04/25/1995 09:25 AM Senate FIN

                                                                               
       HOUSE BILL NO. 124                                                      
       "An Act extending  the termination date of the Board of                 
  Nursing         Home  Administrators; and  providing  for an                 
  effective date."                                                             
                                                                               
  Senator Rieger MOVED to adopt CSHB  124 (FIN) "G" version as                 
  a working draft.  No objection being heard it was ADOPTED.                   
                                                                               
  Benjamin Brown, Legislative Aid to Rep. Toohey was  asked to                 
  give  testimony  on  the  original  bill and  the  sponsor's                 
  statement. He stated that HB 124 is introduced to extend the                 
  sunset date  of the  Board of  Nursing Home  Administrators,                 
  which  must  exist  according  to  federal regulation  as  a                 
  condition for the  state's receipt of Medicaid  funds. After                 
  the  initial  bill was  introduced,  the State  Hospital and                 
  Nursing Home Administration  decided on  its own, that  they                 
  did not want  a Board  of Nursing Home  Administrators.   It                 
  would be easier to abolish the Board and transfer its duties                 
  to the Division of Occupational Licensing.  The Division was                 
                                                                               
                                                                               
  happy with the proposed change which  evolved into a CS from                 
  the H&SS Committee.  The House Finance Committee changed the                 
  bill further,  giving  the Division  the ability  to deny  a                 
  license  to  a  Nursing  Home  Administrator  who  falsifies                 
  information on the application.  There was a loophole in the                 
  statute, meaning  they would have  had to give  the license,                 
  and  then  take  it  back  if   they  found  out  there  was                 
  falsification.   The bill is needed  because without it, the                 
  State  will  be at  risk at  not  receiving $157  million in                 
  Medicaid  in  the  coming  fiscal  year,  from  the  Federal                 
  Department of Health. The moratorium  on long term care beds                 
  is a  means  of controlling  the  growth of  the  facilities                 
  component of the Medicaid budget.                                            
                                                                               
  Catherine  Reardon,    Director,  Division  of  Occupational                 
  Licensing,  Dept   of  Commerce   &  Economic   Development,                 
  testified that  as of  July 1st,  the Board  will go  out of                 
  existence  if  this   legislation  does   not  pass.     The                 
  elimination of the Board and the change to have the Division                 
  directly   manage   the   licensing   program,   will   save                 
  approximately  $1.0  to $1.3  in  travel costs.  The primary                 
  advantage is that  it is much easier to issue  licenses in a                 
  timely fashion.                                                              
                                                                               
  Jay  Livey,  Deputy Commissioner,  Dept  of Health  & Social                 
  Services,  addressed Section 14:  Moratorium on Nursing Home                 
  Certificates of Need.   The department  is in favor of  this                 
  section.   Nursing home  care is  expensive. The  department                 
  spent  $50  million  on  nursing  home  care.    A  two-year                 
  moratorium will  give  the State  a chance  to develop  less                 
  expensive alternatives  that are  currently being  developed                 
  through the  home and community  based waiver program.   The                 
  moratorium allows for more services at less cost.                            
                                                                               
  Kip Knutson, Aid to Rep. Hanley said the state  pays for 87%                 
  of the long term  beds through the Medicaid program.   Their                 
  addition drives  the cost  of Medicaid  up.  Cost  increases                 
  amount to  10-15% each  year in  the Medicaid  budget.   The                 
  Certificate of Need process is broken.  The department needs                 
  attention before new beds are added.                                         
                                                                               
  Harlan Knudson, President, Alaska Hospital  and Nursing Home                 
  Association, spoke in  favor of the  original version of  HB
 and  speaking in opposition  to CSHB  124 as far  as the                 
  moratorium  on nursing home  beds.  There  is agreement with                 
  the original  HB 124 and  the intent.   With  regard to  the                 
  moratorium on  nursing home  beds, there  is agreement  that                 
  nursing  home  care  is  very  expensive.    There  is  also                 
  agreement where there are situations  where very frail, ill,                 
  or  disabled  individuals,   who  need   home  care.     The                 
  Certificate of Need determines who needs  how many beds.  He                 
  asked to move forward with the  Certificate of Need process.                 
  It has all  the tools  needed to stop  unnecessary beds.  He                 
  stated that community based care will increase costs because                 
                                                                               
                                                                               
  many people will never go to a nursing home since the family                 
  is  currently  taking  the  extra effort  to  care  for  the                 
  individual.  The non-facility portion of the budget reflects                 
  a higher rate, meaning a new level of service to a new level                 
  of  clients.   There  will  still  be a  need  for increased                 
  nursing beds.   There will  be an increase  in the  Medicaid                 
  Program for community based care.                                            
                                                                               
  Senator  Rieger inquired as to the percentage of people that                 
  could  be  placed in  the  community  based  care  that  are                 
  currently receiving  nursing beds  within the  institutions?                 
  Mr.  Knudson  responded  that  he   could  not  answer  that                 
  question.                                                                    
                                                                               
  Senator  Sharp  MOVED  to  adopt  CSSB 124  with  individual                 
  recommendations and a zero fiscal note.  No objections being                 
  heard, CSSB 124  was REPORTED OUT  of committee with a  zero                 
  fiscal note from the Dept of Health &  Social Services and a                 
  "do  Pass"  from  Co-chairs Halford  and  Frank,  along with                 
  Senators Rieger and Sharp.  Senator Phillips recommended "do                 
  not  pass".    Senators  Donley   and  Zharoff  signed,  "no                 
  recommendation".                                                             
                                                                               
  The meeting RECESSED at approximately 10:00 a.m.                             
                                                                               
  The meeting RECONVENED at approximately 2:45 p.m.                            
                                                                               
  PRESENT                                                                      
                                                                               
  Co-chair  Halford, along with  Senators Rieger, Zharoff, and                 
  Sharp were present.