the full value - the maximum payout - of the typical
long-term insurance plan, except in very unusual circumstances.
3:12:53 PM
REPRESENTATIVE STORY asked whether there was a need to raise
rates to bring them up to date and whether a public comment
period would be necessary if it was determined that rates needed
to be higher than the SSA index.
REPRESENTATIVE FIELDS responded that under Version U, the
maximum rate increases would be capped at the SSA increases. If
in the future the legislature decided that more revenue was
needed for Level III care and could be collected, a statutory
change would be required. He maintained that this was the
reason for bringing the rates up to date for inflation.
3:14:14 PM
REPRESENTATIVE VANCE cited the Agnew::Beck study and the efforts
of APH to assess whether the needs of Alaskans are being met,
the sustainability of its services, the intense needs of
dementia patients, and the tiered levels of care. She mentioned
that the study was the first of its kind to be done on APH. She
asked for comment regarding the scenarios that have been
recommended for implementation for best practices to utilize the
beds and services to the community. She asked how Version U
would help APH reach that goal.
REPRESENTATIVE FIELDS expressed his belief that the Agnew::Beck
study properly recognized that APH has always had a diverse mix
of residents. Some residents are quite independent and other
have much more intense needs. The Agnew::Beck study supports
continuing to have a diverse group of residents. He maintained
that Version U is targeted toward APH continuing to be welcoming
to people who live independently. It has been suggested that
APH could be exclusively for people needing higher level of care
and could exclude the traditional population of self-pay people
who live independently in the Level I service of care. He said
that the Agnew::Beck study maintains that it is valuable to have
a diversity of residents in APH - in terms of social
relationships and quality of life. He commended APH staff who
try to accommodate residents with a wide range of needs.
3:16:55 PM
REPRESENTATIVE VANCE cited page 7 of the study under the section
entitled "Cost Impact Key Findings," which read in part as
follows:
Scenario 1: Operational status quo.
Scenario 2: Balance the social and medical
services of assisted living and operate at full
capacity.
Scenario 3: In addition to the assumptions in
Scenario 2, increase number of higher acuity
residents served to maximize community benefit.
REPRESENTATIVE VANCE directed attention to the cost analysis in
the study demonstrating the financial impact of moving from
Scenario 1 to Scenario 2 and 3. She expressed that she does not
understand how Version U of HB 96 would help reach the goal of
generating the revenue and meeting the needs of the residents.
REPRESENTATIVE FIELDS answered that a key change under Version U
is the expansion to five tiers of care. He cited page 8 of the
study, which read:
However, the rate structure of the Pioneer Homes does
not currently reflect the actual cost of this higher
level of care, so the increased revenue does not cover
the increased costs. This is most pronounced when
staffing up for a complex behavior neighborhood at a
higher staffing intensity of one direct care aide
(such as a CNA) for every three residents, 24 hours
per day, seven days per week. Under the current rate
structure, these residents would be charged for level
3 services.
CO-CHAIR FIELDS said that under Version U and in APH's internal
planning, APH would have five levels of care; the fifth level of
care would have higher reimbursement rates because the care is
higher intensity. He added that even if the state did not
capture higher reimbursement rates, it could still save money
through a fifth tier of care - a complex behavior neighborhood -
in a separate area in the APH building. People with complex
behavior health needs could be relocated from API, which would
bring in over $500,000 per year. He maintained that the major
change in the proposed legislation - allowing for the fifth tier
of care - supports the cost-saving measure, the quality of life
measure, and the safety measure. He added that under Version U,
the fifth tier allows for prices to match the cost of care -
recognizing that there could be higher reimbursement rates for
tier-five care. He pointed out that for the existing tiers, APH
would provide a degree of protection for residents who expected
affordable rates.
3:21:22 PM
REPRESENTATIVE VANCE asked whether APH could implement the five
tiers of care if mandated under Version U. She also asked
whether APH could implement Scenario 2, as outlined in the
study.
