Legislature(2003 - 2004)

03/23/2004 03:03 PM HES

Audio Topic
* first hearing in first committee of referral
+ teleconferenced
= bill was previously heard/scheduled
HB 440-PIONEERS' HOMES/VETERANS' HOMES                                                                                        
                                                                                                                                
Number 1890                                                                                                                     
                                                                                                                                
CHAIR WILSON announced  that the next order of  business would be                                                               
HOUSE  BILL NO.  440, "An  Act relating  to the  Alaska Pioneers'                                                               
Home, and the Alaska Veterans'  Home; relating to eligibility for                                                               
admission  to  the Alaska  Pioneers'  Home  and Alaska  Veterans'                                                               
Home;  relating  to  state   veterans'  home  facilities;  making                                                               
conforming amendments; and providing for an effective date."                                                                    
                                                                                                                                
Number 1918                                                                                                                     
                                                                                                                                
DENNIS DeWITT,  Special Staff Assistant, Office  of the Governor,                                                               
testified  in support  of HB  440 and  answered questions  of the                                                               
members.   He  told  the  members that  HB  440  would allow  the                                                               
administration  to  proceed with  the  conversion  of the  Palmer                                                               
Pioneers'  Home to  a veterans  home.   The [existing]  pioneers'                                                               
home waiting  list would be  used to fill  the beds in  the home.                                                               
The population would be 75  percent veterans and the remaining 25                                                               
percent would be filled from the waiting list.                                                                                  
                                                                                                                                
Number 1982                                                                                                                     
                                                                                                                                
MR.  DeWITT  explained  that  there   is  a  20-year  history  in                                                               
implementing a way  for Alaska's veterans to  get their veterans'                                                               
benefits.   He has been involved  in the process for  the last 14                                                               
years, he added.  The  administration has worked closely with the                                                               
U.S. Department of  Veterans Affairs (VA).   Through this process                                                               
it was  determined that  the Palmer Pioneers'  Home was  the best                                                               
option in providing  a veteran home with the least  impact on the                                                               
pioneer home system.                                                                                                            
                                                                                                                                
MR. DeWITT said that last August the  VA sent a team to tour both                                                               
the Anchorage and  Palmer Pioneers' homes and  provided the state                                                               
with  suggestions  in implementing  a  VA  home.   One  of  their                                                               
primary interest  was the pioneers'  homes approach  to geriatric                                                               
care.   Mr.  DeWitt emphasized  that the  VA found  the pioneers'                                                               
homes program  very good.   It was  explained that Alaska  uses a                                                               
social model as opposed to  the traditional medical model used in                                                               
most  veteran  homes  [in  the   United  States].    The  primary                                                               
difference  is that  in the  social model  an effort  is made  to                                                               
consider an individual's care and  needs, and implement them in a                                                               
home-like setting for the rest of  the resident's life or time in                                                               
the facility.   The medical model emphasizes  caring for specific                                                               
medical needs in  more of a nursing home setting,  rather than an                                                               
assisted living home.   It took a day and a half  for the VA team                                                               
to  understand  what  was  being done  and  appreciate  the  high                                                               
quality program that  was being provided in  the pioneers' homes.                                                               
When  the team  left Alaska  the  members were  saying that  they                                                               
wanted  to  take this  program  [as  a  model] and  implement  it                                                               
throughout  the veterans  homes  system.   Mr. DeWitt  summarized                                                               
that  the administration  felt very  proud of  the program  being                                                               
offered in Alaska.                                                                                                              
                                                                                                                                
Number 2112                                                                                                                     
                                                                                                                                
MR. DeWITT  said the VA  then sent its  architect to look  at the                                                               
Palmer Pioneers' Home  to see what changes would need  to be made                                                               
to ensure it  meets federal standards.  The  heating and plumbing                                                               
systems need  to be brought up  to standards that will  provide a                                                               
functional building  for 20 years  into the future.   The capital                                                               
expenditures  required to  meet these  standards would  be shared                                                               
with the federal  government who would pay 65  percent, while the                                                               
state will  pay 35  percent of  the upgrade.   As  the transition                                                               
into a veterans home proceeds  those individuals who are veterans                                                               
will  be eligible  to receive  $26.95 per  day reimbursement  for                                                               
their cost of care.  For  those who are currently paying for care                                                               
at the  pioneers' home out  of their  own pocket that  would mean                                                               
about an $800  per month offset of their payment.   For those who                                                               
are being subsidized  fully by the pioneers' home,  that would be                                                               
an offset  of about $800 per  month from the general  fund.  That                                                               
is a strong reason to move in this direction, he commented.                                                                     
                                                                                                                                
