Legislature(1995 - 1996)
04/20/1995 08:45 AM House FIN
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* first hearing in first committee of referral
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= bill was previously heard/scheduled
HOUSE BILL NO. 219
"An Act authorizing special medical parole for
terminally ill prisoners."
DENNIS DEWITT, STAFF, REPRESENTATIVE MULDER testified in
support of HB 219. He provided members with a proposed
committee substitute for HB 219, work draft #9-LSO810\M,
dated 4/19/95 (copy on file). He explained that the
committee substitute removes the requirement for parolees
and prisoners to pay for drug testing. He observed that HB
219 provides the Department of Corrections additional tools
to control spiraling inmate health care cost by allowing
special medical parole for terminally ill and severely
disabled prisoners. The legislation also allows the
Department to charge for medical services within facilities.
The legislation creates a new category of parole called
"special medical parole" for inmates who are suffering from
terminal diseases or are severely disabled. The
classification only allows parole. It does not guarantee
parole. The judgment will still rest with the Parole Board.
The change was recommended by the Alaska Sentencing
Commission. He observed that inmates may be medicaid
eligible if they are paroled. Medicaid pays 50 percent of
health care costs.
Mr. DeWitt noted that the legislation will also allow the
Commissioner of the Department of Corrections to establish
charges for the health care provided by the Department. He
emphasized that the legislation will help deter frivolous
use of health care by inmates.
In response to a question by Representative Brown, Mr.
DeWitt clarified that the committee substitute would result
in a zero fiscal note by the Department of Corrections.
Representative Brown asked if there would be projected
savings. Mr. DeWitt acknowledged that a savings is
expected. He emphasized that it is difficult to calculate
the savings. Representative Mulder observed that the
Department expressed concern that their budget not be
effected by an anticipated savings.
Representative Mulder spoke in support of HB 219. He noted
that the Department is in strong support of the legislation
in order to control spiraling medical costs in the
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institutions. He MOVED to adopt the committee substitute
for HB 219, work draft #9-LSO810\M, dated 4/19/95. He
explained that the costs of administering the drug testing
repayment overshadowed the benefits in the legislation.
There being NO OBJECTION, work draft #9-LSO810\M was
adopted.
JERRY SHRINER, SPECIAL ASSISTANT, DEPARTMENT OF CORRECTIONS
clarified that the Department of Corrections would support a
zero fiscal note with the adoption of CSHB 219 (FIN). He
stressed that collection would be difficult and the cost of
collecting could exceed the amount collected.
In response to a question by Representative Martin, Mr.
Shriner noted that there are no prisoners who would be
currently affected by the legislation. He stated that it is
difficult to anticipate potential savings.
Mr. DeWitt reiterated that parolees would be eligible for
the medicaid program.
In response to a question by Representative Grussendorf, Mr.
DeWitt clarified that parole cannot be forced on an
individual. He stated that the state or the inmate could
initiate a request for parole. The current terms of parole
would not be changed. Representative Grussendorf noted that
some prisoners may have no place to go outside of the
prison.
Representative Brown noted that the sponsor statement
estimated that 5 to 10 prisoners may be affected. Mr.
DeWitt emphasized that there would not be a large number of
inmates affected. Representative Mulder stressed that a few
drive the majority of the costs. He observed that one
terminally ill prisoner had medical bills of $567.0 thousand
dollars over two months.
Representative Brown asked if prisoners have alternative
health insurance. Mr. Shriner estimated that very few would
have alternative health insurance other than medicaid. He
noted that one prisoner who would have been eligible under
the bill was recently placed in a nursing home.
Representative Brown noted that section 13 states that
prisoners are responsible for their own medical care and
would be required to pay a portion of the costs based upon
the prisoner's ability to pay. Mr. DeWitt noted that
section 13 is new policy. He stressed that many inmates
have some funds. He stated that the co-payments would be
small. The provision is designed to act as a deterrent to
frivolous complaints.
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Representative Brown expressed concern with the effect that
the provision would have on people with resources and who
are confined for some period of time. She observed that
health insurance is more expensive if the person is not part
of an employee's plan. Mr. DeWitt replied that the
expectation is that there would be a relatively small number
of inmates that would have the independent wealth to cover
their own health care. He stressed that it is an attempt to
allow the Department to get control on utilization as
opposed to securing revenue.
Mr. DeWitt noted that there will be individuals in halfway
houses and soft beds that will have other coverage or
resources. The legislation allows the Department to become
a secondary payer to the primary health care provider.
Representative Brown asked if the income of a working spouse
could be reached by the Department. Mr. DeWitt expected
that the initial focus would be to deter unnecessary
utilization and capture available other coverage. He
acknowledged that the legislation allows a broader
interpretation. He emphasized that Alaska is not a
community property state. He stressed that because the
institution does not have its own billing system it is going
to be difficult to bill other coverage externally. He noted
that the intent is to allow the Department to take advantage
of other coverage that is available or to access the
resources of someone that is independently wealthy.
Representative Brown questioned the legality of the
retroactive provision.
MICHAEL STARK, ASSISTANT ATTORNEY GENERAL, DEPARTMENT OF LAW
assured her that the retroactive provision would not present
a legal problem. He emphasized that the provision is not
intended as part of the punishment imposed on an inmate. It
is a reasonable effort by the state to defer expenses. He
added that institutionalized populations often include
individuals that manifest medical complaints in which there
is no basis in fact. He stressed that the legislation will
deter frivolous medical complaints.
Representative Brown reiterated concerns with the breadth of
the provision. She asked to what extent the state would
pursue other resources. Mr. Stark suggested that some
mechanism could be developed to pursue resources that
inmates may have. He stressed that it will take time to
develop procedures. He emphasized that there will be no
denial of medical services. He observed that regulations
will have to be adopted.
Representative Therriault MOVED to report CSHB 219 (FIN) out
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of Committee with individual recommendations and with the
accompanying fiscal notes. There being NO OBJECTION, it was
so ordered.
CSHB 219 (FIN) was reported out of Committee with a "do
pass" recommendation and with two zero fiscal notes; one by
the Department of Administration, dated 3/27/95; and one by
the House Finance Committee for the Department of
Corrections, dated 4/20/95.
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