04/23/2001 01:44 PM Senate JUD

         SB 135-MENTAL HEALTH INFO/RECORDS/COMMUNICATIONS                                                                   
                                                                                                                                
CHAIRMAN TAYLOR announced SB 135 to be up for consideration.                                                                    
                                                                                                                                
TAPE 01-22, SIDE A                                                                                                            
                                                                                                                              
MS. PAT  DAVIDSON,  legislative auditor,  said,  "Without data,  the                                                            
Department  is unable to determine  if services are being  paid dual                                                            
billed, paid  for both with Medicaid  funds and state funds  nor can                                                            
they offer  the providers  feedback  about services  and  associated                                                            
costs."                                                                                                                         
                                                                                                                                
SENATOR THERRIAULT  asked if this concern came from  the findings of                                                            
an audit.                                                                                                                       
                                                                                                                                
MS. DAVIDSON  answered  yes. The first  audit was  on mental  health                                                            
services  in 1997.  Senate Finance  was concerned  about  escalating                                                            
costs in that  program. They found  and in the subsequent  follow-up                                                            
(January  2001) is that a  fee for service  Medicaid financing  plan                                                            
and a state  funded grant program  are inherently difficult  to work                                                            
with. Providing  client data  to the Department  to do the  analysis                                                            
will allow  that Department to actually  manage the program  the way                                                            
it needs to be done.                                                                                                            
                                                                                                                                
CHAIRMAN  TAYLOR  noted for  the  record  that he  was  the one  who                                                            
requested that audit in 1997. He added that:                                                                                    
                                                                                                                                
     We  found that  the reserve accounts  of a  couple of  our                                                                 
     larger  providers  had grown  significantly  to the  place                                                                 
     where they had between half  and two-thirds of a year cash                                                                 
     income  reserves  setting  in their  account.  Nobody  was                                                                 
     asking  them to spend down those  reserves before we  gave                                                                 
     them state money even though  my mental health programs in                                                                 
     Ketchikan  and  other places  where communities  assisted                                                                  
     them, before the community  would step in and assist, they                                                                 
     would  make sure  those reserves  were spent  down to  the                                                                 
     place where  they had maybe a month or six weeks  worth of                                                                 
     reserves.  Some of these larger  entities had six to  nine                                                                 
     months  reserves and  were paying  themselves significant                                                                  
     salary  increases. In  one year, south  central paid a  14                                                                 
     percent across  the board salary increase to every  one of                                                                 
     the employers,  including their executive director,  which                                                                 
     would  have violated  state law, had  they been paying  it                                                                 
     under state monies…                                                                                                        
                                                                                                                                
SENATOR  ELLIS asked  why  the entire  mental  health  record of  an                                                            
individual  client  is  needed.  He  asked  if it  was  possible  to                                                            
transmit  only the information  that was  necessary for the  express                                                            
purpose.  He also said that  the broad title  of this bill  troubles                                                            
him, although there was nothing specific he wanted to preclude.                                                                 
                                                                                                                                
Number 364                                                                                                                      
                                                                                                                                
MS. ANN  HENRY, Special  Projects  Coordinator,  Division of  Mental                                                            
Health  and  Developmental  Disabilities,  answered  Senator  Ellis'                                                            
question saying:                                                                                                                
                                                                                                                                
     The information that we  gather is demographic information                                                                 
     that   uses   a  unique   identifier   rather   than   the                                                                 
     individual's  name  and  social security  number.  We  use                                                                 
     initials,  the last  four digits  of the  social security                                                                  
     number  and  the person's  birth  date  to  identify  that                                                                 
     person and then link that  person to subsequent documents,                                                                 
     which give  information about the kind of encounters  they                                                                 
     have  had, the  duration of  the encounter,  that sort  of                                                                 
     thing…                                                                                                                     
                                                                                                                                
She said they  don't request the entire file or go  through progress                                                            
notes. "It's  just the  diagnosis, the  person's housing  situation,                                                            
their legal  status,  things like  that that allow  us to  determine                                                            
what kind of help  different communities need and  what we're seeing                                                            
in the big picture  for the mental health situation  for the state."                                                            
                                                                                                                                
SENATOR THERRIAULT said,  "We need to get enough information so that                                                            
we can  track how  services  are being  offered to  this person.  If                                                            
we're looking  for some accountability, you've got  to know what the                                                            
person is getting."                                                                                                             
                                                                                                                                
He also  explained regarding  the title, that  when he had  the bill                                                            
drafted, he wasn't  anticipating any chicanery or  things tacked on.                                                            
He wasn't opposed to tightening the title.                                                                                      
                                                                                                                                
MS. HENRY  continued saying  that her division  had worked  with the                                                            
community mental  health providers  for several years trying  to get                                                            
this  data  from  them  and  haven't  been  successful  for  various                                                            
reasons.  She said the  lawsuit by  the Board  of the Mental  Health                                                            
Center that was  suing will be put aside with passage  of this bill.                                                            
That is why the  bill covers some of the issues that  it covers. She                                                            
explained  that they had  also amended the  initial bill to  include                                                            
requiring that  the mental health centers provide  data for the last                                                            
two years.                                                                                                                      
                                                                                                                                
SENATOR  THERRIAULT  said  that  the  lawsuit  was  initiated  by  a                                                            
Fairbanks provider  and he concurred that they backed  away from the                                                            
litigation with the introduction of this bill.                                                                                  
                                                                                                                                
SENATOR ELLIS  moved to tighten up  the title to SB 135.  There were                                                            
no objections and it was so ordered.                                                                                            
                                                                                                                                
SENATOR  COWDERY moved  to pass  CSSB 135(JUD)  from committee  with                                                            
individual recommendations.  There were no objections  and it was so                                                            
ordered.