MR. DeWITT told  the members that the administration  is about 99                                                               
percent completed  with its  negotiations.   He noted  that there                                                               
are  currently  some  points  to  be  clarified  with  the  under                                                               
secretary  of the  VA which  would  confirm the  administration's                                                               
understanding  of   the  status  of   the  veterans'  home.     A                                                               
preliminary response  confirms that  the VA  is in  agreement and                                                               
that  as soon  as legislation  has been  approved the  state will                                                               
move forward.  The funding for  this project is in the fast track                                                               
supplemental budget bill  which will provide a 4 to  6 month jump                                                               
in  moving  forward.    The   federal  match  funding  should  be                                                               
available  by  October when  the  state  will be  reimbursed,  he                                                               
added.                                                                                                                          
                                                                                                                                
Number 2205                                                                                                                     
                                                                                                                                
MR.  DeWITT   shared  that  the  administration   is  working  on                                                               
transition issues.   He emphasized that HB 440  has language that                                                               
guarantees  that  no  one  in  the pioneers'  home  now  will  be                                                               
required to  move because  of the change  from pioneers'  home to                                                               
veterans'   home  status.     Mr.   DeWitt  explained   that  the                                                               
administration told the  VA that it believes there  will be about                                                               
a  five-year  transition  period;  however, the  VA  believes  it                                                               
should be longer.   So at this period in  time the administration                                                               
has an open  transition period, he added.   The general operating                                                               
standards that  are currently in  place will continue,  but there                                                               
may be a few slight accommodations  to ensure all the VA criteria                                                               
is  met.     Mr.  DeWitt   stated  that  the   administration  is                                                               
comfortable that the estimated  $3.5 million capital construction                                                               
appropriation will  be adequate to accomplish  necessary changes.                                                               
In  summary,  Mr.  DeWitt  explained that  the  main  reason  the                                                               
administration looked at the Palmer  Pioneers' Home for a VA home                                                               
is that [the VA  would allow] Alaska to have a 79  bed home.  The                                                               
Palmer facility  has 83 beds  and the VA is  comfortable allowing                                                               
the extra [4] beds.                                                                                                             
                                                                                                                                
Number 2364                                                                                                                     
                                                                                                                                
ED  KNOEBEL,  Legion Post  27,  testified  on  HB 440  and  asked                                                               
questions concerning the bill.   He said that he understands that                                                               
the average  reimbursement rate by  the VA is  approximately $800                                                               
per month  for care in  a VA home and  the state will  pickup the                                                               
rest of  the cost.  If  a person is drawing  social security will                                                               
the individual  be allowed  to keep  those funds  or would  it be                                                               
used for payment of care [in the home].                                                                                         
                                                                                                                                
Number 2400                                                                                                                     
                                                                                                                                
JOHN  VOWELL, Director,  Division of  Alaska Longevity  Programs,                                                               
Department of  Health and  Social Services,  testified on  HB 440                                                               
and  answered questions.   The  VA considers  social security  as                                                               
income and that  income is used toward the cost  of care for that                                                               
veteran, he said.                                                                                                               
                                                                                                                                
MR. KNOEBEL replied that it  was his understanding that the money                                                               
received over the  $800 would be available for  the veterans' own                                                               
use.                                                                                                                            
                                                                                                                                
TAPE 04-21, SIDE B                                                                                                            
Number 2371                                                                                                                     
                                                                                                                                
CHAIR WILSON commented that she  believes that the $800 figure is                                                               
what the  VA provides for  payment for a  veteran to stay  in the                                                               
home, but  that is not the  actual cost of staying  in a pioneers                                                               
home.   The cost of  staying in a pioneers'  home is quite  a bit                                                               
more than that amount.                                                                                                          
                                                                                                                                
