Legislature(2021 - 2022)DAVIS 106
05/05/2022 03:00 PM House HEALTH & SOCIAL SERVICES
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| Audio | Topic |
|---|---|
| Start | |
| SB132 | |
| SB98 | |
| HB176 | |
| Adjourn |
* first hearing in first committee of referral
+ teleconferenced
= bill was previously heard/scheduled
+ teleconferenced
= bill was previously heard/scheduled
| += | SB 132 | TELECONFERENCED | |
| += | SB 98 | TELECONFERENCED | |
| + | HB 176 | TELECONFERENCED | |
| + | TELECONFERENCED |
SB 98-ADULT HOME CARE; ADULT ADOPTION
4:12:42 PM
CO-CHAIR ZULKOSKY announced that the next order of business
would be SENATE BILL NO. 98, "An Act relating to medical
assistance for recipients of adult foster care services;
establishing an adult foster care home license and procedures;
and providing for the transition of individuals from foster care
to adult foster care homes." [Before the committee was CSSB
98(FIN), reported out of the Senate Finance Committee on April
12, 2022.]
4:13:29 PM
JOHN LEE, Director, Division of Senior and Disabilities
Services, Department of Health and Social Services, presented
CSSB 98(FIN) on behalf of the bill sponsor, Senate Rules by
request of the governor. He thanked the committee for
considering the bill. He stated that he would be available for
any question.
4:14:10 PM
REPRESENTATIVE SPOHNHOLZ stated that she had supported the
original version of the bill; however, she expressed concerns in
the latest version about the inclusion of a new licensure
category. She shared her understanding that the intent behind
creating adult foster care is to establish continuity of care
for adults aging out of their foster-care placement. She
reported that a typical stipend for foster care is between $40
and $60, with a slight increase for foster children with
disabilities. She expressed concern that a proposed stipend of
$200 per day for adult foster care, combined with lower
licensure requirements, could provide a monetary incentive for
people to get licensed as a workaround of formal assisted living
facilities.
MR. LEE deferred to the deputy director.
4:17:58 PM
TONY NEWMAN Deputy Director, Division of Senior and Disability
Services, Department of Health and Social Services, answered
questions on CSSB 98(FIN), on behalf of the bill sponsor, Senate
Rules by request of the governor. He explained that the
estimated stipend would be about $349, and this number was given
to the committee to encompass all the possible services which
would need to be compensated for, including the daily rate of
$115, the costs of transportation, day habilitation, and other
services the providers would be providing. He offered to
provide the committee with a written breakdown of the different
service rates and how the division arrived at the larger daily
number. He reported that the division had consulted with the
Office of Child Services (OCS) on appropriate stipend amounts,
and the division had learned that a foster child could be
eligible for other waiver services, for which the state would
need reimbursement.
REPRESENTATIVE SPOHNHOLZ expressed appreciation for the
corrected stipend amount and pointed out the rate is five times
higher than the child foster-care rate.
4:20:39 PM
REPRESENTATIVE SNYDER expressed support for expanding care for
the state's elders and those with disabilities; however, she
pointed out the pushback on HB 292, which focuses on providing
the lowest cost for health insurance for individuals receiving
in-home care services. She reported that the concerns about HB
292 were in regard to maintaining and monitoring eligibility.
She posited that the creation of a new category in CSSB 98(FIN)
would introduce the same challenges. She requested
clarification from the department.
4:22:21 PM
MR. LEE explained that the two bills addressed completely
different issues, which explains the different responses from
the department. He stated that the full rates for adult foster
care would need to be decided, but the proposed daily stipend is
$115, which is not three to four times higher than child foster
care. He stressed that the bill would allow certain seniors to
transition from an institution to a home-like setting, and this
would open options for individuals to return to or remain in
their communities near loved ones while still receiving the
services and supports they need. He opined that it would be an
important option for the state to help manage costs as Alaska's
population continues to age.
4:24:50 PM
REPRESENTATIVE FIELDS shared his confusion about how the rates
would compare to rates in other settings. He questioned whether
the new setting would divert existing services from assisted
living facilities or provide additional services. He expressed
indecision on the breadth of the bill.
4:25:32 PM
REPRESENTATIVE SPOHNHOLZ expressed reticence concerning the
proposed legislation bill because of the fiscal note. She
questioned how home-care homes would fit into the spectrum of
service options. She expressed the need for more stakeholder
feedback. She reiterated her support for the "lighter" version
of the bill which focused on extending foster care services to
adults and allowed for the adoption of adults. She expressed
opinion that there is not enough understanding and stakeholder
engagement to make a decision on the creation of a new care
category. She opined that the fiscal notes were "a little
light," considering the higher daily rate. She suggested that a
more "granular" understanding of the issue is needed before
pushing to move people from formal assisted living into home-
care homes. She referenced conversations with professional care
providers and foster parents who had questions which required
very detailed answers. She stated that she is not prepared to
dig into the answers two weeks before the end of session. She
expressed appreciation of the intention of diversifying the
spectrum of care available; however, she would only be
comfortable with passing the House version of the bill which
focused on adult foster care. She surmised that creating a new
category requires more stakeholder alignment, along with a
better understanding of the fiscal impact, of which, there is
not time for this session.
4:29:10 PM
REPRESENTATIVE PRAX expressed agreement with giving consumers
another choice. He posited that creating a setting with lower
licensure requirements may lead to a "lower level of care," but
this could also be more affordable, create more business,
relieving the pressure on assisted living facilities. He said
he was in favor of additional options for care and offered
support for the proposed bill.
4:31:19 PM
CO-CHAIR ZULKOSKY announced that SB 98 was held over.