3:22:25 PM
CLINTON LASLEY, Director, Division of Alaska Pioneer Homes
(DAPH), Department of Health and Social Services (DHSS),
responded that under Version U, which caps rates not meeting
current costs to provide services, and the state budget that has
been passed by the House Finance Committee, there would not be
the funding. The way the budget has been proposed, APH would
charge the full rate of providing services, and there would be
no general fund (GF) money within the APH component of the
budget. The only GF money would be in the payment assistance
component of the budget, which would be a separate component.
Individuals who are "private pay," although still being
subsidized by the state, would be paying the full rate requested
by APH and would not qualify for payment assistance; therefore,
APH would not be able to use the payment assistance component
funds for them. Under payment assistance there is an income
requirement, and if a person's resources are above the level
set, he/she would not qualify for payment assistance and APH
would not be able to use the payment assistance funds. He
concluded that APH could not continue to operate as it is
currently, if the rates are capped as outlined under Version U.
REPRESENTATIVE VANCE asked how APH would provide for current
residents.
MR. LASLEY reiterated that the current version of the budget
does not fund individuals not on a payment assistance program.
The budget was designed with the intent that APH would charge
residents what it truly costs to provide services. Under
Version U, Level IV would be capped with a $10,000 maximum rate;
it currently costs $13,333 to provide that service, which leaves
a $3,333 gap. If an individual can pay the $10,000, then the
state would subside the $3,333. In that case, the individual
would not qualify for payment assistance because he/she would be
paying the full rate, and APH would not be able to use the funds
in the payment assistance component. It is designed to be used
only for those individuals who qualify for payment assistance.
He concluded by saying, "That's where the challenge is with not
charging the full rates as they cost to provide service."
3:25:52 PM
REPRESENTATIVE LEDOUX asked what assets one can have and still
qualify for the payment assistance program.
MR. LASLEY replied that statute lists the resources and assets a
person may retain and still be on the payment assistance
program. He said that primarily the person must be in a
position in which he/she truly needs assistance; resources must
have been liquidated; however, there are items that the person
is allowed. He stated that there is a payment assistance
application; total income and resources are considered to
determine whether the person meets the income level requirement.
Examples of items allowed include $2,000 in assets, a burial
account, resources to pay insurance premiums and federal taxes,
and one's spouse may retain the home.
REPRESENTATIVE LEDOUX asked why a person with only $2,000 would
be paying federal taxes.
MR. LASLEY explained that individuals on payment assistance
might be receiving resources monthly; they pay what they can pay
out of resources. He gave an example: Someone receiving Level
II services under a rate of $4,600 per month receives $2,000 per
month in SSA income. The state reduces its subsidy by the
amount the person can pay; the person keeps $200 per month for
personal needs; the remaining amount is subsidized by the state.
He confirmed for Representative LeDoux that a person can keep
$200, not $2,000 per month.
REPRESENTATIVE LEDOUX asked for confirmation that his example
represents how the program works currently.
MR. LASLEY agreed that what he described was how the program
works today, and it is in statute.
3:29:22 PM
REPRESENTATIVE LEDOUX asked whether under the proposed budget of
the governor [Governor Michael J. Dunleavy], there is no money
for APH in GF.
MR. LASLEY answered that the funds sourced from GF have now been
put into a need-based system, which is a separate component, and
everyone who needs assistance would apply for payment
assistance. Whatever an individual cannot pay would be taken
from the payment assistance component.
REPRESENTATIVE LEDOUX posed a hypothetical situation: The
budget sent to the governor is somewhat different than the
governor's proposed budget. There is [APH] money in a GF
component of the budget, but not much was in the new payment
assistance component. The proposed legislation passed, but the
governor vetoed the GF component portion. She asked what would
happen to APH under the scenario she described.
MR. LASLEY responded that he cannot speak to hypotheticals. He
said that if [APH] funds sourced from GF were put back into the
budget by an entity other than the governor, and the funds were
vetoed, then there would be no funds to operate APH as it
currently exists. He explained that the governor made a
commitment to APH that there would be funds available for
individuals who can't pay; GF for that purpose is still in the
budget but in a separate component, which is a need-based
component. If GF funds in the main budget were cut, but money
was still in the payment assistance component, money would be
available for those who truly need the services.