MR. KNOEBEL asked about the age  for which a veteran could reside                                                               
at  the  home.   He  commented  that  he  knows of  a  completely                                                               
disabled veteran who is  not yet 65 years of age  and needs to be                                                               
accommodated.                                                                                                                   
                                                                                                                                
MR. DeWITT  replied that  the Pioneers'  Home System  offers very                                                               
good geriatric  care.   In this  proposal the  65-age requirement                                                               
has  been  maintained  because  the type  of  care  available  is                                                               
geriatric nature.                                                                                                               
                                                                                                                                
MR. KNOEBEL asked  for clarification that a  veteran who receives                                                               
$850 per  month in social  security benefits [which will  be used                                                               
to pay  for a  veteran to stay  in the home]  will also  have the                                                               
state reimburse the rest of the cost.                                                                                           
                                                                                                                                
MR. DeWITT responded that the lowest  cost of care in the home is                                                               
about $2,100 per  month.  So the contribution by  a veteran would                                                               
be similar to anyone else using the facility.                                                                                   
                                                                                                                                
Number 2305                                                                                                                     
                                                                                                                                
MR. KNOEBEL asked if a  veteran is currently in another pioneers'                                                               
home,  would it  be  necessary for  the veteran  to  move to  the                                                               
Palmer home to received these benefits.                                                                                         
                                                                                                                                
MR. DeWITT  replied that  under this  proposal the  veteran would                                                               
have to  be in the  Palmer home to  receive these benefits.   The                                                               
ability to house folks in other  homes that are not veteran homes                                                               
is  not  achievable  under  any   options  that  are  before  the                                                               
administration.  He explained that  there was a prior proposal to                                                               
make that option  available, but the administration  has not been                                                               
able to  bring that to fruition.   This legislation is  an effort                                                               
to put a veterans' home in Alaska, he stated.                                                                                   
                                                                                                                                
Number 2248                                                                                                                     
                                                                                                                                
CHARLIE HUGGINS, Director, Office  of Veteran Affairs, Department                                                               
of  Military and  Veterans Affairs,  testified in  support of  HB
440.   He  told the  members that  it is  important to  note that                                                               
Alaska  is the  only  state without  a veterans'  home.   In  his                                                               
conversations  with  veterans around  the  state  the number  one                                                               
topic of concern  by veterans, other than  concern about personal                                                               
medical  problems, is  the need  for a  veterans' home,  he said.                                                               
There is a  sense of delight that soon there  will be a veterans'                                                               
home  in Alaska.    It is  important to  note  that the  American                                                               
Legion,  the  Disabled American  Veterans,  and  the Veterans  of                                                               
Foreign Wars have all voted  to support the Palmer Veterans' Home                                                               
concept, he said.   There have been many hollow  promises of what                                                               
would happen and  now there is a course of  action for the Palmer                                                               
home.   Mr. Huggins emphasized  that 100 percent of  the veterans                                                               
are very  concerned about pioneers,  so the fact that  25 percent                                                               
of  the  residents  in  the  Palmer  home  will  be  pioneers  is                                                               
important.                                                                                                                      
                                                                                                                                
Number 2170                                                                                                                     
                                                                                                                                
MR.  HUGGINS shared  a  conversation  he had  at  a McDonalds  in                                                               
Juneau where a  man was concerned that his brother  would have to                                                               
move to  the veterans' home  in Palmer.   He pointed out  that is                                                               
the beauty of  this plan, in that  no one is required  to move to                                                               
other  facilities.   He thanked  the  legislature for  supporting                                                               
this plan.                                                                                                                      
                                                                                                                                
Number 2151                                                                                                                     
                                                                                                                                
CHAIR WILSON asked for clarification  that veterans can be in any                                                               
home across  the state, but the  VA will not pay  the approximate                                                               
$800 toward the veteran's care.                                                                                                 
                                                                                                                                
MR. DeWITT replied that is correct.   He explained that there are                                                               
now pioneers  who are veterans.   These individuals will  have an                                                               
option of residing in any of these homes.                                                                                       
                                                                                                                                
Number 2111                                                                                                                     
                                                                                                                                
REPRESENTATIVE  GATTO pointed  to  the sectional  analysis of  HB
440, dated  March 22, 2004, page  3, Section 24, which  amends AS                                                               
47.55  by adding  a definition  section.   He read  the following                                                               
text:                                                                                                                           
                                                                                                                                
