Legislature(2023 - 2024)ADAMS 519
05/01/2023 10:00 AM House FINANCE
Note: the audio ![]()
and video ![]()
recordings are distinct records and are obtained from different sources. As such there may be key differences between the two. The audio recordings are captured by our records offices as the official record of the meeting and will have more accurate timestamps. Use the icons to switch between them.
| Audio | Topic |
|---|---|
| Start | |
| SB57 | |
| Adjourn |
* first hearing in first committee of referral
+ teleconferenced
= bill was previously heard/scheduled
+ teleconferenced
= bill was previously heard/scheduled
| += | SB 57 | TELECONFERENCED | |
| + | TELECONFERENCED |
SENATE BILL NO. 57
"An Act relating to medical assistance for recipients
of Medicaid waivers; establishing an adult care home
license and procedures; providing for the transition
of individuals from foster care to adult home care
settings; and providing for an effective date."
10:08:49 AM
Co-Chair Foster invited a motion to adopt the proposed
committee substitute.
Co-Chair Johnson MOVED to ADOPT proposed committee substitute
for SB 57, Work Draft 33-GS1708\U (Dunmire, 4/28/23).
Co-Chair Foster OBJECTED for the purpose of discussion.
10:09:37 AM
BRODIE ANDERSON, STAFF, REPRESENTATIVE FOSTER, explained
the changes in the CS, which were requested on behalf of
the Department of Health and were technical in nature. Each
of the changes related to home and community-based service
[Section 1 of SB 57]. Previously, four subsections had been
deleted from SB 57 by the Department of Health in
collaboration with the original sponsor of the home and
community-based service bill [SB 106, sponsored by Senator
Cathy Giessel]. The reason for the deletion was that the
Centers for Medicare and Medicaid Services (CMS) had
indicated that the legislature did not need the permission
of CMS to implement Section 1 of the bill. If the language
stayed in the bill, it could impact the implementation of
services.
Mr. Anderson continued that an older proposed committee
substitute for the bill [Version S.A] included under
Section 7(a) the requirement for a state Medicaid plan to
be submitted prior to implementation of home and community-
based services. He noted that Section 7(a) had been deleted
in Version U. Additionally, Section 8(a) and Section 8(b)
had been deleted, which were related to a conditional
effective date for Section 1 which would require the state
to seek federal approval prior to implementation. A portion
of Section 9 had also been deleted which would have
required federal approval in order to implement Section 1.
10:12:22 AM
Representative Galvin stated her understanding that some of
the changes were related to the effective dates and whether
there was permission from the federal government. She
wondered if the changes were related to the program's
eligibility for federal funding. She asked for
clarification.
Mr. Anderson responded that the deleted Section 8(a) and
Section 8(b) were the conditional effective dates and would
have mandated that Section 1 only go into effect if
approved by federal law. He reiterated that CMS had told
the legislature that it did not need federal approval in
order to implement Section 1.
Representative Galvin recalled that there was a bill
related to extending maternal care with an effective date
of 2025. She thought that the reasoning for the extended
effective date was similar. She wanted to ensure that the
changes in the CS would make it easier for the bill to pass
rather than making it more difficult. She asked if the
changes in the CS were made in order to expedite the
process.
Mr. Anderson responded in the affirmative, but wanted
clarification from the department to ensure that his
understanding was correct.
10:14:43 AM
TONY NEWMAN, DIRECTOR, SENIOR AND DISABILITIES SERVICES,
DEPARTMENT OF HEALTH, responded that Mr. Anderson was
correct. The deleted language would have asked the
department to seek approval when it did not need to, which
would have delayed the implementation process.
Representative Galvin commented that it was a wise move.
Representative Stapp asked what the expected timeline would
be to implement the changes.
Mr. Newman responded that the department still needed to
develop regulations to allow for the changes within the
bill. The department had pledged that the regulatory
changes would be made through a public and participatory
process.
Representative Galvin asked for details on a typical
timeline inclusive of a public process.
Mr. Newman responded that the department anticipated an
enactment date of the bill on July 1, 2024. The department
expected to spend about three months gathering public
input.
10:16:47 AM
Representative Josephson understood that the changes made
in the CS would allow the state to grow its workforce by
paying individuals to care for family members who receive
home and community-based services. He asked for more detail
on the associated costs of the changes.
Mr. Newman responded that the department did not anticipate
any increased Medicaid services costs to implement the
changes in the bill. He explained that the bill would not
make more people eligible for Medicaid but would simply
open up a wider availability of care providers by allowing
individuals already providing care to be reimbursed for
their services.
Representative Josephson asked what it would cost.
Mr. Newman responded that it was difficult to know the
costs because every person would have different needs;
however, it was not anticipated to impact many people.
Co-Chair Foster WITHDREW his OBJECTION to the adoption of
the CS [Work Draft 33-GS1708\U (Dunmire, 4/28/23). There
being NO further OBJECTION, it was so ordered.
Co-Chair Foster suggested that the committee hear a short
synopsis of the bill.
Mr. Newman explained that SB 57 would provide elderly
Alaskans with a new care option called adult home care. The
option would be provided through a new licensed residential
setting called an adult care home and through a
corresponding service called adult home care. The
department would develop a process through which
individuals on Medicaid home and community-based waivers
could apply to receive adult home care. In addition, the
language inserted into SB 57 from SB 106 [Section 1] would
allow "prohibited individuals" or "legally responsible
individuals" to provide personal care services under a new
program called the Community First Choice Program. The
program was a flexibility that was permitted during the
COVID-19 pandemic and it proved to be a successful method
to allow for more individuals to provide care.
10:20:44 AM
Co-Chair Foster stated he would entertain a motion to move
the bill.
Co-Chair Johnson MOVED to REPORT HCS CSSB 57(FIN) out of
committee with individual recommendations and the
accompanying fiscal note. There being NO OBJECTION, it was
so ordered.
HCS CSSB 57(FIN) was REPORTED out of committee with a "do
pass" recommendation and with five previously published
fiscal notes: FN3 (DOH), FN4 (DOH), FN5 (DOH), FN6 (DOH),
and FN7 (DOH).
Co-Chair Foster reviewed the agenda for the afternoon
meeting.
| Document Name | Date/Time | Subjects |
|---|---|---|
| SB 57 Public Testimony Rec'd by 042823.pdf |
HFIN 5/1/2023 10:00:00 AM |
SB 57 |
| SB 57 HCS WORKDRAFT HFIN v.U 042823.pdf |
HFIN 5/1/2023 10:00:00 AM |
SB 57 |
| SB 57 Public Testimony Rec'd by 050123.pdf |
HFIN 5/1/2023 10:00:00 AM |
SB 57 |