Legislature(2009 - 2010)BELTZ 211
02/02/2009 01:30 PM Senate HEALTH & SOCIAL SERVICES
| Audio | Topic |
|---|---|
| Start | |
| SB65|| SB82 | |
| Adjourn |
* first hearing in first committee of referral
+ teleconferenced
= bill was previously heard/scheduled
+ teleconferenced
= bill was previously heard/scheduled
| *+ | SB 65 | TELECONFERENCED | |
| *+ | SB 82 | TELECONFERENCED | |
| + | TELECONFERENCED |
SB 65-MEDICAID FOR ADULT DENTAL SERVICES
SB 82-MEDICAID FOR ADULT DENTAL SERVICES
1:34:02 PM
CHAIR DAVIS announced consideration of SB 65 and SB 82.
LYNNE KORAL, intern to Senator Davis, presented the sponsor's
statement for SB 65.
SB 65 is an Act repealing the repeal of preventative
and restorative adult dental services reimbursement
under Medicaid; providing for an effective date by
repealing the effective date of sec. 3, ch. 52, SLA
2006; and providing for an effective date.
The purpose of this bill is to repeal the termination date on
June 30, 2009 of coverage for adult restorative and preventative
dental services under Medicaid. Without the repeal, the coverage
for adult dental services would revert to minimal treatment for
the immediate relief of pain or to reduce the spread of
infection, as it was before the bill went into effect in April
2007. The coverage under Medicaid began with the passage of HB
105.
It has been demonstrated that across the continuum of the
average life span, good preventative and restorative oral and
dental health is very important. It is a necessity in part
because poor oral and dental health can be linked to
cardiovascular problems, diabetes and other life-threatening
illnesses. It can also contribute to low birth-weight babies.
She pointed out that the federal government contributes at least
50 percent of the funding for this program.
1:36:57 PM
TOM OBERMEYER, aid to Senator Davis, noted that the fiscal note
points out that 7600 people were beneficiaries of this program
in the last year and over half of the cost was paid for by the
federal government.
This bill repeals the sunset provisions of the previous bill and
differs from SB 82 in that SB 82 contains a five year sunset
provision. The fiscal note extends through 2015 with an
anticipated total cost and appropriate increases, with the
greater portion again being covered by federal receipts.
1:38:50 PM
SENATOR DYSON questioned why Senator Davis's bill does not have
a sunset date.
CHAIR DAVIS affirmed that is the difference between the two
bills before the committee.
SENATOR DYSON asked if Senator Davis or her staff would explain
her reasoning.
MR. OBERMEYER said it appears that there will be a continuing
need for adult restorative and preventative care and that, as
this will be an ongoing program, it will save time and money if
it doesn't have to be reauthorized regularly.
CHAIR DAVIS added that everyone agrees with the need for these
services and the people who have contacted her have asked that
it be an ongoing program.
1:41:04 PM
PAT LUBY, Advocacy Director, AARP, Anchorage, AK, said AARP has
heard from older consumers that this program is working well.
Oral health is critical to overall health. Dental problems can
result in diseases varying from malnutrition to heart disease.
Medicare did not provide any funding for dental care; it's
critical that Alaska continue to provide this provision on
dental care and oral health to adults who are on the Medicaid
program. AARP strongly supports it.
1:41:51 PM
CHAIR DAVIS announced that John Sherwood is available to answer
questions.
1:42:09 PM
SENATOR DYSON said he would appreciate hearing the department's
position regarding a sunset date.
JOHN SHERWOOD, Long Term Care Coordinator, Department of Health
and Social Services (DHSS), Juneau, AK, answered that, at this
time the department would support a date to give them additional
time to collect information and evaluate the cost-effectiveness
and adequacy of the enhanced adult dental coverage.
CHAIR DAVIS pointed out that the department has had 2 years or
more [to gather information].
MR. SHERWOOD responded that the program is going on its second
full year of operation. The department has data for one complete
year and part of an earlier year; they don't have their data for
this year yet, so they are not comfortable with the data they
have in terms of making a conclusive determination about the
overall effect. Also, in many places during the first partial
year, there were long waiting periods to get appointments so
even though they began offering it in 2007, very few people were
able to access it.
1:43:51 PM
SENATOR THOMAS asked Mr. Sherwood if the department has other
objections to removing the sunset date.
MR. SHERWOOD answered that the department supports a sunset
date; they would not oppose not having one.
1:45:15 PM
DR. BRAD WHISTLER, Dental Officer, Department of Health and
Social Services (DHSS), said he is primarily here to speak to SB
82.
CHAIR DAVIS suggested that he wait to testify until the
committee has finished discussing SB 65.
DELISA CULPEPPER, Chief Operating Officer, Alaska Mental Health
Trust Authority (AMHTA);,Co-Chair, Alaska Dental Action
Coalition, Anchorage, AK, said AMHTA is very much in favor of
repealing the sunset date; they would not oppose having a five
year sunset, but want to be sure that this program for adult
dental Medicaid moves forward. Many of their clients have
benefited from this in the past two and a half years. They've
worked with the department and others to look at the effects of
this [program] and it really makes a difference in the lives of
vulnerable adults who have no other way to pay for dental
treatment.