CO-CHAIR KREISS-TOMKINS explained that GF refers to cash in the
state's treasury.
3:33:08 PM
REPRESENTATIVE FIELDS commented that his office has been
coordinating with Representative Spohnholz, co-chair of the
House Health and Social Services Standing Committee, and
Representative Johnston, a member of the House Finance
Committee, to ensure that there is adequate GF for APH to be
sustainable. He stated that there are two moving pieces - the
budget and the proposed legislation; he intends to continue
coordinating with the House Finance Committee to avoid the
budget being inconsistent with legislation and to allow the
director of APH maximum flexibility.
CO-CHAIR KREISS-TOMKINS mentioned that the final decisions on
both the budget and the proposed legislation - absent line-item
vetoes - rests with the legislature; therefore, it behooves the
legislature to coordinate with itself to ensure that HB 96,
Version U, is in comportment with the operating budget. If the
governor wants to line-item veto the funding, he can answer to
the seniors in APH.
REPRESENTATIVE WOOL asked if billing at APH is like hospital
billing, in which costs are inflated to pay for those who can't
pay and because insurance companies typically underpay. He
asked, "When you say your true cost is $13,000 ... is that truly
your cost?"
MR. LASLEY responded, "That is our true cost." He explained
that APH charges what it costs to provide services.
REPRESENTATIVE WOOL asked for confirmation that if a certain
level of care costs $13,000 and the maximum charged by APH is
from $6,000-$10,000, even if someone pays the full rate, APH
loses money on every single person staying at an APH facility.
MR. LASLEY answered, "That is correct."
REPRESENTATIVE WOOL expressed his understanding that the intent
of the proposed rate increase is to fully recover the true cost
for those who can pay.
MR. LASLEY relayed that the payment assistance program has been
in statute for a long time; therefore, there is a program in
place that identifies those individuals who do not have the
ability to pay, and the state will subsidize the difference
between the resources of an individual and the amount charged.
He said that currently, APH is not charging the true cost of
providing the service; therefore, it is subsidizing individuals
who can pay. He said that the proposed system, with the new
payment assistance component, was designed to subsidize only
those who truly need assistance and not every resident of APH.
3:39:01 PM
REPRESENTATIVE WOOL asked how the payment assistance has been
funded.
MR. LASLEY said that currently there is about $33 million of GF
in the APH component of the budget. The proposed budget would
move that GF to a separate component that would be used only for
those individuals needing assistance; APH rates would be
increased to be reflective of what it costs to provide services,
therefore, capturing from those who can pay the true cost. For
those who need assistance, APH would pay from the payment
assistance component the true amount that is needed.
REPRESENTATIVE WOOL suggested that raising rates would put more
individuals into the category of needing assistance and the
state cannot predict the effect of that.
MR. LASLEY answered that Representative Wool was correct. He
said that several years ago DAPH started asking residents for
information on their resources to predict the future need for
assistance or eligibility for federal programs. He agreed that
it is somewhat unknown, and for individuals who are living in
APH currently, paying the new rate will cause them to deplete
their resources quicker. He said that one of the challenges of
APH is not knowing the resources of the individuals in APH or
those that will be moving into APH in the future. The system is
designed to serve all Alaskans regardless of ability to pay; the
proposal under the governor's budget is that those who can pay
will pay and the remaining amount will be subsidized.
REPRESENTATIVE WOOL pointed out that the question is whether the
state wants to subsidize the cost of care for every resident of
APH or only for those in need. He acknowledged that such a rate
increase would stress a person's finances.
MR. LASLEY agreed that it is a philosophical question for which
the state must decide.
3:44:26 PM
REPRESENTATIVE STORY maintained that under the DHSS proposal the
long-term policy of the state to provide seniors assistance for
care would shift to one in which the expectation is for seniors
to be self-sufficient.