     The term "veteran" is defined to mean a person who has                                                                     
     not been dishonorably discharged from the armed forces                                                                     
     of the United States.                                                                                                      
                                                                                                                                
REPRESENTATIVE GATTO  said that  according to that  definition he                                                               
would  qualify even  though  he  has never  served  in the  armed                                                               
forces of the United States.                                                                                                    
                                                                                                                                
MR.  DeWITT replied  that  what Representative  Gatto  read is  a                                                               
short definition of  the bill.  He asked for  the members to turn                                                               
to page  12, lines 22 through  25.  The full  definition reads as                                                               
follows:                                                                                                                        
                                                                                                                                
     (5) "veteran"  means a person  who has  been discharged                                                                    
     from the  armed forces of the  United States, including                                                                    
     the  Alaska National  Guard or  the Alaska  Territorial                                                                    
     Guard;  the discharge  from the  armed  forces must  be                                                                    
     other than dishonorable.                                                                                                   
                                                                                                                                
Number 1962                                                                                                                     
                                                                                                                                
REPRESENTATIVE GATTO said he believes  the word "honorably" needs                                                               
to be in the definition.                                                                                                        
                                                                                                                                
MR.  DeWITT replied  that  in  working with  the  VA and  veteran                                                               
groups on the definition there  was some concern.  Originally the                                                               
definition was borrowed from other  sections of law that required                                                               
service  of 180  days and  several  other requirements.   It  was                                                               
pointed  out that  if  a  veteran were  in  for  a shorter  time,                                                               
wounded  in action,  and then  discharged, that  individual would                                                               
not be  covered.   He explained that  this definition  covers the                                                               
greatest number  of veterans  that the VA  would call  a veteran.                                                               
He  emphasized  that  the  administration  worked  with  all  the                                                               
veterans' groups to address their concerns of the definition.                                                                   
                                                                                                                                
REPRESENTATIVE  GATTO asked  how many  kinds of  discharges there                                                               
are and if there is a worse discharge than "dishonorable."                                                                      
                                                                                                                                
MR.  DeWITT  replied that  the  number  and kinds  of  discharges                                                               
depends on who  an individual is speaking with, which  is why the                                                               
definition is  worded as it  is.  He  explained that he  has been                                                               
told  that  there is  "honorable"  and  "dishonorable" [from  one                                                               
source],  but also  [from another  source] that  there are  other                                                               
honorable  discharges that  are not  dishonorable.   There was  a                                                               
general  consensus  that  as  long   as  the  discharge  was  not                                                               
dishonorable these individuals should qualify as a veteran.                                                                     
                                                                                                                                
Number 1863                                                                                                                     
                                                                                                                                
CHAIR  WILSON  commented  that she  believes  there  are  medical                                                               
discharges.                                                                                                                     
                                                                                                                                
MR. DeWITT submitted that there  is an on-going debate that those                                                               
discharges  are other  than honorable.   He  emphasized that  the                                                               
administration's intent  was to  include the  broadest definition                                                               
that  would  be allowed  by  the  VA.   He  pointed  out that  he                                                               
believes it is  important that the Alaska National  Guard and the                                                               
Alaska Territorial  Guard be included  in this  legislation since                                                               
these are  not included in  the federal definition.   Both groups                                                               
would  be   allowed  veteran   benefits,  but   without  specific                                                               
reference to the two groups they would not be included.                                                                         
                                                                                                                                
Number 1812                                                                                                                     
                                                                                                                                
CHAIR WILSON  pointed to  page 6,  lines 29 and  30, and  page 7,                                                               
lines 1  and 3.  She  explained that she received  numerous calls                                                               
from local  municipalities who were  concerned about  language in                                                               
the  bill  that refers  to  "maintenance",  but not  "operation".                                                               
With  the  decrease  in  state   funding  to  municipalities  and                                                               
decreased  revenue to  the  state there  was  concern, she  said.                                                               
Chair Wilson  said for example,  many communities have  seen less                                                               
and  less maintenance  in  harbors,  so there  is  an element  of                                                               
uncertainty.                                                                                                                    
                                                                                                                                
CHAIR WILSON moved Amendment  1, 23-GH2085\I.1, Mischel, 3/23/04,                                                               
which read as follows:                                                                                                          
                                                                                                                                
