Legislature(2025 - 2026)BUTROVICH 205
02/13/2025 03:30 PM Senate HEALTH & SOCIAL SERVICES
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| Audio | Topic |
|---|---|
| Start | |
| Presentation(s): Expanding Eligibility for Alaska's Infant Learning Program | |
| SB76 | |
| SB60 | |
| Adjourn |
* first hearing in first committee of referral
+ teleconferenced
= bill was previously heard/scheduled
+ teleconferenced
= bill was previously heard/scheduled
| + | TELECONFERENCED | ||
| += | SB 76 | TELECONFERENCED | |
| += | SB 60 | TELECONFERENCED | |
SB 76-COMPLEX CARE RESIDENTIAL HOMES
4:08:37 PM
CHAIR DUNBAR announced the consideration of SENATE BILL NO. 76
"An Act relating to complex care residential homes; and
providing for an effective date."
4:08:51 PM
CHAIR DUNBAR opened public testimony on SB 76.
4:09:18 PM
KIM CHAMPNEY, Executive Director, Alaska Association on
Developmental Disabilities, Juneau, Alaska, testified in support
of SB 76. She stated that their 109 member organizations provide
home and community-based Medicaid waiver services to individuals
with developmental disabilities across the state. She described
a recurring cycle where individuals with complex behavioral
needs lose service providers, often following an incident, and
then cycle through hospitals or the Alaska Psychiatric Institute
(API) until another provider is foundfrequently one with
limited experience and inadequate resources. She emphasized that
these unstable transitions are traumatic for both individuals
receiving care, the direct support staff involved, and provider
organizations.
MS. CHAMPNEY expressed that the current system is not working
and acknowledged the need for a different approach to service
delivery. She affirmed AADD's support for SB 76, which she
described as a step toward developing a new type of residential
setting not currently available in Alaska. She added that AADD
looks forward to working with the Departments of Health and
Family and Community Services as service details are developed.
4:11:37 PM
DAVID WALLACE, Chief Executive Officer, Matsu Regional Medical
Center, Palmer, Alaska, testified in support of SB 76 and said
he spoke on behalf of the 1,000 employees at Mat-Su Regional
Medical Center. He described the case of a patient with dementia
who had ten emergency room visits due to unmanaged behavioral
health needs while residing at the Pioneer Home in Palmer. After
being discharged from the Pioneer Home and spending 50 days in
the emergency departmentdesigned for short-term carestaff
experienced distress and frustration over the lack of
appropriate placement options.
MR. WALLACE explained that despite extensive collaboration among
care teams, guardians, and state agencies, no suitable placement
could be found for weeks due to the complexity of the patient's
needs and limited licensed facilities. Eventually, a placement
was secured in a home appropriately licensed and staffed, which
he personally helped the patient transition into. He described
the new setting as ideal and commended the care team. He urged
support for SB 76, which he believes will help prevent similar
situations and ensure proper care for individuals with complex
needs.
4:16:27 PM
JARED KOSIN, President, Alaska Hospital and Healthcare
Association, Anchorage, Alaska, testified in support of SB 76 and
described the legislation as a necessary step to address a
chronic issue affecting Alaska's healthcare system. He reported
that, based on monthly hospital surveys, an increasing number of
patients remain in acute care settings despite no longer needing
hospitalization. This is due to a lack of appropriate post-acute
care placements. Patients are stuck in the most complex
expensive environment in the healthcare system. The hospitals
caring for them loose key resources without reimbursement. He
noted that these patients occupy one out of every seven hospital
beds in Alaska, resulting in over 43,500 additional hospital
days in 2023 alone. He emphasized that a major reason for the
created gridlock is the absence of services for individuals with
complex needs. He stated that SB 76 would create complex care
residential homes providing a more appropriate, lower-level care
setting in communities, helping to ease hospital overcrowding
and reduce unnecessary admissions. He urged the committee to
pass the SB 76 as a critical first step in expanding access to
care.