MR. LASLEY asserted that under the regulations proposed, there
would be no change in the way APH operates. The proposal does
not require individuals be self-sufficient; the rates would
reflect the cost to provide care; if individuals can pay, the
states asks for them to pay; if they can't pay, the protection
of the payment assistant program is available. He emphasized
that it would not be a shift in policy but establishing rates
that are reflective of what it truly costs APH to provide
services.
3:46:13 PM
REPRESENTATIVE LEDOUX relayed that APH is most likely the last
home for a resident. She suggested that the committee or the
legislature must decide whether the state wants its seniors to
be able to will their assets to their heirs or pay what they can
to the State of Alaska for the services. She maintained that
assets of $500,000 or $1 million would disappear quickly at
$15,000 per month. She added that seniors could continue living
in APH, but when they die, there would be no assets for their
heirs.
REPRESENTATIVE FIELDS offered that the actual question is, What
is the correct rate structure so that APH remains attractive to
a diverse population - a healthy mix of socioeconomics. He
maintained that if the rates are too high, the state is
inadvertently telling people to go to the Lower 48 for assisted
living care. According to the Office of Management & Budget
(OMB) presentation to the House Health and Social Services
Standing Committee Finance Subcommittee on 3/5/19, [included in
the committee packet], other regions have comparable rates for
assisted living; it is about $5,000 per month in the Pacific
Northwest. He asserted that the state is trying to strike a
balance between APH being financially sustainable yet continuing
to attract people, which requires that APH continue to attract
middle class and affluent people. Under any model, senior care
is expensive, and people will deplete much of their savings. He
said that rates too high would discourage affluent people from
moving into APH, which raises a concern for the long-term
political and financial viability of APH. He emphasized that
APH are incredibly valuable, an important resource for the
state, and part of the state's commitment to Alaska seniors;
therefore, they must be financially viable into the long-term.
3:50:28 PM
CO-CHAIR KREISS-TOMKINS opened public testimony on HB 96,
Version U.
3:50:54 PM
MIKE COONS stated that he opposed HB 96 and supports the model
in the governor's budget presented by Mr. Lasley.
3:52:57 PM
STAN PARROT, as a resident of the Veterans & Pioneer Home, had
his testimony read by Lisa Smayda as follows [original
punctuation provided]:
I, Stan Parrott, am concerned that the governor is
considering cutting funding for the Pioneer Homes.
These facilities are necessary for our state's Senior
Residents because most of them are unable to live on
their own and many of their families are unable or not
in Alaska to care for them. These seniors who have
given so much to society now need society's help.
If funding is cut, then many of the Pioneer Homes
would not be able to remain open. If they closed their
doors where would the residents go? There are few
private facilities in the state and none that offer
the care and respect for which the Pioneer Homes are
noted.
Living should be more than existing, and the Pioneer
Homes offer activities that enrich the lives of the
people who live here. Speaking specifically of the
Pioneer Home in Palmer I want to make sure you are
aware of the care the staff and volunteers take
with each resident. They do their best to ensure all
needs (physical/ mental/ emotional) are met.
3:55:46 PM
ANNEMIEK BRUNKLAUS, as a resident of the Veterans & Pioneer
Home, testified that she supports HB 96. She stated that she is
88 years old, has lived in Alaska since 1960, has no family in
Alaska, and cannot afford to live anywhere else.
3:57:09 PM
ARDIS STANLEY, as a resident of the Veterans & Pioneer Home
Veterans & Pioneer Home, testified that she has found the care
at the Pioneer Home exceptional. She has been at three other
locations in Alaska near Palmer and Anchorage. Her family is
close by to visit. She asked for information on the proposals
that would be understandable to residents.
4:00:24 PM
BILL BROKAW testified that he has been a resident of the
Veterans & Pioneer Home for nine months; he moved in because of
his wife's Alzheimer's disease. He stated that he would not be
able to afford the increased rate. He offered that he is not
yet familiar with what HB 96 proposes; however, if it proposes a
cost-of-living increase, then he believes he would be able to
afford that level of increase.