     Page 6, line 29, following "Maintenance":                                                                                
     Insert "and operation"                                                                                                   
                                                                                                                                
     Page 6, line 30:                                                                                                           
          Delete "The"                                                                                                          
          Insert "Except as otherwise provided in this                                                                          
     subsection, the"                                                                                                           
          Following "maintain":                                                                                                 
          Insert "and operate"                                                                                                  
                                                                                                                                
     Page 6, line 31 following "Sitka":                                                                                         
          Insert    ",    Anchorage,   Fairbanks,    Juneau,                                                                    
     Ketchikan, Palmer,"                                                                                                        
          Following "and":                                                                                                      
          Delete "at"                                                                                                           
                                                                                                                                
     Page 7, line 1, following "maintain":                                                                                      
          Insert "and operate"                                                                                                  
                                                                                                                                
     Page 7, line 3, following "maintained":                                                                                    
          Insert "and operated"                                                                                                 
                                                                                                                                
CHAIR WILSON explained that this  amendment would ensure that the                                                               
maintenance and  operation of the  pioneers' and  veterans' homes                                                               
would be taken care of by the state.                                                                                            
                                                                                                                                
REPRESENTATIVE COGHILL objected for purposes of discussion.                                                                     
                                                                                                                                
REPRESENTATIVE CISSNA  asked if  this amendment would  change the                                                               
fiscal  note  since  this  bill really  only  addresses  the  one                                                               
veteran home in Palmer.                                                                                                         
                                                                                                                                
Number 1727                                                                                                                     
                                                                                                                                
CHAIR WILSON  responded that this  amendment does not  change the                                                               
fiscal note.   She emphasized that she discussed  that point with                                                               
the  bill  drafter in  Legislative  Legal  and Research  Services                                                               
because  she  did   not  want  to  suggest   changes  that  would                                                               
jeopardize  the purpose  of the  bill.   Chair Wilson  added that                                                               
this language  provides clarity and  security to  the communities                                                               
who have pioneers' and veterans' homes.                                                                                         
                                                                                                                                
Number 1700                                                                                                                     
                                                                                                                                
REPRESENTATIVE  CISSNA  asked  Mr.   DeWitt  to  comment  on  any                                                               
implications this amendment might have on the bill.                                                                             
                                                                                                                                
MR. DeWITT  commented that the  administration's concern  is that                                                               
there would not  be a section inserted in the  bill that would be                                                               
internally  inconsistent.    He  said   that  as  he  reads  this                                                               
amendment he does not see  any significant difference in what the                                                               
administration is trying to accomplish.                                                                                         
                                                                                                                                
Number 1660                                                                                                                     
                                                                                                                                
REPRESENTATIVE  WOLF referred  to page  6, line  31, and  page 7,                                                               
line  1,   where  it  says,   "other  sites  designated   by  the                                                               
commissioner  of  health  and  social services."    He  asked  if                                                               
Anchorage, Fairbanks,  Juneau, Ketchikan, and Palmer  are already                                                               
designated by the commissioner.                                                                                                 
                                                                                                                                
CHAIR WILSON responded that those communities are designated.                                                                   
                                                                                                                                
MR.  DeWITT commented  that those  communities are  where current                                                               
pioneers' homes are sited.                                                                                                      
                                                                                                                                
REPRESENTATIVE  WOLF  asked  if  that  language  doesn't  already                                                               
address that portion of the amendment.                                                                                          
                                                                                                                                
CHAIR  WILSON agreed  that  it  probably does,  but  many of  the                                                               
municipalities felt  more comfortable with its  names included in                                                               
the language.                                                                                                                   
                                                                                                                                
Number 1618                                                                                                                     
                                                                                                                                
REPRESENTATIVE  GATTO   pointed  out   that  by   mentioning  the                                                               
communities by  name it will  lock in  the state to  maintain and                                                               
operate the homes whether they are occupied or not.                                                                             
                                                                                                                                
CHAIR WILSON  responded that it  would be necessary to  come back                                                               
to the  legislature to change  the law.   She clarified  that the                                                               
communities  want   changes  to  done  through   the  legislative                                                               
process.                                                                                                                        
                                                                                                                                
