Legislature(1997 - 1998)
03/31/1998 08:00 AM House STA
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* first hearing in first committee of referral
+ teleconferenced
= bill was previously heard/scheduled
+ teleconferenced
= bill was previously heard/scheduled
HB 464 - NURSING CARE AT STATE VETERANS' HOME Number 370 CHAIR JAMES announced the next order of business would be HB 464, "An Act relating to state veterans' home facilities," sponsored by the House State Affairs Committee. Number 375 GERALD J. DORSHER, Legislative Officer, Alaska Veterans of Foreign Wars (VFW), came before the committee. He explained HB 464 is a bill that his organization has been looking forward to for many years. The language of cleaning up and adding the nursing care and related medical facilities is what the need has been. With the legislation, they will be able to move forward to the federal government. Mr. Dorsher explained that this is a three phased operation. He said, "The first phase needs no fiscal attachments to it. In it's entirety, [it] goes before the bodies for approval if we have then a feasibility study, which the members of the Veterans of Foreign Wars, the American Legions and DAVs [Disabled American Veterans] have appropriated funds for, with matching funds coming from the Governor's office of $20,000, hopefully, for this independent study of feasibility. After this feasibility study, we go to the federal government for monies. The federal government has 65 percent of a veterans' home, under these conditions, for the veterans of Alaska. Thirty-five percent would come from state funds which could be in-kind services as land for the veterans' home. That is where we're at on this. The bill that is before us today, 464 is what the veterans of Alaska are asking for without a fiscal attachment note. That will come down the way through the study of feasibility and then on to the federal government for their appropriations for the veterans' home." MR. DORSHER explained there are 42 states that have veterans' homes and some have more than one. He pointed out that after they're up and running, they're self sufficient through third parties such as veterans' insurance programs and retirement programs. In two years, 47 states will have at least one veterans' home. Alaska has a great population of veterans, and he believes that the state of Alaska should have a veterans home. Number 427 CHAIR JAMES pointed out that Alaska has a larger percentage of population of veterans than any other state. Alaska is also the furthest away from all the rest of the states. She confirmed that the legislation doesn't say that we are going to have a home, it only puts into the law the ability for us to have a study to see if we need one. Without that in the law, there are no federal funds available for a veterans' home. MR. DORSHER responded in the affirmative. Number 456 REPRESENTATIVE IVAN said, "Since Alaska is such a large state, some [veterans] may be living in rural communities and qualify to be in this veterans' home. Does that individual have to move from a community to a veterans' home or would they be allowed to receive the same services from a veterans' home in their community?" MR. DORSHER said there would be one veterans' home which would be ideally attached to a medical services facility. Where it would be, we have no idea and that is why a feasibility would be appropriate. CHAIR JAMES said as she understands, HB 464 only allows a home, it doesn't make one. The feasibility study that Mr. Dorsher is talking about would identify those concerns. She said she believes that Representative Ivan's concern is that currently, because there isn't a veterans' home in the state, these people can get benefits to stay locally. Representative Ivan is worried that if there was a veterans' home, the veterans in the rural areas would have to go to the veterans' home to receive benefits and they couldn't get any in their community. She said she isn't sure that is correct, but that would be something that would be addressed in the feasibility study process. She said, "Before we could get one, you'd have to be back before this body again for the in-kind for the land, or whatever it is, to build a home. So this is not the last door to swing shut. This only opens the door for any possibility of this ever happening." MR. DORSHER pointed out that the bill is only phase I. He noted the first resolution was introduced in 1992, and the nursing facility was not included. To have HB 464 before the committee is a big improvement over anything and the veterans appreciate it. Number 482 JAMES L. KOHN, Director, Division of Alaska Longevity Programs, Department of Administration, came before the committee to testify on HB 464. He stated that the department supports the change to the bill. Mr. Kohn said, "We feel that whether or not a veterans' home is ultimately built, which you've already heard this bill does not build a veterans' home, that in fact what we need to look at is veterans' needs and we need to look at the whole range of veterans' needs from domiciliary care to skilled nursing care. And what this bill allows is that we can look at the entire range of needs that veterans would have. So we endorse the bill." CHAIR JAMES said, "I do have from the Department of Administration a fiscal note here which is pretty scary." MR. KOHN stated that anything relating to long-term care costs is scary. CHAIR JAMES indicated the bill doesn't authorize long-term care. She said, "We're only authorizing the fact that if there was an application before one, we could deal with it because this needs to be changed so..." She pointed out that the committee heard testimony from Mr. Dorsher that the Governor has agreed to put up $20,000 for a feasibility and she can't remember where the rest of the money would come from, but it is a match. Chair James said she assumes the $20,000 would come from the Governor's existing budget. She said it is her impression that the fiscal note is excessive and is not needed. MR. KOHN said that Chair James is correct. He said the department was requested to supply a fiscal note based on the conception of constructing and operating a veterans' home. That fiscal note reflects that conception, however, the bill does not reflect that. Number 516 CHARLES McLEOD, Special Assistant, Office of Veteran Affairs, Department of Military and Veterans Affairs, testified via teleconference from Anchorage. He stated, "I am very much in favor of passage of this amendment that will allow the state to do the nursing care for veterans of this state. As you well know, we