REPRESENTATIVE LEDOUX asked Mr. Brokaw whether the following
scenario would cause him concern: the governor's proposal was
adopted; the charge went up to $15,000; however, the state
provided payment assistance funds to pay for the charge.
MR. BROKAW replied that he has been told that the rate could
increase, and because the state would loan him money to pay the
charge, he would be able to afford it. He expressed his
understanding that it would be a loan; it would need to be
repaid; and the state, instead of his children, would receive
his assets.
4:04:39 PM
DAVE BROWN, as a resident of the Veterans & Pioneer Home,
testified that he gets excellent care at the home; he has
suffered several traumas in the last couple years; and he has
very little family. If the governor's proposed budget is
adopted, Mr. Brown does not know if he could afford the
increased rate. He offered his support for HB 96, because he
could afford a cost-of-living rate increase.
4:05:54 PM
DOROTHY DITTMAN, as a resident of the Veterans & Pioneer Home,
testified that her understanding is that the rate for the home
will more than double in 2019. She asked, "What is the outlook
for the Pioneer Homes, particularly the Veterans & Pioneer
Home?" She offered that privatizing the Pioneer Homes would
result in either collusion or competition with the private
sector nursing homes.
4:08:34 PM
ROCKY PLOTNICK stated that she supports HB 96 in order to
maintain reasonable prices for residents of APH. She stated
that her husband has Parkinson's disease and is a resident of
the Anchorage Pioneer Home. She maintained that the home
provides a wonderful, vibrant, and diverse community. She
relayed that the original intent of APH was to allow Alaskans to
live out their final years with respect and dignity. She
reminded the committee that APH was established long before
Alaska was enriched with oil money or permanent fund dividend
(PFD) payments were made. She offered that continuing to fund
APH is a bipartisan Alaska issue; and it is the right thing to
do to have compassion and take care of Alaska's seniors.
4:11:24 PM
KATIE BOTZ testified that elders have helped Alaska in so many
ways. She maintained that it is only right that the state
repays them by taking care of them.
CO-CHAIR KREISS-TOMKINS closed public testimony on HB 96,
Version U.
4:15:20 PM
MR. LASLEY, in response to the question posed by Ms. Dittman,
said that the governor's budget does not propose privatizing APH
or having APH compete with the private sector. He relayed that
the governor has made a commitment to every senior in Alaska
that APH will be fully funded; the current budget proposal fully
funds them but under a different funding mechanism; the funding
in the fiscal year 2020 (FY 20) budget is the same as in the FY
19 budget. He maintained that there has been no discussion on
privatization of APH; the administration guarantees that every
APH resident has a home and community in which to celebrate life
until his/her final breath. He gave his assurance that the
state is not changing how APH operates; everyone in APH is
protected; it is in statute. He maintained that for individuals
in APH who are currently on payment assistance, nothing would
change under the rate increase proposal. For those on Medicaid
waivers, their resources have already been submitted and a
determination made of their qualification for Medicaid waiver
benefits; nothing more would be asked of them. He asserted that
for those on the payment assistance program, nothing more would
be asked of them, because it has already been determined that
they do not have the resources to pay the full rates. The state
is subsidizing these residents. He maintained that the only
change is for individuals who are in a home or moving into a
home in the future and have resources above what is currently
being charged. These people would be asked to pay the
difference between what is currently being charged
and the true cost of providing services. If they cannot pay
that difference, then the payment assistance program would be
utilized.
MR. LASLEY, in response to Mr. Brokaw, whose wife is in APH and
receiving Level III services, explained that if she is on a
Medicaid waiver, there is no indebtedness to the state;
therefore, Mr. Brokaw would not need to expend his resources
above what he is already expending. He continued by saying that
for someone on payment assistance who has a spouse in the
community, the state would only consider the resources of the
individual in the home and file a claim against that
individual's estate - not against the individual's spouse living
in the community. He clarified that [payment assistance] is not
a loan to the spouse living in the community; it is an
indebtedness to the state for the individual in the home only.
