05/03/2019 01:30 PM House FINANCE

HOUSE BILL NO. 96                                                                                                             
                                                                                                                                
     "An Act relating to Alaska Pioneers' Home and Alaska                                                                       
     Veterans' Home rates and services."                                                                                        
                                                                                                                                
1:31:01 PM                                                                                                                    
                                                                                                                                
Co-Chair Wilson indicated there were two amendments for the                                                                     
bill.                                                                                                                           
                                                                                                                                
Representative Knopp had a conceptual amendment when                                                                            
appropriate.                                                                                                                    
                                                                                                                                
Representative Josephson MOVED to ADOPT Amendment 1 (31-                                                                        
LS0646\U.2) (copy on file):                                                                                                     
                                                                                                                                
     Page 3, line 22:                                                                                                           
          Delete "$3,100"                                                                                                       
          Insert "2,976"                                                                                                        
                                                                                                                                
     Page 3, line 24:                                                                                                           
          Delete "6,090"                                                                                                        
          Insert "5,396"                                                                                                        
                                                                                                                                
     Page 3, line 27:                                                                                                           
          Delete "$8,833"                                                                                                       
          Insert "7,814"                                                                                                        
                                                                                                                                
     Page 30, line 30"                                                                                                          
          Delete "$10,000"                                                                                                      
          Insert "8,500"                                                                                                        
                                                                                                                                
Co-Chair Wilson OBJECTED for discussion.                                                                                        
                                                                                                                                
Representative   Josephson  spoke   to  the   amendment.  He                                                                    
reported there had  been some objection to the  rates and he                                                                    
was  offering an  amendment that  would slightly  reduce the                                                                    
rate  adjustment. He  had learned  that the  rate adjustment                                                                    
that  was  currently  in  the  bill  exceeded  the  rate  of                                                                    
inflation since 2004  when the rates were  last adjusted. He                                                                    
supported HB  96 but thought  the rates should  be adjusted.                                                                    
He  thought Representative  Fields would  not object  to the                                                                    
amendment.  He also  thought  the  amendment was  consistent                                                                    
with Mr.  Teal's testimony from  the previous day,  in which                                                                    
the fiscal  impacts of the  Department of Health  and Social                                                                    
Services  rates  were difficult  to  project.  Mr. Teal  had                                                                    
noted that steep  rate increases, particularly at  the 1 and                                                                    
2 levels of  care could increase state costs  by driving out                                                                    
self-paying,  less  costly  patients.  The  amendment  would                                                                    
still  generate  over  $1  million  in  new  revenues  while                                                                    
aligning  the committee  substitute  with testimony  already                                                                    
heard  from the  public, the  Legislative Finance  Division,                                                                    
and the sponsor.  He asked members for their  support of the                                                                    
amendment.                                                                                                                      
                                                                                                                                
Co-Chair Wilson  asked Representative  Fields to  comment on                                                                    
the amendment.                                                                                                                  
                                                                                                                                
1:33:25 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE  ZACK  FIELDS,  BILL SPONSOR,  supported  the                                                                    
amendment.  He   indicated  that  it  was   consistent  with                                                                    
overwhelming  public   testimony  and  testimony   from  the                                                                    
Legislative Finance Division.                                                                                                   
                                                                                                                                
Vice-Chair  Ortiz  spoke  in  favor  of  the  amendment.  He                                                                    
thought  it  could  help  to  put  the  state  in  a  better                                                                    
situation,   a   goal   originally    put   forth   by   the                                                                    
administration.                                                                                                                 
                                                                                                                                
Co-Chair Wilson WITHDREW her OBJECTION.                                                                                         
                                                                                                                                
There being  NO OBJECTION,  it was  so ordered.  Amendment 1                                                                    
was ADOPTED.                                                                                                                    
                                                                                                                                
Co-Chair Wilson MOVED to ADOPT Amendment 2 (copy on file):                                                                      
                                                                                                                                
     Page 4, line 8:                                                                                                            
          Delete "$70"                                                                                                          
          Insert "$160"                                                                                                         
                                                                                                                                
     Page 4, line 13:                                                                                                           
          Delete "$100"                                                                                                         
          Insert "$322"                                                                                                         
                                                                                                                                
Vice-Chair Johnston OBJECTED for discussion.                                                                                    
                                                                                                                                
Co-Chair Wilson  explained her  amendment. She  relayed that                                                                    
the on  the previous  day the committee  had heard  that $70                                                                    
[Bill language: a  day for services provided in a  home to a                                                                    
recipient  who requires  the  provision  of housing,  meals,                                                                    
emergency  assistance,  medication  administration,  health-                                                                    
related services, recreation,  and extensive assistance with                                                                    
activities  of daily  living for  up  to eight  hours a  day                                                                    
between 6:00  a.m. and 6:00 p.m.,  including meals scheduled                                                                    
during the  period the recipient is  receiving the services]                                                                    
was not close  to the amount per day and  that $160 would be                                                                    
more appropriate.  She continued that  24 hours per  day for                                                                    
up to  14 days was $322  [Bill language: a day  for room and                                                                    
board provided  in a  home to a  recipient who  requires the                                                                    
provision   of   housing,   meals,   emergency   assistance,                                                                    
medication    administration,    health-related    services,                                                                    
recreation,  and  extensive  assistance with  activities  of                                                                    
daily living  for 24 hours  a day  for up to  14 consecutive                                                                    
days]. She  was inserting  the amounts  that had  been heard                                                                    
the previous day.                                                                                                               
                                                                                                                                
