Legislature(2001 - 2002)
03/27/2001 05:17 PM House MLV
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* first hearing in first committee of referral
+ teleconferenced
= bill was previously heard/scheduled
+ teleconferenced
= bill was previously heard/scheduled
HB 88 - PIONEERS' AND VETERANS' HOME/ADVISORY BD CHAIR CHENAULT announced that the next order of business would be HOUSE BILL NO. 88, "An Act changing the name of the Alaska Pioneers' Home to the Alaska Pioneers' and Veterans' Home and of the Alaska Pioneers' Homes Advisory Board to the Alaska Pioneers' and Veterans' Home Advisory Board; relating to services for veterans in the home; relating to the advisory board for the home; making other amendments to the statutes relating to the home; making conforming amendments to other statutes; and providing for an effective date." Number 2344 LADDIE SHAW, Special Assistant, Office of Veteran Affairs, Department of Military & Veterans' Affairs (DMVA), testified via teleconference. Mr. Shaw announced that the veterans truly need the Pioneers' and Veterans' Home project to move forward. He informed the committee that Alaska has one of the largest veteran populations in the nation. However, the state provides the smallest amount of support. Presently, [DMVA] has a $540,000 budget that supports in excess of 50,000 veterans in the state. In comparison, Mississippi - one of the poorest states in the nation - has four veterans' homes that are supported with over $4 million in state general funds. Mr. Shaw requested the committee's support in moving this idea forward. Number 2437 MG PHILLIP OATES, Adjutant General/Commissioner, Department of Military & Veterans' Affairs, said that he wanted to begin by impressing upon the committee the weight of the decision that it's making. General Oates announced that not moving this bill forward is a vote against veterans. TAPE 01-8, SIDE B GENERAL OATES discussed the military presence in Alaska. For Alaska, the military has been and is currently the largest industry of the state. Furthermore, one in five Alaskans has some connection with the military. In regard to why the veterans haven't been more active in working with the legislature, General Oates explained: "That's because they know selfless service. And they depend on their elected representatives to do what's right for them." GENERAL OATES stressed, "It's disgraceful that the state with the second highest per capita number of veterans in our nation does not have a veterans' home." He said that the congressional delegation and the Secretary of Veterans Affairs (VA) have indicated that they want to help, but can't until the state takes a move forward. "It's time to move forward," he charged. He remarked that this is the largest shortcoming during his time in office. GENERAL OATES described a recent meeting with a Dr. Cohen(ph), a former paratrooper in the Israeli Army who now lives in the U.S., in the Anchorage Pioneers' Home. Dr. Cohen and his wife have expertise in designing homes to help those in severe medical need in the Alzheimer's category. General Oates described the medical model in which the medical needs are met, but the human needs are not. He recalled that Dr. Cohen contrasted the medical model with the Pioneers' Home system and how something such as a Pioneers' or Veterans' Wall of Honor in the home could make things better. In Alaska there are six regional Pioneers' Homes across the state and thus Alaska has the opportunity to go beyond Mississippi with its four homes. He pointed out that if Alaska builds veterans' homes, there will be fewer beds, it will cost more, and will result in the medical model. In conclusion, General Oates said, "So, when you think about what you owe to the veterans, I would ask you to think of what they've done for Alaska. ... And if we say, as a state, we can't afford to assist our veterans, it's not a state that I'd want to stay in as a military member." Number 2280 REPRESENTATIVE MURKOWSKI referred to General Oates testimony at the prior hearing that she understood to mean that Alaska's one- year residency requirement precludes the state from obtaining federal VA money. GENERAL OATES pointed out that the state has the opportunity to earn veterans' benefits that were earned through the [Pioneers' Home] system. However, since it's a nontraditional veterans' care system, the state cannot receive the per diem that is available. There is great interest from Secretary Principi to make this a pilot project and thus make the per diem available. When Secretary Principi visited two of Alaska's [Pioneers'] homes, he said that Alaska's homes compare very well with other veterans' homes and have a better approach to long-term care than in other homes around the nation. However, the concern is in regard to the homes meeting basic needs such as fire protection, health, sanitation, safety, and handicap access. General Oates related his confidence, after visiting the homes himself, that when the state commits to going forward and the federal VA comes down, those federal VA benefits for [veteran] residents will come. General Oates reiterated his testimony from the prior hearing that this is the best idea that has been presented and thus if it isn't acceptable, he requested help developing another idea. Number 2159 REPRESENTATIVE MURKOWSKI related her understanding that the "hitch" in not being able to obtain federal dollars is because the Pioneers' Home System is a nontraditional facility. However, it isn't necessarily tied into the one-year residency requirement. GENERAL OATES said her understanding seems to be correct. MR. SHAW pointed out that presently there are no requirements in the system because veterans aren't acknowledged as a part of the VA's entitlement programs because they don't have their own bed space. If this legislation moves forward and there is a Pioneers' and Veterans' Home, then the VA will potentially move forward the entitlements to those veterans in those beds. Those per diem entitlements would range between $39-$52 a day. Number 2108 REPRESENTATIVE MURKOWSKI recalled General Oates eloquent testimony regarding the debt we owe veterans. However, in conversations with less supportive people, she has discovered concern that by having a combination home, "we" are taking respect from the Pioneers' of Alaska. There is fear that there will be change [if the veterans move in]. She asked whether the name is that critical. GENERAL OATES remarked that the more "we" talk to groups, the more their concerns are alleviated. When talking with the residents and watching them embrace the veterans, he didn't think that they have such concern. Also, this is important to the veterans, who view