MS. CULPEPPER said AMHTA has been working with the dental
society and the department regarding whether or not a sunset is
needed and, until now, the discussion was leaning toward not
having one. They felt that budgeting and other issues could be
handled through regulation and through the annual budget
process. In all of the bills addressing adult dental Medicaid
however, they would like to address repeal of the three year
sunset and address the cap, which is set in statute at $1150.
The statute allows that cap to be reduced, but not to be
increased in any way; both the dental society and AMHTA fear
that will limit access to the program in the future.
She closed by saying she hopes the committee will support
reauthorization of adult dental Medicaid.
CHAIR DAVIS closed public testimony on SB 65 and announced
consideration of SB 82.
1:48:24 PM
DR. BRAD WHISTLER, Dental Officer, Department of Health and
Social Services (DHSS) said he is in favor of the governor's
bill SB82 to reauthorize the adult preventive dental services.
SB 82 provides for an extension of adult dental preventive
services through June 30, 2014, or five years past the current
sunset date.
He continued that good oral health is a quality-of-life issue.
Pain from dental infections can result in missed work; adults
with missing or decayed front teeth have problems getting jobs
or job enhancement, especially in Alaska's customer service
sector, where it is part of the image one presents to the
public. For Alaska seniors and adults, lack of dentures or ill-
fitting dentures can contribute to food choices such as
nutritional choices of fresh fruits and vegetables. Coverage of
preventive and routine dental services reduces the progression
of dental decay to the point that the pulp doesn't become
involved and it isn't necessary to extract permanent teeth. Once
that happens, all other alternatives are more expensive.
Finally, adult dental services are important in terms of a
comprehensive approach to reducing dental decay in Alaska's
children. The bacteria that cause dental decay are usually
passed from caregiver to child; if the caregiver has a lot of
decay, he or she can transmit those organisms to the infant by
means of sampling bottles or tasting foods and once the teeth
erupt it creates a risk factor for developing early dental decay
in the child. He stressed that Department of Health and Social
Services (DHSS) is trying to convince people, especially in
rural areas where there are high rates of decay, of the
importance of keeping teeth through proper oral hygiene and good
nutrition. That was a hard message to sell when the state was
only offering emergency services.
DR. WHISTLER reiterated that the department is supporting the
passage of SB 82 with the sunset extension to June 30, 2014. As
John Sherwood indicated, by the time they had received federal
approval to proceed with this program, they were able to give
only very short notice and few people were able to make
appointments during that first quarter of FY07, so FY08 was the
first full year of information. They would like to extend the
sunset date to give them time to discuss whether the program
actually results in fewer extracted teeth or other things the
legislature was concerned about when this pilot program was
passed.
1:53:22 PM
CHAIR DAVIS commented that she has received emails from several
people who state that the current cap does not cover a full set
of dentures. There are other issues related to the cap as well,
but she does not particularly want to take them up in this bill.
She pointed out that no one here has denied the need for these
services and all of the testimony supports it. Even though the
department feels it needs time to establish its database, she
does not understand why they need five years to gather the
information to prove this is a much-needed service.
1:54:54 PM
DR. WHISTLER said he can only echo John's comments that the
department would prefer to respond to the directive it was given
by the legislature when they authorized these services, to
report back on whether the services were effective in reducing
emergency services and to answer other questions that came up at
that time.
He clarified that, when he spoke about annual limit being
adequate to cover an upper or lower denture, he based that on
what the state pays for reimbursement on the Medicaid program.
1:55:52 PM
SENATOR PASKVAN asked if there has been any thought of including
a medical or dental escalator to the $1150 limit.
DR. WHISTLER answered that the department has not looked at that
issue; they've just been looking at this as a reauthorization
with the $1150.
1:56:51 PM
SENATOR DYSON said he is generally in favor of showing respect
for the department; if they want a sunset, that's fine. He also
thinks there will be significant changes in the next two to four
years in the way health care issues are dealt with and financed,
so there is some wisdom to retaining the sunset.
CHAIR DAVIS said she wants this to be an ongoing program. She
knows there will probably be significant changes in our health
care system under the new federal administration and it will
probably be safe to leave the sunset in the bill; she does not
see the necessity for it, but has no problem leaving it if that
is the consensus. She agreed to withdraw her bill and proceed
with SB 82 if the vice-chair would be willing to make a motion.
SENATOR PASKVAN moved to withdraw SB65 and to place SB82 before
the committee for consideration. There being no objection, the
motion carried.
SENATOR DYSON moved to report SB 82 from committee with
individual recommendations and attached fiscal note(s). There
being no objection, the motion carried.
2:02:18 PM
There being no further business before the committee, CHAIR
DAVIS adjourned the meeting at 2:02 PM.
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