Legislature(2019 - 2020)SENATE FINANCE 532
03/23/2020 09:00 AM Senate FINANCE
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| Audio | Topic |
|---|---|
| Start | |
| HB139 | |
| HB96 | |
| HB106 | |
| HB235 | |
| Adjourn |
* first hearing in first committee of referral
+ teleconferenced
= bill was previously heard/scheduled
+ teleconferenced
= bill was previously heard/scheduled
| + | TELECONFERENCED | ||
| += | HB 106 | TELECONFERENCED | |
| += | HB 96 | TELECONFERENCED | |
| += | HB 139 | TELECONFERENCED | |
| += | HB 235 | TELECONFERENCED | |
CS FOR HOUSE BILL NO. 96(FIN)
"An Act relating to Alaska Pioneers' Home and Alaska
Veterans' Home payments, rates, and services."
9:28:37 AM
Co-Chair von Imhof shared that the bill had been heard on
March 9, 2020. She relayed that a CS had been distributed
for consideration.
Ms. Lucky discussed the changes in the CS. She spoke to an
Explanation of Changes document (copy on file):
The criteria for the levels of care are removed from
statute and will be defined by regulation. These
changes can be seen in sections 7, 10, and 11 of the
bill.
NEW: Section 1: Changes the word "lease" to "use" to
allow Pioneer Homes more flexibility in increasing
revenue with excess space. NEW:
Section 2: Decreases the age of eligibility to 60
(from 65) for Alaskan residents due to dementia,
physical disabilities, and other physical needs. This
will allow more flexibility, especially in allowing
spouses to move into the home together.
AMENDED: Section 7: Two rate caps were increased:
1. the level IV rate was increased to $9,333 (from
$8,500) in (4); and
2. the daily rate for "respite" care was increased to
$200 (from $160) in (6).
NEW: Effective date of July 1, 2020.
The changes to the monthly income threshold in the
bill are removed; income thresholds will remain as
they are in current statute. The language previously
appeared in sections 3 and 4 of the bill.
Ms. Lucky explained that the monthly threshold change had
been made due to concern that the rates would be changed
for Pioneer Homes only and similar facilities in the state
would have a different rate.
9:32:35 AM
Co-Chair Stedman asked for clarity regarding the spendable
monthly allowance for residents who received financial
assistance. He understood that and earlier version had
allowed for $500, the current version allowed for $200.
Ms. Lucky replied in the affirmative. She said that the
previous bill would have increased the amount a resident
could keep to $500 per month.
Co-Chair Stedman reminded the committee that the base rates
were being changed. He asked about the rate of growth in
the current version.
Ms. Lucky deferred to the Department of Health and Social
Services.
9:33:39 AM
Co-Chair von Imhof clarified Co-Chair Stedmans question.
CLINTON LASLEY, DEPUTY COMMISSIONER, DEPARTMENT OF HEALTH
AND SOCIAL SERVICES, stated that in the CS the rate was not
tied to cost of living increase (COLA). He believed that
the bill sponsor could speak to the question.
9:34:41 AM
Ms. Lucky stated that the rate of growth had not changed in
the CS. The rate of growth remained the same as the
original bill.
Co-Chair Stedman asked what the calculation was based on.
Ms. Lucky specified that the amount was the Social Security
benefits cost of living.
Co-Chair von Imhof spoke to the Social Security Act:
under the Social Security Act the department shall
adjust the monthly and daily rates of this section by
percentage equal to the percentage increase in the
cost of living adjustment provided of the Social
Security benefits.
9:35:45 AM
Senator Wielechowski asked whether there were provisions in
the bill requiring notice for rate increases.
Ms. Lucky responded in the negative and deferred to the
bill sponsor.
Co-Chair von Imhof understood that notification
requirements would be discussed my Mr. Lasley.
9:36:23 AM
Mr. Lasley stated that residential licensing for the state
required at least 30-days' notice be given to a resident
prior to a rate increase. He said that the department
followed this requirement in their practices.
Co-Chair von Imhof understood that residents and their
families would receive 30-days notice on rate changes.
Mr. Lasley replied in the affirmative.
9:36:55 AM
Senator Olson asked whether the sponsor supported the
changes in the current CS.
Ms. Lucky stated that the sponsor had been involved in the
crafting of the CS. She deferred to the sponsor for further
clarification.
Co-Chair von Imhof suggested inviting the sponsor to the
table.
9:37:29 AM
REPRESENTATIVE ZACH FIELDS, SPONSOR, expressed support for
the CS.