Number 1572                                                                                                                     
                                                                                                                                
REPRESENTATIVE WOLF posed a  hypothetical example where residents                                                               
of the pioneers'  home in Fairbanks voluntarily  moved to Palmer.                                                               
If this  amendment passes it would  be necessary to come  back to                                                               
the legislature  to delete the  maintenance and operation  of the                                                               
Fairbanks pioneers' home from state law.                                                                                        
                                                                                                                                
CHAIR WILSON agreed with Representative Wolf's assumption.                                                                      
                                                                                                                                
REPRESENTATIVE WOLF  commented that  he has  a problem  with that                                                               
concept.                                                                                                                        
                                                                                                                                
CHAIR  WILSON said  that  she  understands Representative  Wolf's                                                               
concern.    Some of  these  homes  are old  and  may  have to  be                                                               
dismantled at some time in the  future, but she said she believes                                                               
it is important to discuss it openly as is being done now.                                                                      
                                                                                                                                
REPRESENTATIVE WOLF said he objects to Amendment 1.                                                                             
                                                                                                                                
Number 1506                                                                                                                     
                                                                                                                                
REPRESENTATIVE SEATON asked  if this amendment is  in response to                                                               
the move of the ferry office.                                                                                                   
                                                                                                                                
MR.  DeWITT  commented  that  there   are  no  residents  of  the                                                               
pioneers' homes that are ferry office employees [laughter].                                                                     
                                                                                                                                
CHAIR WILSON explained that she  believes some municipalities are                                                               
concerned about  the possibility that  it might be  necessary for                                                               
them to  take over funding of  the homes, especially in  light of                                                               
the reduced revenue sharing.                                                                                                    
                                                                                                                                
REPRESENTATIVE  COGHILL commented  that  in reading  the bill  it                                                               
never  crossed his  mind that  the  state would  not operate  the                                                               
homes  as well  as  maintain  them.   He  said  he believes  this                                                               
language is somewhat redundant.                                                                                                 
                                                                                                                                
NUMBER 1441                                                                                                                     
                                                                                                                                
CHAIR WILSON reminded the members  of a comment the governor made                                                               
at the meeting  in Fairbanks when he was asked  what would happen                                                               
if the legislature does not produce  a fiscal plan.  The governor                                                               
commented  that he  would  go to  plan 2  which  named the  Sitka                                                               
Pioneers' Home  as one that would  cease to exist.   That comment                                                               
has made people nervous, she said.                                                                                              
                                                                                                                                
Number 1416                                                                                                                     
                                                                                                                                
REPRESENTATIVE GATTO said that he does  not like to see the state                                                               
being  forced to  operate and  maintain  a building  that has  no                                                               
occupants.  He said he disagrees with this concept.                                                                             
                                                                                                                                
CHAIR WILSON pointed to page 8,  lines 6 through 9, where it says                                                               
the following:                                                                                                                  
                                                                                                                                
     (e) The  department may  engage in  activities directed                                                                    
     to increase revenue from a  home.  These activities may                                                                    
     include the lease  of excess bed or floor  space, up to                                                                    
     50  percent of  the total  floor  space in  a home,  or                                                                    
     lease of space or buildings that  are not in use or are                                                                    
     underutilized.                                                                                                             
                                                                                                                                
Number 1346                                                                                                                     
                                                                                                                                
CHAIR WILSON pointed  out that this is new verbiage  that has not                                                               
been in  statute before  now.   The state  is looking  ahead, she                                                               
added.                                                                                                                          
                                                                                                                                
A roll  call vote  was taken.   Representatives  Cissna, Kapsner,                                                               
Coghill,  Seaton,  and Wilson  voted  in  favor of  Amendment  1.                                                               
Representatives  Gatto and  Wolf  voted against  it.   Therefore,                                                               
Amendment 1 was adopted by a vote of 5-2.                                                                                       
Number 1275                                                                                                                     
                                                                                                                                
REPRESENTATIVE CISSNA moved to report  CSHB 440 as amended out of                                                               
committee  with individual  recommendations and  the accompanying                                                               
fiscal  notes.   There being  no  objection, CSHB  440 (HES)  was                                                               
reported out of  the House Health, Education  and Social Services                                                               
Standing Committee.                                                                                                             

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