04/15/2010 08:30 AM House FINANCE

SENATE BILL NO. 13                                                                                                            
                                                                                                                                
     "An Act relating to eligibility requirements for                                                                           
     medical assistance for certain children and pregnant                                                                       
     women; and providing for an effective date."                                                                               
                                                                                                                                
SENATOR BETTYE  DAVIS expressed appreciation for  the bill's                                                                    
hearing. She  thanked those working on  the legislation. She                                                                    
stressed that  this bill  will improve  the health  of young                                                                    
children  in Alaska.  She believed  that approximately  1200                                                                    
families would  be eligible  for the  Denali Kid  Care (DKC)                                                                    
program.                                                                                                                        
                                                                                                                                
Co-Chair Hawker reported that the  bill changes 3 numbers in                                                                    
statute,  which   changes  the  poverty  level   limits  for                                                                    
participation in DKC from 175%  of the Federal Poverty Level                                                                    
(FPL) to 200%. Senator Davis replied that was correct.                                                                          
                                                                                                                                
Representative Gara thanked the Senator  for her work on the                                                                    
bill.                                                                                                                           
                                                                                                                                
JOY LYON,  EXECUTIVE DIRECTOR, ASSOCIATION OF  THE EDUCATION                                                                    
OF YOUNG CHILDREN (AYEC), testified  in support of the bill.                                                                    
She claimed that the legislation  will eventually save money                                                                    
with the early investment in young children's health.                                                                           
                                                                                                                                
JORDEN NIGRO,  PAST PRESIDENT, ALASKA ASSOCIATION  HOMES FOR                                                                    
CHILDREN, voiced her support of the bill.                                                                                       
                                                                                                                                
ROD  BETIT,  PRESIDENT,  ALASKA HOSPITAL  AND  NURSING  HOME                                                                    
ASSOCIATION, testified in support of this bill.                                                                                 
                                                                                                                                
JOHN  SHERWOOD,  MEDICAL   ASSISTANCE  ADMINISTRATOR,  DHSS,                                                                    
stated that the administration supports the legislation.                                                                        
                                                                                                                                
Co-Chair Hawker asked to know  income guidelines for 200% of                                                                    
FPL. Mr.  Sherwood responded  that annual  income guidelines                                                                    
for a household of 4 are $55,000.                                                                                               
                                                                                                                                
Co-Chair Stoltze  stated that he  was raised in a  family of                                                                    
ten children and he asked  to know the income guidelines for                                                                    
a family of  that size. Mr. Sherwood  answered $112 thousand                                                                    
per year.                                                                                                                       
                                                                                                                                
9:39:52 AM                                                                                                                    
                                                                                                                                
NANCY DAVIS,  REGISTERED NURSE AND PRESIDENT,  ALASKA NURSES                                                                    
ASSOCIATION  JUNEAU CITIZEN,  testified  in  support of  the                                                                    
bill.                                                                                                                           
                                                                                                                                
DEBBIE   THOMASON,   EXECUTIVE   DIRECTOR,   ALASKA   NURSES                                                                    
ASSOCIATION, testified in support of the legislation.                                                                           
                                                                                                                                
GARA   BIRDWELL,  PRESIDENT,   AEYC  (via   teleconference),                                                                    
testified in  support of the  bill. She echoed  the comments                                                                    
of the prior testifiers.                                                                                                        
                                                                                                                                
CANDACE  WINKLER, CEO,  THREAD, ALASKA'S  CHILDCARE RESOURCE                                                                    
AND  REFERRAL  NETWORK  (via teleconference),  testified  in                                                                    
support of  the bill. She  mentioned that she serves  on the                                                                    
Best  Beginning's early  learning council.  She stated  that                                                                    
she also represents 40  organizations affiliated with United                                                                    
Way who also support the passage of the bill.                                                                                   
                                                                                                                                
JUNE    SOBOCINSKI,   UNITED    WAY   OF    ANCHORAGE   (via                                                                    
teleconference), testified in support of the legislation.                                                                       
                                                                                                                                