Representative  Josephson thought  the rate  increases would                                                                    
be short-lived because  of a transition period.  He asked if                                                                    
he had  heard correctly. Co-Chair Wilson  responded that the                                                                    
daily rate  for 24-hour care  was limited to  14 consecutive                                                                    
days.  She highlighted  page 4,  lines 13-16.  There was  no                                                                    
limit on  the daily rate  for 8  hours per day.  One service                                                                    
was day service as opposed to an over-night service.                                                                            
                                                                                                                                
Representative Sullivan-Leonard  was aware,  having personal                                                                    
experience dealing with home  healthcare for family members,                                                                    
that the  proposed increase did  not cover the cost  but was                                                                    
closer  to what  it might  be. She  would be  supporting the                                                                    
amendment.                                                                                                                      
                                                                                                                                
Vice-Chair Johnston WITHDREW her OBJECTION.                                                                                     
                                                                                                                                
There being  NO OBJECTION,  it was  so ordered.  Amendment 2                                                                    
was ADOPTED.                                                                                                                    
                                                                                                                                
1:36:39 PM                                                                                                                    
AT EASE                                                                                                                         
                                                                                                                                
1:38:16 PM                                                                                                                    
RECONVENED                                                                                                                      
                                                                                                                                
Representative Knopp  MOVED to ADOPT Conceptual  Amendment 3                                                                    
(copy on file):                                                                                                                 
                                                                                                                                
     Page 1, line 6                                                                                                             
          Delete "$200"                                                                                                         
          Insert "$500"                                                                                                         
                                                                                                                                
Co-Chair Wilson OBJECTED for discussion.                                                                                        
                                                                                                                                
Representative Knopp explained  his amendment. He understood                                                                    
increasing  rates for  those who  could pay.  However, there                                                                    
were seniors  that simply  could not pay.  He was  trying to                                                                    
offer protection on the lower end.                                                                                              
                                                                                                                                
Representative  Tilton  referred to  page  2,  line 13.  She                                                                    
asked  if  the   amount  needed  to  also   be  changed  for                                                                    
consistency.                                                                                                                    
                                                                                                                                
Co-Chair Wilson read from line  13. She thought the line had                                                                    
to do with  payment assistance received by  a home resident.                                                                    
She  suggested directing  the question  to  Mr. Lasley,  the                                                                    
division director.                                                                                                              
                                                                                                                                
1:40:38 PM                                                                                                                    
                                                                                                                                
CLINTON LASLEY, DIRECTOR, DIVISION  OF ALASKA PIONEERS HOME,                                                                    
DEPARTMENT    OF   HEALTH    AND   SOCIAL    SERVICES   (via                                                                    
teleconference),  responded that  the $200  was referred  to                                                                    
HB 96  and in  regulations.  The amount  was  related to  an                                                                    
individual  on   payment  assistance.  The   individual  was                                                                    
allowed to keep  $200 of their monthly income  and could use                                                                    
it for things like  clothing and, personal hygiene products.                                                                    
The  payment assistance  program  took  taxes and  insurance                                                                    
premiums into account. They were  taken off the top of their                                                                    
income prior to  determining how much they  were required to                                                                    
pay. He reiterated  that the $200 was for  items personal in                                                                    
nature.                                                                                                                         
                                                                                                                                
Co-Chair  Wilson suggested  that  the  amendment would  give                                                                    
individuals $500 to  spend the way they  liked. She referred                                                                    
the $200  noted on  page 2,  line 13.  She thought  the $200                                                                    
amount had  to do  with payment  assistance and  what funds;                                                                    
were  included  in  the  payment  assistance.  She  wondered                                                                    
whether  the $200  listed would  need to  change to  $500 as                                                                    
well, or whether they were 2 separate ideas.                                                                                    
                                                                                                                                
Mr. Lasley  thought the amount  on page  2 would need  to be                                                                    
changed as well.                                                                                                                
                                                                                                                                
Representative  Knopp   MOVED  to   ADOPT  Amendment   1  to                                                                    
Conceptual Amendment 3:                                                                                                         
                                                                                                                                
     Page 1, line 6                                                                                                             
          Delete "$200"                                                                                                         
          Insert "$500"                                                                                                         
                                                                                                                                
     Page 2, line 13                                                                                                            
          Delete "$200"                                                                                                         
          Insert "$500"                                                                                                         
                                                                                                                                
Co-Chair Wilson OBJECTED for discussion.                                                                                        
                                                                                                                                
Representative Knopp explained the change.                                                                                      
                                                                                                                                
There being NO OBJECTION, it was so ordered.                                                                                    
                                                                                                                                
Co-Chair  Wilson  WITHDREW  her OBJECTION.  There  being  NO                                                                    
OBJECTION, it  was so ordered. Amended  Conceptual Amendment                                                                    
3 was ADOPTED.                                                                                                                  
                                                                                                                                
Vice-Chair  Johnston MOVED  to  report CSHB  96(FIN) out  of                                                                    
Committee   with   individual    recommendations   and   the                                                                    
accompanying fiscal notes. There  being NO OBJECTION, it was                                                                    
so ordered.                                                                                                                     
                                                                                                                                
CSHB 96(FIN)  was REPORTED  out of  committee with  four "do                                                                    
pass"  recommendations  and  with  six  "no  recommendation"                                                                    
recommendations and with two new  fiscal impact notes by the                                                                    
Department of Health and Social Services.                                                                                       
                                                                                                                                
1:44:30 PM                                                                                                                    
AT EASE                                                                                                                         
                                                                                                                                
1:45:04 PM                                                                                                                    
RECONVENED