9:37:56 AM
Co-Chair Stedman MOVED to ADOPT proposed committee
substitute for CSHB 96(FIN), Work Draft 31-LS0646\E (Marx,
3/21/20). There being NO OBJECTION, it was so ordered.
9:38:32 AM
AT EASE
9:40:28 AM
RECONVENED
Co-Chair von Imhof relayed that while the committee was
waiting for documents to be distributed Senator Wilson
would speak to Amendment 1, regarding a sunset date.
Senator Wilson MOVED to ADOPT Amendment 1, 31-LS0646\E.1
(Marx, 3/22/20) [note: due to length, Amendment 1 is not
included here. See copy on file].
Senator Wilson spoke to Amendment 1. He explained that the
amendment was a sunset date for a five-year repeal. The
sunset date was to ensure that rates were on track with the
consumer price index (CPI).
Representative Fields stated he would defer to the will of
the committee. He emphasized that stability and
predictability for Pioneer Home residents was important for
the Pioneer Homes overall finances. He did not see the
need for a sunset, as the legislature could repeal the bill
in the future.
9:42:12 AM
Co-Chair Stedman was concerned with the aggressiveness that
the agency adopted an escalation in fees. He did not think
the process had been long enough nor had the public been
sufficiently informed. He relayed that he was hesitant to
sunset the legislation. He felt that the issue should come
back to the table in the future. He contended that the fees
were still too high and should be lowered.
Co-Chair von Imhof stated that the rate the committee
considered was one of the lowest rates, year over year,
compared to CPI or medical CPI. She affirmed that if an
imbalance was found, the department could alert the
legislature and suggest changes. She asked for verification
the amendment would implement a sunset date of 2025.
Senator Wilson responded affirmatively.
Co-Chair von Imhof MAINTAINED her OBJECTION.
A roll call vote was taken on the motion.
IN FAVOR: Wilson
OPPOSED: Olson, Wielechowski, Bishop, Hoffman, Stedman, von
Imhof
The MOTION to adopt Amendment 1 FAILED (1/6).
9:45:02 AM
Senator Wilson MOVED to ADOPT Amendment 2, 31-LS0646\E.2
(Marx, 3/21/20) (copy on file):
Page 4, line 9:
Delete "$9,333 a month"
Insert "a monthly rate the department considers
sufficient to compensate the state for the cost of
care and support of the person at the home"
Co-Chair von Imhof OBJECTED for discussion.
Senator Wilson spoke to the amendment.
9:46:57 AM
Representative Fields did not support the amendment. He
reminded that individuals in Level 4 care were already
experiencing large rate increases. He said that the CS
contained a sizeable rate increase for those residents who
had been at Level 3 under previous rate structures. He did
not support uncapping the rate increase and reiterated the
need for stability and predictability in rate levels. He
said that the state should be trying to get more revenue
for skilled nursing level care, but he believed that a
better way to do that would be for the department to pursue
certification for the nursing home level of care.
9:48:27 AM
Senator Wilson lamented that he had not received answers
from questions he had submitted to the department.
Co-Chair von Imhof queried whether Level 4 patients had
left facilitates due to the rate increase.
Mr. Lasley stated that the number of individuals that had
moved out of the Pioneer Homes system since the
announcement of the rate increase on August 1, 2019, was
24. He said that 18 were directly related to the rate
increase. He stated that he would get back to the committee
about Level 4 patients specifically.
Co-Chair von Imhof found it interesting that the state
already provided subsidies for various populations such as
students, special-needs students, college students, and
many kinds of transportations. She acknowledged that the
rates in the bill had increased rates for Level 4 care. She
recalled conversations about the distribution of PFDs that
suggested that $2000 could stand between starvation or
hypothermia. She countered that the bill would make elderly
people pay an additional $4000, per month, for care.
9:51:29 AM
Senator Olson referenced the 24 people that left the
Pioneer Homes and asked whether there were currently
vacancies.
Ms. Lasley confirmed that there were vacancies in all
Pioneer Homes across the state. He noted that there was
currently about a 91 percent occupancy rate.
Senator Olson thought if the idea was to increase revenue
to the state, the state should be working to keep that
occupancy rate a 99 percent.
Co-Chair von Imhof added that when running the numbers, if
a person had a certain level of assets, and was charged
$13,000 per month rather than $9,000, the state would
subsidize them for less time. The assets would last longer
paying slightly less than full rate and the state paid less
overtime.
Senator Olson maintained his opinion.