Co-Chair Hawker closed public testimony.                                                                                        
                                                                                                                                
Co-Chair  Hawker asked  to know  the fiscal  consequences of                                                                    
the bill.                                                                                                                       
                                                                                                                                
Mr.  Sherwood explained  the fiscal  notes. The  first is  a                                                                    
note for the public assistance  workers as the caseload will                                                                    
increase  by  approximately  1300   children  and  over  200                                                                    
pregnant  women.  For  FY11, the  total  is  $167,400,  with                                                                    
approximately two thirds from  federal sources and one third                                                                    
from the  general fund. The  services are split  between two                                                                    
Medicaid  components, the  Acute  and Primary  Care and  the                                                                    
Behavioral   health  components.   The  first   year  totals                                                                    
approximately $2.3  million, roughly a two  third, one third                                                                    
split  between  federal  and general  fund.  The  behavioral                                                                    
health component equals $467 thousand  the first year with a                                                                    
similar split  between federal and  general funds.  He noted                                                                    
that different  matching rates apply  to pregnant  women and                                                                    
children  eligible for  the  enhanced  chip match.  Services                                                                    
provided through  the tribal health facilities  are eligible                                                                    
for the 100 percent match.                                                                                                      
                                                                                                                                
Co-Chair Hawker asked how many  additional children would be                                                                    
served  with the  requested  funds.  Mr. Sherwood  responded                                                                    
1300.                                                                                                                           
                                                                                                                                
9:47:48 AM                                                                                                                    
                                                                                                                                
Vice-Chair Thomas  asked about a residency  requirement. Mr.                                                                    
Sherwood responded  yes, a residency requirement  exists for                                                                    
the   Medicaid  program.   The   requirement  is   sometimes                                                                    
described as  non-durational where a person  must be present                                                                    
in the state with the intent to stay.                                                                                           
                                                                                                                                
Representative  Foster  noted  that the  bill  restores  the                                                                    
program to the  levels in effect 12 years  ago. He supported                                                                    
the  legislation.   He  mentioned   that  the   program  was                                                                    
beneficial to rural Alaska.                                                                                                     
                                                                                                                                
Co-Chair Stoltze  stated that the Parnell  administration is                                                                    
in support of this bill.                                                                                                        
                                                                                                                                
Representative  Gara  added that  with  the  passage of  the                                                                    
bill, Alaska will be joining  44 other states that provide a                                                                    
similar  standard. The  legislation  includes  a 70  percent                                                                    
federal match.  The increase  in federal  funds leads  to an                                                                    
increase   in   public   health   and   medical   profession                                                                    
employment.                                                                                                                     
                                                                                                                                
Representative Kelly  mentioned one  down side  that federal                                                                    
funds are  dropping and state  will have to back  fill every                                                                    
dollar and with  the bill, Alaska is teaching a  family of 4                                                                    
that they cannot live on $55,000  a year to feed their kids.                                                                    
He  believed  that  the  bill   was  a  step  in  the  wrong                                                                    
direction.                                                                                                                      
                                                                                                                                
9:52:04 AM                                                                                                                    
                                                                                                                                
Co-Chair  Stoltze MOVED  to report  SB 13  out of  Committee                                                                    
with individual recommendations  and the accompanying fiscal                                                                    
notes. There being NO OBJECTION, it was so ordered.                                                                             
                                                                                                                                
SB 13 was REPORTED out  of Committee with no recommendations                                                                    
and with  previously published fiscal notes:  FN5 (DHS), FN6                                                                    
(DHS), FN7 (DHS).                                                                                                               
                                                                                                                                
9:52:44 AM          AT EASE                                                                                                   
9:54:13 AM          RECONVENED                                                                                                
                                                                                                                                
Co-Chair Hawker made a list of bills order.                                                                                     
                                                                                                                                
9:55:16 AM          AT EASE                                                                                                   
10:02:17 AM         RECONVENED