4:19:54 PM
REPRESENTATIVE WOOL asked if a dependent of a resident of APH -
a spouse or offspring - would be asked to pay APH charges, or
only the resident.
MR. LASLEY responded that under the payment assistance program,
a dependent's resources would not be considered, but a spouse's
resources would be considered. If the spouse is living in the
community, there are provisions in the payment assistance
program to allow the spouse to keep resources necessary to
provide quality of life and keep the home. The resources of any
other person who is paying for the care of the individual in the
home are not considered. If the rates increase, a son or
daughter can choose to pay a portion; however, their resources
are not considered to be resources of the elder living in the
home.
REPRESENTATIVE WOOL mentioned that the sponsor of the proposed
legislation discussed the concept of striking the right rate
balance. If it is too high, people will not choose to live in
APH, and the only residents living there will be the ones who
are subsidized. If it is too low, it would be because the state
is providing everyone subsidy. He mentioned that residential
care may be lower in another state; however, if the resident
runs out of money, most likely that other state would not
subsidize payment. He said that Mr. Lasley has assured the
committee that in Alaska, the state will cover the charges. He
suggested that Alaskans are understandably anxious about the
policy changing in the future.
MR. LASLEY reaffirmed that under the state's long-term model,
residents who use up their resources and don't have the ability
to pay would not be evicted; it is clear in statute and will not
change. He mentioned Co-Chair Fields's reference to the socio-
economic mix of APH and said that APH has never considered the
socio-economic status of an individual when he/she is moving
into a home. He said that APH is for everyone 65 and older who
has the need to move into a Pioneer Home, regardless of his/her
resources. He mentioned that it is nice to have a socio-
economic and ethic mix of people from all backgrounds; however,
APH does not accept individuals based on their resources; it
wants to serve individuals that choose and need to live in APH.
4:25:08 PM
REPRESENTATIVE LEDOUX said that even if the spouse [of an APH
resident] had possession of the home, a $15,000 monthly payment
to APH would indubitably have a large impact on the spouse's
life. She offered that in many marriages, the assets are
totally joint; and if they are not joint and are totally in the
possession of the person in APH, the spouse could be left in a
bad way. She asked for a clarification of treatment of assets
in these situations.
MR. LASLEY replied that by statute and regulation, the spouse is
allowed the primary residence, $2,000 for one's personal needs,
and some other assets. The DHSS has requested a regulation
change to change the amount allowed for personal needs to
reflect the standard used under the Medicaid waiver, which is
$3,100. He stated that he would provide more information.
REPRESENTATIVE LEDOUX stated that mortgage payments of $1,500 -
$2,000 per month would leave the spouse very little money even
if the amount allowed is increased to $3,100.
MR. LASLEY replied that neither HB 96, Version U, nor the
current statute would change that policy. He offered that any
federal or state assistance program has resource limits and
resource requirements. He reiterated that the allowance has
been $2,000 for many years; DHSS is requesting the amount be
tied to Medicaid at $3,100 per month.
REPRESENTATIVE LEDOUX relayed that the difference [under the
governor's budget] is that the maximum rate is now $15,000,
which would quickly deplete the estate and leave the spouse in a
difficult predicament. She maintained that she is sympathetic
to the concept of raising the rates when she views it in the
context of the assets going to the entity that is providing care
versus the heirs. She emphasized that concern for the spouse
presents a much different view.
MR. LASLEY relayed that if there is a mortgage on the spouse's
primary residence, it is a deduction that can be taken through
the assistance program. By statute, the payment assistance
program protects the spouse living in the community; the
proposed $3,100 would be for the spouse's personal needs; and
deductions may be taken for taxes, insurance premiums,
medications, the cost of maintaining the home, and similar
items.
CO-CHAIR KREISS-TOMKINS stated that HB 96, Version U, would be
held over.