Legislature(2001 - 2002)
02/08/2001 03:30 PM Senate STA
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* first hearing in first committee of referral
+ teleconferenced
= bill was previously heard/scheduled
+ teleconferenced
= bill was previously heard/scheduled
SB 55-PIONEERS' AND VETERANS' HOME/ADVISORY BD
CHAIRMAN THERRIAULT asked Major General Oates if he would like to
testify on SB 55.
MAJOR GENERAL OATES said he was in support of SB 55 and would
testify after Commissioner Duncan.
Number 1787
JIM DUNCAN, Commissioner of Administration, said that SB 55 was
introduced by the Governor and would require a number of changes to
the current Pioneer Home system. It would rename the present
Pioneer Home system to Pioneer and Veterans' Home system; it would
provide, in statute, a preference for veterans admission; it would
change the name of the Pioneer Home Advisory Board to the Pioneer
and Veterans' Home Advisory Board; it would require at least two
members of the board to be veterans; and finally it would require
that one of those board members be the chairman of the Veterans'
Advisory Council.
COMMISSIONER DUNCAN then gave some background information
explaining why the Governor has introduced the bill. In 1992,
legislation was passed to establish a veterans' home in Alaska. It
was to be operated by the Department of Administration but would
meet federal requirements so that the residents payments and
federal funding would cover the costs of operation. In 1998 the
legislature amended the 1992 statute to allow the proposed
veterans' home to provide nursing care. The idea behind this was to
increase federal funding so that the state didn't have to make up
operational shortfalls. However, this wasn't successful. State
funding would still be required because federal funding and
veterans payments wouldn't cover the nursing costs in Alaska. Thus,
there is still the unrealized intent and definite need to serve the
veterans.
Number 1914
Governor Knowles recently appointed a cabinet level team comprised
of the Commissioner of Administration, Major General Oates and
Commissioner of Health and Social Services to explore options to
fulfill the commitment made to veterans in the 1992 and 1998
legislation. One of the options explored was to determine the cost
of a stand-alone veteran's home. The capital construction costs for
an 80-bed facility would be about $24 million with federal funding
providing about 65 percent. This would require state funding of
about $8.5 million for construction and then an additional $7.2
million annually for operational costs. The federal government
would contribute about $4 million, residents would pay about
$900,000 and the state would have to contribute the balance, which
is about $2.4 million per year.
Number 2000
Looking at other options, the team determined that using the
current Pioneer Home infrastructure would be more fiscally
responsible. There are six Pioneer Homes located throughout the
state and they are not being fully utilized. Using this
infrastructure would make it easier to provide long term care
needs, closer to the veterans' homes and communities, than if there
was just one veterans' hospital in the state.
COMMISSIONER DUNCAN emphasized the quality of the Pioneer Home
System and pointed out that it is a system that is not fully
utilized. There are 600 beds in the six homes and there are about
90 vacant beds at any given time. SB 55 designates 125 beds or 21
percent of the total beds for veterans. It would say veterans have
a preference in statute, while the 125-bed designation would be
instituted through regulation.
In the system now, there are about 78 veterans. Of the 167 people
on the active waiting list, 44 are veterans. If funds were made
available to fill the empty beds, those 44 veterans would be
accommodated as well as close to 50 pioneers who are on the active
waiting list.
SB 55 would provide needed funding for 24 hour nursing care, which
is the level of care that is needed for those beds. The fiscal note
accompanying the bill indicates $2.6 million in general funds and
about the same in pioneer home receipts which would provide the
funding to hire necessary staff to fill the 90 vacant beds.
COMMISSIONER DUNCAN explained that the fiscal note intentionally
does not include federal receipts. Care has been taken so that the
Pioneer Home system is not changed to require federal regulation
such as would happen if it were under the Veterans Administration
system. Otherwise, many Pioneer Home requirements such as
residency, age and building codes would have to be changed.
Number 2225
While federal dollars aren't being solicited, they are actively
exploring options with the federal government to discover what
might be available in terms of federal assistance and federal
support.
COMMISSIONER DUNCAN said that they had worked closely with affected
interest groups and that there were a number of supporting letters
in the committee packets one of which was from Senator Ted Steven's
office. He went on to point out a paper giving the background and
history of the proposal as well as a number of frequently asked
questions.
COMMISSIONER DUNCAN concluded his testimony and said that Major
General Oates had some comments on SB 55.
CHAIRMAN THERRIAULT asked for questions first. There were none so
he asked Major General Oates to address his comments to the
committee.
