Legislature(2005 - 2006)
05/07/2005 06:12 PM FIN
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CS FOR SENATE BILL NO. 125(JUD) An Act relating to the licensing, regulation, enforcement, and appeal rights of ambulatory surgical centers, assisted living homes, child care facilities, child placement agencies, foster homes, free-standing birth centers, home health agencies, hospices or agencies providing hospice services or operating hospice programs, hospitals, intermediate care facilities for the mentally retarded, maternity homes, nursing facilities, residential child care facilities, residential psychiatric treatment centers, runaway shelters, and rural health clinics; relating to possession of a firearm at licensed entities and facilities; relating to criminal history requirements, and a registry, regarding certain licenses, certifications, approvals, and authorizations by the Department of Health and Social Services; making conforming amendments; and providing for an effective date. DR. RICHARD MANDSAGER, DIRECTOR, DIVISION OF PUBLIC HEALTH, DEPARTMENT OF HEALTH & SOCIAL SERVICES, provided Committee members a handout - Public Health, Protecting and Promoting the Health of All Alaskans. (Copy on File). Dr. Mandsager pointed out the three goals of the bill. · The Department currently licenses or certifies 19 programs administered under at least 12 different statutory schemes. The Division of Public Health has been given the responsibility of managing the licensure and certification of the programs. Dr. Mandsager explained that each program has different rules and the goal is to standardize and simplify regulatory and statutory law. 8:05:16 PM · The second goal is to determine how to minimize the risk to vulnerable clients by utilizing background checks as they work with the institutions. There would be a two-part background check modeled on existing programs. · The bill envisions a private registry. Dr. Mandsager noted that Amendment #1, clarifies the immunity language. (Copy on File). 8:08:22 PM Co-Chair Meyer asked about the zero fiscal notes. Dr. Mandsager explained that the original bill had a small fiscal note from the Department of Law, however, that Division received a large federal grant from the Centers for Medicare and Medicaid Services to pilot the approach to the background checks. There is money in the grant to pay for regulation development; hence, the notes were zeroed out. MICHAEL MACLEOD BULL, EXECUTIVE DIRECTOR, AMERICAN CIVIL LIBERITIES UNION (ACLU), voiced concern with how vague the criminal registry was and the prohibition conflict with the State's duty to provide service to prisoners. Mr. Bull supported the link between the restriction imposed on a person coming out of prison, who may or may not have been rehabilitated. Basically, ACLU opposes implementing more barriers for those re-entering society. Mr. Bull proposed use of a mechanism to define the listing process. If the name were on a registry then that person would be barred from interacting with the entity. Objections exist on two levels: · Policy level - The more barriers placed on a person, the more difficult it becomes to reenter society; and · Constitutional right for rehabilitation of prisoners. 8:13:40 PM MARIE DARLIN, COORDINATOR, ALASKA ASSOCIATION OF RETIRED PERSON'S (AARP) TASK FORCE, JUNEAU, spoke in support of the legislation, which would put all regulations for assisted living into one place. AMY ONEY, ASSISTED LIVING HOME, ANCHORAGE, spoke in support of the reorganization, but expressed concern with the registry. She believed that the language was too broad. 8:17:10 PM Representative Holm inquired if the proposed legislation could level the playing field between profits and non- profits. Ms. Oney agreed, pointing out that the bill has brought attention to that matter, yet voiced concern that licensing costs for funding would not be able to keep up with regulation requirements. 8:19:24 PM Ms. Oney discussed the regulations detrimental to the existing homes because of extensive requirements for those homes. There is no way for those costs to be recouped, which places the home in a difficult position. Representative Holm mentioned his concerns with the regulation requirements. Ms. Oney explained that in the proposed regulations, there are requirements on food handling such as the number of times hand towels must be laundered and how that is documented. 8:21:26 PM Representative Holm felt that regulations could be onerous in regard to family-style dinner situations. Ms. Oney agreed. Representative Holm reiterated his concern about the process and asked if the elderly are threatened in the homes in any way. Ms. Oney responded that in some homes, there are existing beds. If there is no quality level of care, the homes loose clients. There are regulations now regarding the certification process; the next step proposed could place a "huge burden" on the administrative process for the smaller homes. 