9:53:06 AM
9:53:08 AM
Co-Chair von Imhof MAINTAINED her OBJECTION.
A roll call vote was taken on the motion.
IN FAVOR: Wilson
OPPOSED: Olson, Wielechowski, Bishop, Hoffman, von Imhof,
Stedman
The MOTION to adopt Amendment 2 FAILED (1/6).
9:53:34 AM
AT EASE
9:53:51 AM
RECONVENED
Co-Chair von Imhof noted that Amendment 2 had failed, and
Co-Chair Stedman would offer a conceptual amendment.
Co-Chair Stedman MOVED to ADOPT Conceptual Amendment 1. He
explained that the original bill had included $500 for
spend money for Pioneer Home residents. The amount in the
current bill was $200. The amendment would increase the
amount by $100 to a total of $300 per month.
Co-Chair von Imhof OBJECTED for discussion.
Representative Fields asked the department what the maximum
level residents could collect without any negative
unintended consequences in terms of Medicaid eligibility or
other.
Ms. Lasley stated that the department would not be opposed
to raising the amount.
Representative Fields thought the conceptual amendment made
sense.
9:55:40 AM
Senator Olson reiterated the question about any negative
consequences due to the raise from $200 to $300.
Mr. Lasley addressed the previously proposed $500 limit for
monthly spending. He stated that the long-term unintended
consequences for the $500 limit pushed against the limit of
assets an elder could have and qualify for Medicaid. The
worry was that if the elder could not spend the money each
month, they could build up assets that could get them
kicked out of the program and disqualify them for the
Medicaid program. He did not feel that the $300 amount
would have unintended consequences for residents.
9:56:58 AM
Co-Chair Stedman recognized that there had been an erosion
of purchasing power for seniors and it was good for elders
and seniors to participate in gift-giving for birthdays and
Christmas or visit a hair salon using their $300 per month
spending money. He said that residents in Pioneer Homes
would not be able to hoard cash and giving seniors the
ability to have spending money was important.
9:58:18 AM
Ms. Lucky wanted to confirm that the conceptual amendment
would be on page 2, line 7 and on page 2, line 28. The
amount of $200 would change to $300 on each of those pages.
Co-Chair Stedman thought the amount also appeared on page 4
of the bill, line 13.
Ms. Lucky understood that Co-Chair Stedman's reference was
to a respite charge and not an asset limit. She deferred to
the department for clarification.
Ms. Lucky asked if Mr. Lasley could confirm the reference
on page 4, line 13.
Mr. Lasley confirmed that the $200 respite charge found on
page 4, line 13 did not relate to the monthly spending
amount referenced in Co-Chair Stedman's amendment.
Co-Chair von Imhof WITHDREW her OBJECTION. There being NO
further OBJECTION, Conceptual Amendment 1 was ADOPTED.
10:00:37 AM
Mr. Lasley announced that an updated fiscal note from the
department would be provided to the committee.
Co-Chair von Imhof requested a motion to move the bill.
Co-Chair Stedman MOVED to report SCS CSHB 96(FIN) out of
Committee with individual recommendations and the
accompanying fiscal notes. There being NO OBJECTION, it was
so ordered.
SCS CSHB 96(FIN) was REPORTED out of committee with a "do
pass" recommendation and with two forthcoming fiscal impact
notes from the Department of Health and Social Services.
| Document Name | Date/Time | Subjects |
|---|---|---|
| HB 96 Work Draft v. E 3.21.2020 Explanation of Changes.pdf |
SFIN 3/23/2020 9:00:00 AM |
HB 96 |
| HB 96 Work Draft v. E 3.21.2020.pdf |
SFIN 3/23/2020 9:00:00 AM |
HB 96 |
| HB 235 Sponsor Statement 2.21.2020.pdf |
SFIN 3/23/2020 9:00:00 AM |
HB 235 |
| HB 235 Support Letters provided by Sponsor.pdf |
SFIN 3/23/2020 9:00:00 AM |
HB 235 |
| HB 235 TVEP Annual Report 2019.pdf |
SFIN 3/23/2020 9:00:00 AM |
HB 235 |
| HB 235.Backup Flow Chart 2.21.2020.pdf |
SFIN 3/23/2020 9:00:00 AM |
HB 235 |
| HB 235 work draft version O.pdf |
SFIN 3/23/2020 9:00:00 AM |
HB 235 |
| HB 139 Work Draft v. S 3.20.2020.pdf |
SFIN 3/23/2020 9:00:00 AM |
HB 139 |