Number 2300
MAJOR GENERAL OATES thanked Chairman Therriault for the opportunity
to testify. He went on to say that it was important to consider why
Alaska does not have a veterans home since Alaska ranks second of
the 50 states in terms of its number of veteran residents. In
addition, Alaska is the only state in the Union that does not have,
or is not in the process of building, a state veterans' home.
He assured members that the lack of a veterans' home was not due to
apathy, but rather due to uncertainty of where such a home should
be located and how you afford such a facility when you already have
a costly pioneer home system. Because of the size on the state, it
would also be very difficult to meet veterans' needs state wide
with just one facility. Veterans would be displaced from their
communities when they needed care.
Side B
Number 2320
Looking for creative solutions, they came up with the idea to use
existing resources. There are Pioneer Homes in Ketchikan, Sitka,
Juneau, Palmer, Anchorage and Fairbanks with empty beds due to
under staffing. If these facilities were utilized, there would be
no new construction costs, the problems associated with one
regional center would be ameliorated and there would be more beds
for less operating costs than if a single 80-bed home were built.
Senator Stevens has expressed a willingness to help but says he
can't move ahead until the state takes the first step. He will do
all he can to help make this a model of federal/state cooperation
on veteran's issues.
Senator Frank Murkowski is bringing Secretary of Veterans' Affairs,
Anthony Principi, to Alaska and one of the important items on his
agenda is to visit the Anchorage Pioneer's Home and discuss the
merits of this proposal. The Veterans' Administration is looking
for creative proposals to meet the needs of its veterans because
the current veterans' home system is expensive, not regionally
located and isn't meeting the care needs of veterans. This proposal
is a first step in meeting those needs.
Number 2237
MAJOR GENERAL OATES said that veterans need to be shown that they
are important. Providing for their care needs is one way to show
the measure of their importance. He went on to say that many of the
veteran organizations statewide have indicated support for this
proposal. There is also support from many of the state pioneer
organizations. He reiterated the need to take the first step to
provide for veterans living in Alaska and said that the state could
have a nationally recognized model program.
CHAIRMAN THERRIAULT asked for questions. He said that although
there were letters of support there were some seniors that have
questions and it is the duty of the committee to ensure that the
move is advantageous. Some of the letters of support indicated a
very limited understanding of the details.
COMMISSIONER DUNCAN said that the proposal wasn't easy to
understand but that the Department of Administration is in the
process of organizing statewide visits to provide information and
answer questions. He emphasized that this proposal should benefit
both pioneers and veterans in the state.
Number 2103
CHAIRMAN THERRIAULT asked for a breakdown on the vacancy rates in
each of the homes and number of veterans in each of the homes.
COMMISSIONER DUNCAN said that a portion of the information was in
the packet but that he would provide the number of veterans in each
home and the information about which home each of the 44 veterans
on the active waiting list had requested.
CHAIRMAN THERRIAULT wanted information on how many individuals
might have to move to a different location due to lack of bed space
in the community of first request.
COMMISSIONER DUNCAN said that the vacancies are primarily in
Palmer, Anchorage and Sitka.
MAJOR GENERAL OATES added that the plan stipulates that if a bed
isn't available in the community of your choice you may enter the
home in another community then move to the community of your choice
when a bed becomes available.
CHAIRMAN THERRIAULT called for teleconference testimony.
MR. MERRILL HAKALA testified via teleconference saying that he was
a veteran and was opposed to the pioneer homes becoming
pioneer/veteran homes but was in favor of a stand-alone veteran's
home. If the proposal were adopted, there would be a "complete
change in what the pioneer homes were meant to be." He said all
veterans are welcome as long as they meet the current entrance
requirements and it should stay this way. He went on to say that if
the state would recognize Alzheimer's disease and related dementia
as a mental disease there would be Medicaid coverage and therefore
costs to the state and individual residents would be reduced.
MR. GERALD BOHMS testified via teleconference saying that he too
was a veteran and not in favor of changing the current Pioneer Home
System. He didn't think it was fair for veterans to be given
preference. He pointed out that the state could fund the vacant
beds now and they wouldn't be empty.
MR. GARY BERRY testified in person and said that he was
representing the American Legion, Veterans of Foreign Wars and
Disabled American Veterans. These Alaska service organizations are
in favor of designating 125 beds in the Pioneer Homes for veterans.
They feel that all Alaskan veterans deserve long term care for
physical and mental disabilities. It is time to show appreciation
to these men and women.
CHAIRMAN THERRIAULT called upon Lt. Colonel (Retired) Pat Caruthers
to testify.
LT. COLONEL PAT CARUTHERS said that he supports this proposal
because it benefits both veterans and pioneers. If this proposal is
passed, critical care nursing will be funded and it is the lack of
funding for this highest nursing tier that is causing the
vacancies.