this as a right and something they have earned. Therefore, General Oates said that he would be opposed to not changing the name. Number 1944 REPRESENTATIVE GREEN recalled that when he first came to the state in 1977, he felt that the Pioneers' Home concept was fantastic. Although litigation changed that [concept] significantly, the home remained wonderful. Then, about 10-15 years ago the residents of the Pioneers' Homes changed from the average elderly person to persons with various forms of dementia. When he visited the Pioneers' Home [in Anchorage] two or three years ago, it was demoralizing because of the state of the residents, although the care was still there. Therefore, he asked whether a healthy, aging veteran in that environment would appreciate being placed in such a situation. GENERAL OATES said that as [the state] becomes more involved with long-term care, he has found that [residents of homes] migrate to the more extreme end. From his perspective, there are just more people in that population and there is also a change in the way people view healthcare. That's another reason why the veterans' home system is in crisis around the U.S.; it's not the same home once envisioned. GENERAL OATES, in regard to whether this [combination] home meets all the needs, responded no. He remarked that maybe those veterans [with dementia] are the ones that we should reach out to the most. As Dr. Cohen related, "we" have a responsibility to help their quality of life. He also recalled Dr. Cohen saying that the veterans cannot recall the short term, but can remember the "spark," military service, of the past. GENERAL OATES stated: "If we are unsuccessful in a committee that has military and veterans in its title and its job description, I don't give much hope for the rest of our ... prospects. Don't sit on this bill, pass it forward." REPRESENTATIVE MURKOWSKI inquired as to the percentage of the veterans in the [Pioneers' Homes] that meet the 70 percent disability requirement. Number 1647 JIM KOHN, Director, Division of Alaska Longevity Programs, Department of Administration, informed the committee that presently there are about 90 veterans in the [Pioneers' Homes]. Of those 90 veterans, about six receive monthly veterans payments due to their injuries in service. However, that group of six is known because they utilize the payment assistance program. Only those utilizing the payment assistance program are asked about their income and assets. Mr. Kohn noted that half the residents in the homes utilize the payment assistance program and thus he guessed that as many as a dozen [veterans in total] actually receive monthly veterans payments due to injuries incurred during service. Number 1590 REPRESENTATIVE HAYES noted his support of this legislation, but pointed out that it will have a difficult time in its next committee of referral. REPRESENTATIVE CISSNA recalled testimony from last week regarding what was perceived as inadequate funding for this program. MR. KOHN explained that the present staffing in the Pioneers' Homes are based on the levels of care, of which there are five. There is the coordinated services, which is the old residential care for which there are no direct care services unless there is an emergency. The basic assisted living level provides sporadic services. There is the enhanced assisted living services, which tends to have people who are more in need of medical help while the Alzheimer Disease and Related Dementia (ADRD) residents are in need of help with their dementia and have less medical problems. However, the ADRD residents need 24-hour assistance. There are also the comprehensive services for those that need help with all tasks of daily living. Mr. Kohn informed the committee that 4.9 hours of care per resident per day is provided to those in the enhanced assisted living, the ADRD, and the comprehensive services levels. That average time is systemwide. MR. KOHN turned to the national figures in regard to the number of hours provided in nursing home facilities in the Lower 48, which struggle to provide 2.5 hours per resident per day. Therefore, Mr. Kohn felt that the staffing for the Pioneers' Homes is good. He mentioned that a lady who performs accreditation for assisted living visited the Anchorage Pioneers' Home during dinnertime and this lady said that the building looks good all the way through. Mr. Kohn acknowledged that people have testified that there isn't enough staff at the Pioneers' Homes. However, as a nurse he has worked in hospitals in long-term care settings where he felt that there was never enough staff, as far as he was concerned, because one can always do more. Adding more staff is attempted through volunteers, from which there is much support throughout the state. Furthermore, there is a nursing shortage and thus if nursing staff is necessary for safety reasons, the nurses on staff are required to come in because although the position is empty, the work has to be done. From that situation, the staff says that there isn't enough staff and although that is true, it doesn't mean that the residents are suffering. More help is necessary so that staff can return to more reasonable hours. Number 1120 MR. KOHN noted that he has been the director of the Pioneers' Homes for eight years and the staffing is very adequate. However, for the staff doing the work, they feel overworked and under supported. This is very difficult work. CHAIR CHENAULT placed the legislation before the committee and announced that he would entertain a motion. REPRESENTATIVE MURKOWSKI expressed hope that the committee would move HB 88 out of committee and recognize the comments of General Oates. She noted that the legislation has the following committee referrals: the House State Affairs Standing Committee and the House Finance Committee, respectively. Representative Murkowski related her strong feeling that "we" have an obligation to provide some facility for Alaska's veterans. This is an area in which [the state] has failed its veterans. She informed the committee that she had the opportunity to speak with Secretary Principi when he was in town. From that conversation, she had the impression that Secretary Principi wanted to make something happen in Alaska, but the state has to take the first step. Therefore, if the full deal, as encompassed in HB 88, can't be done, then perhaps a pilot project could be started. Number 0938 REPRESENTATIVE MURKOWSKI moved to report HB 88 out of committee with individual recommendations and the accompanying fiscal note. There being no objection, HB 88 was reported from the House Special Committee on Military and Veterans' Affairs.
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