4:18:29 PM
PHILLIP TAFS, representing self, Anchorage, Alaska, testified in
support of SB 76. He said that as a consultant for the Complex
Behavior Collaborative (CBC) for over a decade, he emphasized
that creating a stable, well-trained complex care residential
home system is the most impactful step Alaska can take to
stabilize services for individuals with severe behavioral
challenges. He described a revolving door pattern between
hospitals, the Alaska Psychiatric Institute (API), out-of-state
placements, and waiver-funded homes unequipped to handle such
cases. He stated that this cycle is both financially costly and
deeply harmful to individuals, leading to behavioral
deterioration and reduced options for future transitions. He
cited longstanding research, including the original Western
Interstate Commission for Higher Education (WICHE) report, that
has consistently identified this gap in the system. He also
shared a recent tragic case of a young Alaskan who cycled
through six to seven placements in one year due to lack of
appropriate care and ultimately died, emphasizing that the cost
and human toll of the current system far exceed the cost of
building the right infrastructure. He strongly urged passage of
the SB 76 to address this urgent and unmet need.
4:21:27 PM
LUCY BAUER, Representative, Alaska Assisted Living Home
Association, Anchorage, Alaska, testified in support of SB 76.
She said she is a provider operating a large home in Anchorage
for residents with mental health conditions since 1999. She
described the challenges she regularly faces, including frequent
crises and threats, and stated that while she loves her work and
the people she serves, Alaska's mental health system is missing
a critical piece. She expressed hope that SB 76 will serve as a
vital bridge between hospitals and assisted living homes. She
shared a tragic example of a 29-year-old man placed in the
Department of Corrections (DOC). He required a higher level of
care, but no facility would accept him, and five days later, he
died in jail. She emphasized her 25 years of experience and
stressed the urgent need for a proper system to support
vulnerable adults. She thanked the Governor, the Department of
Health, and others supporting the bill, expressing optimism for
the positive changes SB 76 could bring.
4:23:54 PM
JAMIE ELKHILL, Vice President, Youth and Transitional Age Youth
(TAY) Services, Volunteers of America (VOA) Alaska, Eagle River,
Alaska, testified in support of SB 76. She emphasized that
complex care residential homes would provide a less restrictive,
stable, and supportive environment for youth, young adults, and
familiesreducing hospitalizations and out-of-state placements
while keeping individuals close to their support systems. She
shared that her organization, Volunteers of America Alaska (VOA
Alaska), regularly sees the effects of this gap, including youth
who relapse into substance use or self-destructive behavior due
to unstable post-treatment living environments. She noted that
during clinical reviews, 30 percent of youth ages 13 to 18 who
completed treatment relapsed due to lack of support, with actual
rates likely higher. She concluded that this legislation would
not only improve individual outcomes but also reduce strain on
other systems, such as hospitals, psychiatric facilities, the
Office of Children's Services, and the criminal justice system.
She urged the committee to support the SB 76, and other bills
like it, stating it address a long-standing need that will help
Alaskans with complex needs thrive in their communities.
4:27:57 PM
MICHELLE OVERSTREET, Chief Executive Officer, My House, Wasilla,
Alaska, testified in support of SB 76. She testified that Alaska
faces a dire need for supportive housing for individuals with
disabilities as they receive recovery services. She echoed the
concerns shared by Mr. Wallace and Ms. Elkhill, emphasizing that
this population needs structured support to heal and that the
current gap in housing leads to continued trauma and risk,
including death. She stated that while the proposed statutory
changes may carry a cost, the savings from reduced reliance on
crisis services and avoidance of additional harm would far
outweigh them. She shared that her organization serves youth
ages 14 to 24, many of whom are impacted by fetal alcohol
spectrum disorders (FAS/FASD), attention deficit hyperactivity
disorder (ADHD), traumatic brain injuries, and other behavioral
health and medical conditions. A significant number are trauma
survivors, including victims of incest, child rape, sexual
assault, domestic violence, and neglect. She described a
recurring pattern where clients cycle between emergency rooms,
residential care, inpatient treatment, and correctional settings
due to the lack of supportive housing at discharge. She gave the
example of a current client, an incest survivor, staying at a
shelter in Anchorage after spending three months in a behavioral
health unit, with no suitable placement available. She stated
that without housing support, this individual remains in danger
and struggles to maintain services. She expressed strong support
for SB 76, stating that the opportunity to establish this type
of housing could help save lives.
4:30:27 PM
CHAIR DUNBAR closed public testimony on SB 76.