8:24:21 PM Representative Holm recalled the arbitrary decision made to cut back dollars allocated for each patient. Ms. Oney said that resulted from refinancing room and board cap. It went from beyond the indicated amount for Adult Public Assistance (APA) and refinanced that into the Adult Medicaid funds. The amount changed from $75 dollars per day to $18.54 per day. She added, her business has experienced a net loss of $4,000 to $5,000 per month. Homes have gone through the regulatory review for those extra funds in order to meet their business obligations. 8:26:32 PM Representative Holm was disturbed with the way the State of Alaska treats elderly. It is not in the best interest for the State to make the regulatory practice so difficult that it impacts providing consistent care. 8:27:44 PM SHERRY METTLER, (TESTIFIED VIA TELECONFERENCE), ASSISTED LIVING INDUSTRY, FAIRBANKS, addressed concerns of the non- profit versus the profit playing field. Larger homes have higher resources and time to review regulations, which total 230 pages. She addressed "safety issues" and how regulations affect the simplest tasks. Ms. Mettler commented on the registry and the process of hiring. She indicated concern with misconduct and abuse issues the registry proposes, pointing out that every person working in the industry must have a criminal background check. To create another level of criminal justice could potentially destroy lives and discredit homes. It puts everyone at risk working in that industry. She reiterated her concerns regarding the registry, the burden on those homes and cuts to administrative costs. 8:31:22 PM Representative Hawker MOVED to ADOPT Amendment #1, #24- GS1016\L.1, Mischel, 5/7/05. Co-Chair Meyer OBJECTED. STACY KRALY, ASSISTANT ATTORNEY GENERAL, DEPARTMENT OF LAW, noted that Amendment #1 provides a technical correction. Co-Chair Meyer WITHDREW his OBJECTION. There being NO further OBJECTION, Amendment #1 was adopted. 8:34:28 PM Representative Croft MOVED to ADOPT Amendment #2. Vice- Chair Stoltze OBJECTED for the purpose of discussion. Representative Croft pointed out that there are different classes of volunteers. He maintained the purpose of the amendment was to remove the requirement for criminal background checks for "supervised" volunteers in facilities listed. Dr. Mandsager agreed with the intent of the amendment. He pointed out that problems arise where volunteers might form a regular relationship with the home's clients and then might take advantage of that client. Dr. Mandsager suggested alternative language on Page 11, Line 15, deleting "or" and inserting "and who have regular contact with individuals who receive services from the entity or". That language should cover volunteers that are coming on a regular basis. 8:38:20 PM Representative Croft pointed out that there could be a regular volunteer group such as a Sunday church group. He suggested that the Department provide guidance through the regulations. 8:39:05 PM Representative Croft reiterated his argument in support of the amendment. Vice-Chair Stoltze noted that he has regular contact with the homes in his district, as do the Eagle Scouts and other groups. 8:40:36 PM Dr. Mandsager noted that the intent was to limit the number of crime background checks on volunteers to those that spend regular, unsupervised time with the clients. He hoped to do that through regulation. 8:41:25 PM Vice-Chair Stoltze mentioned clerical visitations as being one of the most regular-type of volunteer help. Representative Hawker spoke in support of the amendment, suggesting that "unsupervised" would be the correct approach. Discussion followed between members regarding the intent of "unsupervised". 8:43:59 PM Representative Holm stressed the importance of encouraging volunteers and cautioned against creating more bureaucracy than necessary. He requested that the bill be held in Committee. Vice-Chair Stoltze WITHDREW his OBJECTION. There being NO further OBJECTION, Amendment #2 was adopted. 8:45:32 PM Representative Croft MOVED to ADOPT Amendment #3. Co-Chair Meyer OBJECTED. Representative Croft explained that the amendment would insert language on Page 14, Line 25, "shall be notified of such placement and", and on Page 14, Line 28 insert, "if the department finds no relation between the information placed on the registry and the risk of harm to the entity's clientele". Ms. Kraly noted that the Department would support that language. In response to Representative Hawker, Representative Croft reviewed the definition of "substantial". Representative Hawker questioned if "substantial" should be struck. Representative Hawker MOVED to AMEND the New Amendment #3, by deleting "substantial". There being NO OBJECTION, it was amended. Co-Chair Meyer WITHDREW his OBJECTION to the amended amendment. There being NO further OBJECTION, amended Amendment #3 was adopted. Vice-Chair Stoltze MOVED to REPORT HSC CSSB 125 (FIN) out of Committee with individual recommendations and with the accompanying fiscal notes. Representative Holm OBJECTED. A roll call vote was taken on the motion. IN FAVOR: Joule, Stoltze, Croft, Hawker, Meyer, Chenault OPPOSED: Holm Representative Kelly, Representative Moses, and Representative Foster were not present for the vote. The MOTION PASSED (6-1). HCS CS SB 125 (FIN) was reported out of Committee with "individual" recommendations and with zero note #2 by the Department of Health & Social Services and zero note #3 by the Department of Law.