Number 1474
MR. JOHN DAPCEVICH said he was a member of the American Legion,
Veteran of Foreign Wars, Disabled American Veteran, Pioneer of
Alaska and has served the last four governors on the Pioneers
Advisory Board. The Pioneer Advisory Board has unanimously given
its support to SB 55. He said that veterans are just as eligible in
the current pioneer homes as non-veterans and their entry
requirements will be the same as non-veterans. This proposal isn't
going to displace pioneers who are not veterans.
SENATOR PHILLIPS asked for the make up of the Pioneer Advisory
Board.
MR. DAPCEVICH said that the Governor appoints a member from every
community having a home; there is one at large appointment and the
chairperson of the Older Alaska Commission serves on the board.
Number 267
MR. JIM KOHN, Director of Alaska Longevity Program that includes
the Pioneers' Homes, wanted to comment on two points made earlier.
First was preference. It should be understood that Pioneer Home
beds are currently filled with about 17 percent veterans and over
30 percent of those on the waiting list are veterans. Looking at
the statistical makeup of the waiting list, it is apparent that,
over time, there will be more than 21 percent of the beds filled
with veterans whether they are given a preference or not. After the
125 beds are filled, it is unlikely that a veteran would ever need
to be given preference.
The second issue he wanted to address was about Medicaid funding
for the home. He said that the homes would be changed completely
with Medicaid funding because residency and age requirements would
have to be abolished. They would no longer be Pioneer Homes. This
needs to be understood if you're looking at other sources of
revenue.
CHAIRMAN THERRIAULT asked, "If you're the next person on the list
and you weren't a veteran and a veteran space was open would you
get that spot?"
MR. KOHN said that it was more complicated than that. He explained
that people generally apply to the waiting list in their own
communities. If an opening was to occur in Anchorage, for example,
and veterans were occupying 124 beds, the veteran priority list
would be given preference. If there were no veterans on the
Anchorage waiting list then the next person would be given the bed.
Then, the next bed opening in any community would be given veteran
priority. If the number of veterans filling the beds rose to more
than 125, there would be no veterans preference given until that
number fell below 125.
ALFREDA DORE asked the chair if she could address a question to Mr.
Kohn. She came forward and asked if widows and widowers of eligible
veterans would be given preference in the Pioneer Homes as they are
in Veteran Homes in the Lower 48.
MR. KOHN said that the Pioneers' Homes have always made an effort
to keep spouses together when one needs to enter the home and they
would continue to do so. However, this issue would have to be
looked at carefully to decide whether or not spouses and other
family members of qualified veterans were given preference. He said
to keep in mind that in Veterans' Homes, family members of veterans
may not occupy more than 25 percent of available beds. He went on
to say that this should be resolved through regulation as the
process moves forword.
CHAIRMAN THERRIAULT asked if a regulation packet was being
developed for this legislation.
MR. KOHN said none had been started officially but that an outline
was being prepared.
CHAIRMAN THERRIAULT asked for a copy of what had been developed. He
then asked for any other questions.
Number 665
SENATOR DAVIS asked them to address the question as to whether or
not it is a regulation to give spouses and other family members
preference.
MR. KOHN said that they want to make sure that the Pioneer Home
System not come under federal regulation. They have made this clear
to both the Alaska Delegation and Secretary of Veterans' Affairs
Principi who has expressed interest in innovative programs for
veteran homes. He said that perhaps the Veterans Administration
would be able to waiver funds designated for a Pioneer/Veteran
Home.
Number 549
CHAIRMAN THERRIAULT said that when looking at the fiscal note for
SB 55 it shows it to be general fund and program receipts so all
the vacant beds could be opened with these funding sources to
anyone on the waiting list.
MR. KOHN said that is correct. The vacant beds are general care
beds and the people on the waiting list need high level care so
providing additional funding for high level care would fill those
beds. However, if that were done there would be a missed
opportunity to work with the Veterans Administration to find
innovative ways to care for veterans in assisted living programs.
Number 381
SENATOR PHILLIPS asked if the opportunity became available recently
and whether there is urgency to act.
MR. KOHN said he does believe that time is of the essence. The
Governor has given a mandate to find a program that will work and
this is what the three commissioners have devised and it is a
program that has ignited the interest of the Veterans
Administration.
CHAIRMAN THERRIAULT asked if there was anyone else who wanted to
testify either in person or via teleconference. There was no one.
He said that if there is a bill requiring more work or if work
needs to be done on the wording of an amendment the bill will be
brought up again as bills previously heard. However, because of the
level of interest in this bill he will give generous notice before
this bill is heard again.
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