Legislature(1999 - 2000)
05/06/1999 01:55 PM House FIN
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* first hearing in first committee of referral
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+ teleconferenced
= bill was previously heard/scheduled
HOUSE BILL NO. 187
An Act relating to the certificate of need program for
nursing care facilities and other facilities; and
providing for an effective date.
Co-Chair Therriault advised that the committee substitute
would provide for a "tighter" title.
Representative Bunde MOVED to adopt work draft, 1-LS0708\D,
Lauterbach, 5/6/99, as the version before the Committee.
There being NO OBJECTION, it was adopted.
Representative Bunde noted that he had been involved with
the Long Term Health Care Task Force which spent much time
discussing nursing concerns and costs related to nursing
home facilities. He pointed out that the legislation would
address the State's need for a nursing home facility.
SHEILA PETERSON, STAFF, SENATOR GARY WILKEN, stated that
Alaska has had a Certificate of Need (CON) law since 1976.
The purpose of that law is to insure the development of an
accessible, cost-effective health care system with quality
service. Currently, the Department of Health and Social
Services reviews all nursing home expansion projects with an
estimated cost of over $1 million dollars. The review of
each request is limited to factors of accessibility and
quality in order to determine if the service is available
and could be provided in a quality manner.
Under the proposed legislation, a new standard of need would
be adopted for nursing home CON requests. The revised
standard allows decisions to be made based on additional
criteria such as need, financial feasibility and
availability of alternatives. Under the change, a new
nursing home project would need to demonstrate cost
effectiveness and appropriateness of the service.
Ms. Peterson advised that the Department of Health and
Social Services estimates that on the average, ten new
nursing home beds would increase the Medicaid budget by
about $1 million dollars annually. The decision to expand
existing nursing home facilities has long-term implications
to both the State treasury, senior citizens and those with
disabilities. The legislation will give the Department of
Health and Social Services the tools necessary to make
informed decisions.
Co-Chair Therriault pointed out that a primary concern is
that the beds are eligible for Medicaid participation. If a
facility over bills and has fixed costs, those costs are
passed on to the State through Medicaid billings. The
proposed method allows front-end participation.
Representative Bunde recommended that it is financially
advisable to limit the number of nursing home beds. The
legislation would encourage more home and community care.
Co-Chair Therriault referenced Page 4, asking if CON would
continue to be in place for other medical facilities.
Representative G. Davis asked how the proposed legislation
would apply to HB 161. Co-Chair Therriault explained that
Medicaid considerations are exempt from HB 161 because they
are exempt from statute mechanisms addressing costs and the
options list.
JAY LIVELY, DEPUTY COMMISSIONER, DEPARTMENT OF HEALTH AND
SOCIAL SERVICESS pointed out that language had been included
to clarify that existing standards would apply to acute care
and that new standards will only apply to long term care.
Mr. Lively commented that the Department strongly supports
the legislation.
In response to Representative J. Davies, Mr. Lively
stipulated that some home care provided for individuals who
would have been eligible through the nursing home component,
would now be eligible through home and community based
services. Waiver costs are considerably less than nursing
home costs. The legislation provides for alternative use to
the most expensive care.
Representative Bunde pointed out that in order to be
Medicaid eligible, a person would need to be impoverished.
Representative J. Davies elaborated that it would ultimately
be cheaper for those people to stay in their own homes.
Representative Bunde noted that group would still require
State payment.
RICK SOLIE, (TESTIFIED VIA TELECONFERENCE), FAIRBANKS
MEMORIAL HOSPITAL, FAIRBANKS, spoke in support of the
legislation. He reiterated that this bill is the product of
the Long-Term Care Task Force recommendations and would also
represent a good effort on the part of providers and users,
to address future problems of a growing elderly population.
LISA WOLF, (TESTIFIED VIA TELECONFERENCE), DIRECTOR OF
PLANNING, PRIVIDENCE MEDICAL CENTER, ANCHORAGE, voiced
support of the proposed legislation.
Representative Kohring asked if a certificate would be
required of all nursing care facilities which receive
Medicaid funds. Mr. Lively replied that would be a portion
of any nursing home cost. He added that the nursing homes
in Alaska are primarily funded (about 85%-90%) by Medicaid.
Care in this State is so expensive that most people can not
afford to pay for it privately.
Representative Foster MOVED to report CS HB 187 (FIN) out of
Committee with individual recommendations and with the
accompanying fiscal note. There being NO OBJECTION, it was
so ordered.
CS HB 187 (FIN) was reported out of Committee with "no
recommendation" and with a fiscal note by Department of
Health and Social Services dated 4/26/99.
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