Legislature(1999 - 2000)

04/17/2000 02:05 PM House FIN

Audio Topic
* first hearing in first committee of referral
+ teleconferenced
= bill was previously heard/scheduled
txt
CS FOR SENATE BILL NO. 73(FIN)                                                                                                
                                                                                                                                
     "An Act relating to assisted living homes; and                                                                             
     providing for an effective date."                                                                                          
                                                                                                                                
SHARON CLARK,  STAFF, SENATOR MILLER testified  in support of                                                                   
the legislation, on behalf of  the sponsor. She observed that                                                                   
the State of Alaska with its scattered  population represents                                                                   
a unique challenge to provide  services to residents who need                                                                   
assisted  living supports.  The  intent of  this  bill is  to                                                                   
provide  good health  care for  long-term  care residents  in                                                                   
assisted  living homes.  While  the term  Assisted Living  in                                                                   
Alaska includes  smaller and  larger facilities,  the primary                                                                   
focus is  on smaller facilities  (15 beds or less.)  Assisted                                                                   
living homes,  which were formerly  called adult  foster care                                                                   
homes, provide a cost effective  alternative to institutional                                                                   
care. The program is regulated  by the old general assistance                                                                   
regulations, which need to be  revisited and updated to be in                                                                   
line  with the  standard of  care  that is  practiced by  the                                                                   
other assisted living programs.                                                                                                 
                                                                                                                                
The rate  was established in 1983  at $35 dollars a  day. The                                                                   
Alaska Rate Study  Report completed December  1998 found that                                                                 
the value of $35 dollars in 1983  would be equal to $68.30 in                                                                   
1998  dollars.  The rate  study  concludes that  the  general                                                                   
relief rate be increased by $38.31.                                                                                             
                                                                                                                                
Ms.  Clark reiterated  that  the purpose  and  intent of  the                                                                   
legislation was to  increase the daily rate paid  to the "mom                                                                   
and pop" (15 beds  and less) facilities by the  state for the                                                                   
vulnerable  adults  that are  unable  to provide  safely  for                                                                   
their own  medical, emotional  and personal  care needs.  She                                                                   
noted  that the  original  intent by  Senator  Miller was  to                                                                   
increase the base rate from $34.50  dollars to $70.00 dollars                                                                   
per  day, based  on  individual  care needs.  Senator  Miller                                                                   
acknowledged  that  the  increase  to  $70  dollars  was  not                                                                   
supportable with the current budget.  He therefore supports a                                                                   
base rate of $42.25  dollars a day the first  year and $51.00                                                                   
dollars a day for the second and  following years. This would                                                                   
include a geographical cost of living differential.                                                                             
                                                                                                                                
Ms.  Clark  observed  that  Senator  Miller  has  a  personal                                                                   
interest in the legislation as  the result of the care of his                                                                   
father.                                                                                                                         
                                                                                                                                
Ms. Clark  referred  to a report  published  by the from  the                                                                   
Alaska Commission  on Aging "Alaska Seniors',  Living Longer,                                                                   
Growing  Strong"  February 1998.  "Alaska  is  second in  the                                                                   
nation  in a proportional  growth of  our senior  population-                                                                   
with a 42% increase in people age 65+ in only 6 years (1990-                                                                    
1996...  Equally  impressive  is  the  anticipated  long-term                                                                   
growth of Alaska  Senior population. In 1980,  there were 11,                                                                   
547  people  over  the  age of  65.  Using  moderated  growth                                                                   
projections, population  experts agree this number  may reach                                                                   
80,927 by the year  2015. This is a cost of  600% increase in                                                                   
only 35 years."                                                                                                                 
                                                                                                                                
Ms. Clark maintained that caregivers  cannot afford to remain                                                                   
in  business.  She questioned  how  care  would be  given  to                                                                   
Alaska's seniors. Nursing homes  and hospitals cost over $300                                                                   
dollars  a day. She  stressed  that an increase  in the  rate                                                                   
would keep  people in  their own  communities and in  smaller                                                                   
homes.                                                                                                                          
                                                                                                                              
Representative Phillips noted  that the rate was increased to                                                                   
$75 dollars  in the  House HESS  Committee. Ms. Clark  stated                                                                   
that the sponsor supports the increase.                                                                                         
                                                                                                                                
Co-Chair Therriault  observed that  the issue is  the overall                                                                   
cost. The Alaska  Mental Health Trust Authority  will cover a                                                                   
portion for  the first  two years.  The Trust indicated  that                                                                   
they would cover an additional year at a smaller amount.                                                                        
                                                                                                                                
Representative  Phillips  observed  that  the Trust  and  the                                                                   
Division of Mental  Health have requested in  the fiscal note                                                                   
that the payment be increased to $100 dollars.                                                                                  
                                                                                                                                
DWIGHT  BECKER,  PROGRAM  COORDINATOR,   DIVISION  OF  SENIOR                                                                   
SERVICES,  DEPARTMENT OF  ADMINISTRATION, ANCHORAGE  provided                                                                   
information on  the legislation.  He responded to  a question                                                                   
by Vice  Chair Bunde. He agreed  that closer of the  "mom and                                                                   
pop" organizations  would result  in increased state  support                                                                   
and cost.                                                                                                                       
                                                                                                                                
KAY   BURROWS,  DIRECTOR,   DIVISION   OF  SENIOR   SERVICES,                                                                   
DEPARTMENT   OF  ADMINISTRATION   ANCHORAGE   testified   via                                                                   
teleconference  in support of  the legislation.  She stressed                                                                   
the  need  for small  assisted  living  homes to  receive  an                                                                   
increased rate.                                                                                                                 
                                                                                                                                
ALISON    ELGEE,   DEPUTY    COMMISSIONER,   DEPARTMENT    OF                                                                   
ADMINISTRATION testified  in support of the  legislation. The                                                                   
legislation impacts both the Division  of Senior Citizens and                                                                   
Division of Mental Health clientele.  General relief payments                                                                   
do  not  go   to  every  assisted  living   client.  Personal                                                                   
resources  are offset.  The department  also  looks at  other                                                                   
forms of public assistance and waivers.                                                                                         
                                                                                                                                
Vice Chair Bunde  questioned the impact of the  loss of small                                                                   
assisted living homes.                                                                                                          
                                                                                                                                
Ms. Elgee  responded that the  information was  not currently                                                                   
available.  She  clarified  that  the  concern  is  that  the                                                                   
existing  assisted living  providers would  refuse to  accept                                                                   
general  relief clients.  These  clients  are vulnerable  and                                                                   
subject  to  abuse.  More  expensive  alternatives  would  be                                                                   
required if  they were not cared  for by the  smaller private                                                                   
providers.  Assisted  living  homes  cost  approximately  $70                                                                   
dollars a  day versus $300 dollars  a day in a  nursing home.                                                                   
Not all of the placements would  be eligible for nursing home                                                                   
assistance.   She   explained    that   the   Department   of                                                                   
Administration  initiated a study  in response to  complaints                                                                   
that the  rates ($35  dollars a  day) were insufficient.  She                                                                   
explained  that  the 1998  study  identified  a cost  of  $70                                                                   
dollars a day. Individuals in  assisted living are allowed to                                                                   
keep $75  to $100 dollars a  day in personal  needs allowance                                                                   
before the department offsets the cost.                                                                                         
                                                                                                                                
Vice Chair Bunde  questioned if people could be  feed for $35                                                                   
dollars a day, let alone be cared for at that rate.                                                                             
                                                                                                                                
SB  73   was  heard  and   HELD  in  Committee   for  further                                                                   
consideration.                                                                                                                  
                                                                                                                                

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