Legislature(2021 - 2022)BUTROVICH 205
04/28/2022 01:30 PM Senate HEALTH & SOCIAL SERVICES
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| Audio | Topic |
|---|---|
| Start | |
| SB183 | |
| Adjourn |
* first hearing in first committee of referral
+ teleconferenced
= bill was previously heard/scheduled
+ teleconferenced
= bill was previously heard/scheduled
| + | TELECONFERENCED | ||
| += | SB 183 | TELECONFERENCED | |
SB 183-HOME AND COMMUNITY-BASED SERVICES
1:36:53 PM
CHAIR WILSON announced the consideration of SENATE BILL NO. 183
"An Act relating to home and community-based services; and
providing for an effective date."
CHAIR WILSON solicited a motion to adopt the work draft
committee substitute (CS) for SB 183.
1:37:09 PM
SENATOR HUGHES moved to adopt the Health and Social Services CS
for SB 183, work order 32-LS1346\I, as the working document.
1:37:20 PM
CHAIR WILSON objected for purposes of discussion.
1:37:30 PM
At ease.
1:38:17 PM
CHAIR WILSON reconvened the meeting.
1:38:36 PM
JASMIN MARTIN, Staff, Senator David Wilson, Alaska State
Legislature, Juneau, Alaska, stated that the CS mirrors the
companion bill for this legislation, HB 292. She paraphrased the
explanation of changes from version B to version I that read as
follows:
Version 32-LS1346/I (Senate Health and Social
Services)
Throughout:
Changes references from Department of Health and
Social Services to Department of Health.
Section 2:
Page 1, line 14
Removed "reduce payment for services." Payment for
services is determined through a rate-setting process,
if this language remained in the bill, the Department
of Health & Social Services would have needed to do an
individual assessment for anyone on a waiver if the
rates changed in a given year. Assessments for
reductions in level of services will still need to
occur.
Page 2, line 22
Replaced language so the assessment process for
reduced services only applied to personal care
services instead of all home and community-based
waiver services. Personal care services were the
services most frequently referred to in testimony.
This change narrows the scope of the bill and reduces
implementation costs while still helping the
population in need.
Page 2, line 29
Removes "live independently" and goes back to the
original statutory language of "materially improved"
as the threshold for reducing or terminating services.
This means that to reduce or terminate services, an
individual needs to have "materially improved" since
their last assessment.
Page 3, line 25
Removes language changing the definition for an
"independent qualified health care professional." The
definition is now what it originally was in statute.
Section 5:
Page 4, line 14 Inserts a new section requiring the
[Department of Health] to produce a report that
includes:
? An assessment of the payment rates for home and
community-based services that address the adequacy of
those rates to meet relevant workforce needs
? The number of individuals receiving services, the
number of individuals eligible for services, the
average amount of time spent on a waitlist, and the
average amount of service hours a recipient receives
annually, monthly, weekly
? An assessments and recommendations to enhance the
delivery of relevant services to eligible individuals
Additional sections were renumbered accordingly.
1:39:50 PM
SENATOR HUGHES asked why the phrase in Section 2, reduce
payment for services was removed.
1:40:01 PM
MS. MARTIN said it matches the House version of the bill. She
offered her belief that this was one of the many questions that
will require some follow up.
CHAIR WILSON advised that once HB 292 comes to the Senate, the
committee will hear a presentation that will answer many of the
questions. He asked Mr. Lee if he wished to comment on the
reason for removing the phrase.
1:40:47 PM
JOHN LEE, Director, Division of Senior and Disability Services,
Department of Health and Social Services (DHSS), Anchorage,
Alaska, stated that the change was made in negotiation with the
sponsor of the companion bill, HB 292. As originally drafted,
both SB 182 and HB 292 required the department to put the
approximately 8,000 individuals it serves through an assessment
process that envisions a rate reduction. These bills are not
about rate setting; theyre about services that are provided to
individuals and the phrase was deleted to reflect that
difference.
1:42:07 PM
SENATOR REINBOLD asked who requested the changes and why, if the
changes affect the indeterminate fiscal note, and if the sponsor
supports the changes.
1:42:30 PM
CHAIR WILSON said the changes were to align SB 183 with HB 292.
As Mr. Lee indicated, the other body identified certain changes
that would improve the bill. He asked the sponsor if she wished
to speak to her support for these changes.
1:43:09 PM
SENATOR GRAY-JACKSON, Alaska State Legislature, Juneau, Alaska,
sponsor of SB 183, stated support for the changes to align SB
183 with HB 292.
CHAIR WILSON mentioned an earlier conversation from department
representatives about the work being done to clarify some items
in the fiscal note. Nevertheless, it was indeterminant at this
time.
SENATOR HUGHES offered her understanding that a primary request
was to narrow the scope of services provided by home and
community based waivers to just personal care services. She
asked for an explanation of what services this change would
exclude.
SENATOR GRAY-JACKSON deferred the question to Mr. Lee.
1:44:56 PM
MR. LEE limited his comments to Medicaid funded services. He
related that the Personal Care Services Program (PCS) provides
services for such things as activities of daily living. The
Community First Choice Program is similar PCS, but for
individuals who meet institutional level of care needs. Home and
Community-Based Waiver services are the third group of services
the department provides. He said these are all a bit different
but they all provide what's called home and community based
services. He clarified that home and community based waiver
services (1915(c) Medicaid waiver) are a subset of the home and
community based services.
1:46:19 PM
SENATOR HUGHES commented on the explanation and asked for some
examples of home and community based services that are not
personal care services.
1:47:13 PM
MR. LEE explained that the home and community waiver services
(1915(c) Medicaid waiver) are for individuals who meet
institutional level of care needs. Personal care services are
for lower level of needs. Personal care services are typically
in home services, but its not mandatory; examples include help
with bathing, eating, toileting, and chores. Examples of home
and community based waiver services include: residential
services in a group home; supportive employment services for on-
the-job activities; and day-hab services such as taking an
individual to a movie, bookstore, or other location where the
individual is able to interact with the broader community.
SENATOR REINBOLD urged the chair to schedule a hearing on SB
191. [Chair Wilson concluded the business on SB 183 and then
advised that the schedule for next week was being developed.]
1:49:26 PM
CHAIR WILSON removed his objection; he found no further
objection and the CS for SB 183, version I, was adopted.
[SB 183 was held in committee.]
| Document Name | Date/Time | Subjects |
|---|---|---|
| SB 183 Work Draft Version I.pdf |
SHSS 4/28/2022 1:30:00 PM |
SB 183 |
| SB 183 Explanation of Changes v.B - I.pdf |
SHSS 4/28/2022 1:30:00 PM |
SB 183 |