04/08/1999 01:40 PM Senate L&C

         SB 59-CERTIFICATES OF NEED FOR HEALTH FACILITY                                                                         
                                                                                                                                
CHAIRMAN MACKIE announced SB 59 to be up for consideration.                                                                     
                                                                                                                                
SENATOR WILKEN said SB 59 was recommendation 21 from the Long Term                                                              
Care Task Force which suggests that legislation be introduced to                                                                
adopt a new standard for the Nursing Home Certificate of Need                                                                   
Program.  Currently, if he were to build a care facility, the State                                                             
would be interested in two aspects: its accessibility and its                                                                   
quality.  SB 59 adds a new standard: whether the facility is cost                                                               
effective recognizing that a care facility bed may be worth                                                                     
$100,000 per year of which the State picks up 40 percent.                                                                       
                                                                                                                                
The Alaska State Hospital and Nursing Home Association asked for a                                                              
change on page 2, line 26 after "foster" to insert "unnecessary"                                                                
which both he and the Department agree with.                                                                                    
                                                                                                                                
SENATOR KELLY moved to adopt that as an amendment.  There were no                                                               
objections and it was so ordered.                                                                                               
                                                                                                                                
MR. LINDSTROM testified that Certificates of Need are issued for a                                                              
variety of facilities.  The purpose of this bill is to have                                                                     
separate and more appropriate standards specifically for long term                                                              
care nursing beds and allowing them to include consideration of the                                                             
cost to the State of the construction of the additional beds which                                                              
are paid for by the State through the Medicaid Program.  They have                                                              
no objection to the amendment.  There is a fiscal note in the                                                                   
amount of $26,500 which allows them to implement the new standards                                                              
as it is a very complex program.                                                                                                
                                                                                                                                
CHAIRMAN MACKIE noted that if there was no fiscal note, the bill                                                                
would not have to go through Finance Committee.                                                                                 
                                                                                                                                
MR. LINDSTROM said the costs were appropriate.                                                                                  
                                                                                                                                
MR. DAVID PIERCE, Certificate of Need Coordinator, Department of                                                                
Health and Social Services, said the fiscal note is an estimated                                                                
one-time cost to develop the standard based on prior work done by                                                               
consultants.                                                                                                                    
                                                                                                                                
CHAIRMAN MACKIE asked if it was something that could be done within                                                             
the Department.                                                                                                                 
                                                                                                                                
MR. PIERCE answered that it is somewhat unusual as it hadn't been                                                               
done by any state before.  The main thing they would be doing is a                                                              
comparison of assisted living and long term care and how many                                                                   
assisted beds should be in a community before new long term beds                                                                
will be allowed.  The trend is to move towards assisted living and                                                              
more community based services.  The State does not have the                                                                     
expertise to do it.                                                                                                             
                                                                                                                                
SENATOR LEMAN asked if there was someone uniquely qualified to do                                                               
that.                                                                                                                           
                                                                                                                                
MR. PIERCE answered that he hadn't identified anyone, but the state                                                             
of Georgia is now working on it and maybe we could get some help                                                                
from them.  He is the only person who works on the Certificate of                                                               
Need Program and wouldn't have the time to do it.                                                                               
                                                                                                                                
MS. DERR testified that they support this bill with the inclusion                                                               
of the word "unnecessary".  She explained it leaves it open for                                                                 
more support.                                                                                                                   
                                                                                                                                
SENATOR LEMAN noted the words "relating" in sections four and five                                                              
should be changed to "related".                                                                                                 
                                                                                                                                
SENATOR LEMAN moved to pass CSSB 59(L&C) from committee.  There                                                                 
were no objections and it was so ordered.