4:31:20 PM
EMILY RICCI, Deputy Commissioner, Department of Health (DOH),
Juneau, Alaska, put herself on the record to answer questions on
SB 60.
4:31:30 PM
SENATOR HUGHES stated that the testimony provided made the need
for SB 76 clear, particularly in light of the risks of placing
individuals in inappropriate environments like jails or
hospitals. She emphasized the severity of consequences,
including the risk of death, when individuals with complex needs
are not placed in proper care settings. She questioned whether
the limit of 15 residents per home contained in SB 76 is
appropriate, especially given the testimony about increasing
need. While acknowledging that 15 residents may fill a large
home, she raised the possibility of multiple homes sharing
common areas, such as a courtyard, and asked if that would
require a different licensing approach. She requested
clarification on whether the 15-resident limit is based on
research or regulatory constraints and whether a higher number
could be considered if proper staffing ratios are maintained.
4:33:04 PM
MS. RICCI explained that the limit of 15 residents is tied to a
federal requirement related to Medicaid funding, specifically
the "Institution for Mental Disease" (IMD) exclusion. This
exclusion restricts how Medicaid dollars can be used for
facilities with 16 or more beds that serve individuals with
mental health conditions. She stated that to maintain
eligibility for Medicaid funding, residential long-term care
settings must remain under that 16-bed threshold. This
constraint is why the bill proposes a cap of 15 residents. She
added that other states with similar programs also commonly use
this limit for the same reason, even though program models vary.
4:34:11 PM
SENATOR HUGHES asked whether, under SB 76, multiple homes
clustered on a shared courtyard would each require separate
licenses, even if operated by a single business entity. She
assumed this could be the case and requested clarification. She
mentioned significant permitting delays for assisted living
homes, acknowledging that while this is a new license type,
similar issues could arise. She expressed hope that the
licensing process for complex care residential homes would be
more efficient and not take months to complete. She requested
information on the expected processing time for licensure under
SB 76 and confirmation that one business owner would be allowed
to operate multiple licensed homes.
4:35:10 PM
MS. RICCI responded that the specific licensure requirements for
complex care residential homes, including whether multiple homes
on a shared property can be operated by a single business, will
be promulgate regulation. She noted that careful design and
implementation will be necessary to ensure compliance with
federal requirements. She explained that while SB 76 allows for
homes with up to 15 beds, the Department anticipates tailoring
bed capacity through regulation based on the population served.
For example, smaller settings may be more appropriate for youth
or individuals with severe needs.
MS. RICCI said regarding concerns about licensing delays, she
clarified that assisted living home licensure is handled by the
Division of Health Care Services, which includes two sections
for licensing: one for health facilities (e.g., hospitals) and
another for residential licensing (e.g., assisted living homes).
She acknowledged that residential licensing faced significant
staffing shortages in FY24, with a vacancy rate between 29 and
31 percent. However, the Department has been working to fill
positions and, as of three weeks ago, residential licensing had
only one vacancy remaining. She said that while many team
members are new and still in training, improvements are underway
to speed up the licensing process. She added that SB 76, as
written, considers the licensing of complex care residential
homes to fall under the health facilities licensing and
certification sectiondistinct from the residential licensing
section that manages assisted living homes.
4:38:24 PM
CHAIR DUNBAR held SB 76 in committee.
| Document Name | Date/Time | Subjects |
|---|---|---|
| GCDSE.ICC Presentation 2025 Senate HSS 02-13-2025.pdf |
SHSS 2/13/2025 3:30:00 PM |
GCDSE.ICC Presentation 2025 Senate HSS 02-13-2025 |
| CSS LOS HB73 and SB76 2-6-25 (v.2 corrected).pdf |
SHSS 2/13/2025 3:30:00 PM |
HB 73 SB 76 |
| SB 76 CPH Letter of Support 2.12.25.pdf |
SHSS 2/13/2025 3:30:00 PM |
SB 76 |
| SB 76 LoS Foundation Health Partners 2.6.25.pdf |
SHSS 2/6/2025 3:30:00 PM SHSS 2/13/2025 3:30:00 PM |
SB 76 |
| SB76 LOS VOA 2.11.25.pdf |
SHSS 2/13/2025 3:30:00 PM |
SB 76 |