Legislature(2005 - 2006)

05/07/2005 06:12 PM FIN


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* first hearing in first committee of referral
+ teleconferenced
= bill was previously heard/scheduled
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.                                                                                                          

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