04/06/1993 01:00 PM House CRA

  HB 209:  COMMUNITY HEALTH AIDE GRANTS                                        
                                                                               
  Number 312                                                                   
                                                                               
  MYRA MUNSON, LOBBYIST, ALASKA NATIVE HEALTH BOARD, testified                 
  in support of HB 209 saying, "The Community Health Aide                      
  Training Program is a grant program supported by the state                   
  to assist in a federal effort that supports over 400 health                  
  aides throughout the rural villages of Alaska, providing                     
  health care to the residents of the most remote and rural                    
  communities of Alaska.  All the salaries of those employees                  
  are paid for by federal funds.  The Alaska contribution to                   
  sustaining that part of our health care system has been to                   
  provide some training funds through a grant program that was                 
  established in 1985."                                                        
                                                                               
  MS. MUNSON continued, "In order to control the budget of                     
  that program without anticipating the way things could                       
  change over time, that grant program was established so that                 
  the only eligible grantees were those corporations and                       
  communities which were currently receiving federal funds and                 
  currently employing health aides.  That worked fine until                    
  last year (1992) when in one region...Eastern Aleutian                       
  Tribes formed and began receiving the federal funds to                       
  provide the health aides.  When they came to the state to                    
  apply for the grant for training they were told, 'Sorry, you                 
  are not eligible because you did not exist in 1985'."                        
                                                                               
  MS. MUNSON continued further, "That was fixed for the first                  
  year by an agreement of subcontracts between the two                         
  organizations, but it had the effect of changing the amount                  
  of funding that was available within the organization.  We                   
  worked with the Department of Health and Social Services to                  
  try to come up with a minimal solution to that problem and                   
  that is the bill that was introduced here (HB 209), that                     
  provides a very technical change that says any organization                  
  which is receiving the federal funds to provide Community                    
  Health Aide Service can receive a grant, but we left in                      
  place the limit on the size of that grant based on the                       
  number of health aides that were employed in 1985.  It                       
  simply says, they had to be employed by some regional                        
  organization, not necessarily the same organization, and it                  
  reflects the tendency to form smaller organizations that can                 
  provide better services in a local area."                                    
                                                                               
  MS. MUNSON concluded, "This bill (HB 209) is a very                          
  technical solution to one of those glitches that develops as                 
  time goes by..."  She then addressed the zero fiscal note.                   
                                                                               
  Number 381                                                                   
                                                                               
  REPRESENTATIVE CYNTHIA TOOHEY said, "I support this bill (HB
).  When Myra first came to me, there was some feeling                    
  that this would create a large fiscal note...that apparently                 
  has been straightened out.  It does show that there is no                    
  fiscal note with it..."  She then asked, "Does this allow                    
  other communities to tighten up if they had aides in place?"                 
                                                                               
  MS. MUNSON said, "This bill (HB 209) will allow new programs                 
  to come into existence and receive the funding.  The                         
  protection against diminishing the level of funding for any                  
  program too much is that, only programs which can receive                    
  the base funding, if the total were appropriated of $30,000,                 
  (but) no one has ever gotten that full amount, is if they                    
  had three health aides in 1985..."                                           
                                                                               
  Number 416                                                                   
                                                                               
  DEBORAH ERICKSON, HEALTH PROGRAM SPECIALIST II, DIVISION OF                  
  PUBLIC HEALTH, DEPARTMENT OF HEALTH AND SOCIAL SERVICES,                     
  testified in support of HB 209.  "The department feels that                  
  under self-determination these communities have the right to                 
  choose who is going to be providing the services for them,                   
  if they are going to provide the services for themselves.                    
  Under the current statute it is not equitable in that if a                   
  community, if a village decides to change the organization                   
  that was providing services to them, under the Community                     
  Health Aide Program in 1984, they would no longer be                         
  eligible for state funds..."                                                 
                                                                               
  Number 436                                                                   
                                                                               
  REPRESENTATIVE DAVIES asked why HB 209, introduced by the                    
  HESS Committee, will be referred to the HESS Committee.                      
                                                                               
  MS. MUNSON said, "I was out of town.  The bill (HB 209) went                 
  to the speaker's office for referral and the speaker's staff                 
  recognized that if the bill went into effect and the                         
  legislature was to appropriate at the one hundred percent                    
  appropriation level, which as I have indicated has never                     
  occurred, there could be a possible fiscal impact..."                        
                                                                               
  REPRESENTATIVE TOOHEY concurred, "We were not able to get a                  
  hold of her to reassure the speaker's chamber that it was as                 
  face value.  So that is why the delay and long list of                       
  referrals..."                                                                
                                                                               
  Number 483                                                                   
                                                                               
  REPRESENTATIVE TOOHEY then MOVED that HB 209 be PASSED out                   
  of committee with individual recommendations.  There were no                 
  objections, and the MOTION CARRIED.                                          
                                                                               
  Number 492