have pretty close to over 65,000 veterans in the state of Alaska, one of the highest number of veterans per capita. We're one of three states that presently do not have a state home. The other two states are Hawaii and Delaware. And as mentioned by the testimony of Mr. Dorsher, this amendment does not obligate the state to any funds at this time. There will be a study to determine the needs of the veterans as far as nursing care, domiciliary care, and so forth. And at that time we will be able to approach this particular project with some ideas on how we should move forward." Number 533 DOUG VIG, State Commander, The American Legion, testified via teleconference from Ketchikan. He noted he has sent the committee a letter dated March 27, 1998, regarding the bill. He emphasized that for the past several years, the joint coalition of the American Legion, the VFW and the DAV have supported the need for a state veterans' home. The Veteran's Administration indicates that there are close to 63,000 veterans residing in Alaska. Many are Korean War and Vietnam veterans moving into the twilight years. Mr. Vig informed the committee members that some veterans are currently in nursing care facilities such as the Pioneers' Home and others will need this type of facility in the near future. He reiterated Mr. Dorsher's testimony regarding the number of states operating veterans' homes. He noted other states are appropriating money for this purpose. It is projected that within two years, 47 states will be operating over 120 veterans' homes, and Alaska has none. Mr. Vig stated they asked for the $40,000 appropriation to conduct a thorough comprehensive and independent third party study for the need of a veterans' home or homes in Alaska to support existing and projected veterans' needs. Mr. Vig said the Governor has indicated that he would come up with $20,000 for that study. The joint coalition of the VFW and The American Legion has come up with $10,000. There have been indications that the Finance Committees could come up with another $10,000 to match the other parts of that appropriation so that there would be the $40,000 for an independent study. Mr. Vig stated, "All indications of preliminary studies, that we have had individuals go down to Oregon and Idaho, indicate that the cost to the states are minimal. Third party payers, such as insurance companies and the Medicare and Medicaid, are usually self sustaining, but as pinpointed out that's kind of putting the cart before the horse because we do need the nursing care part put in that bill and I thank Representative James for doing that. Thank you." Number 570 LEON BERTRAM testified via teleconference from Anchorage. He stated, "I believe that the case has pretty well been stated and I think that the committee has the information that is necessary. Mr. Vig, from our office, did cover it pretty well. I know there is going to be a lot to be done in the future on this. I thank you very much, Madam Chairman, for your input." Number 578 JOSEPH CRAIG testified via teleconference from Ketchikan. He said, "I concur with basically everything that our commander, Doug Vig, has said and the coalition. But I would like to add that I just returned from Washington, D.C., and talking to our three representatives there they were all very supportive of a veterans' home in Alaska as long as things can be worked out on this end. So I would like to note that we do have support in Washington for a veterans' home in Alaska. Thank you." GARY KURPIUS, Veterans of Foreign Wars, was next to testify via teleconference from Anchorage. He said, "On behalf of the Veterans of Foreign Wars, I would like to thank you for putting in this amendment and assure you that of our close to 7,000 members of the state of Alaska - we are all in support of this." He indicated he would answer any questions the committee may have. Number 589 CHAIR JAMES referred to the letter that Mr. Vig sent to the committee and said he indicated that the $40,000 that is needed for the study, which the Governor has committed $20,000 from his existing budget. In the letter, he talks about another $10,000 commitment on the Senate side in the state budget. She said that is out of her reach and she is not interested in putting any kind of a fiscal note on the bill today. Number 577 ALAN F. WALKER, Legislative Assistant to the Department of Alaska, Disabled American Veterans, came before the committee. He pointed out that the Governor did commit that he would put up $20,000 for a study. The veterans service organizations, at that time committed to $10,000 from the VFW. He referred to their national convention two weeks ago and explained that they were able to receive from the DAV, Department of Idaho, a commitment for a $1,000 contribution towards the study, and the same from the Department of Oregon. Mr. Walker said they are seeking those additional funds so that there would not be any need to address the fiscal issue to the House, Senate or the Governor so that the $20,000 commitment would stand. He stated, "We will find those matching funds, somewhere - somehow. And I think this reflects clearly the perception of need for the state of Alaska from other veterans' organizations in the Lower 48, that no one wants to see a veteran displaced from their home just because they need medical care, least of all, out of the state of Alaska. We don't want to see a veteran in Kotzebue or in Dutch Harbor who has to relocate to Idaho to go to one of their veterans' homes just because they need necessary care." Number 616 REPRESENTATIVE ETHAN BERKOWITZ indicated concern regarding the broadness of the title. He suggested tightening it up. CHAIR JAMES asked Representative Berkowtiz if he has any suggestions. REPRESENTATIVE BERKOWITZ said he understands that what the committee is trying to do is to attempt to initiate a study, which is a preliminary step. CHAIR JAMES explained the purpose of the legislation is to note that nursing home care and related medical services is also allowed. Currently, it is not allowed under the statute. She said they want to open the door so that along with the domiciliary care that nursing home care and related medical services can be provided in-home. She said, "All this does is make a change in the law so that that would qualify to be able to have that in Alaska and get federal funds to do it. We have to have this in our laws to be able to get federal funds for this facility." REPRESENTATIVE BERKOWITZ stated he supports the legislation, but perhaps "An Act permitting nursing home care with related medical service in state veterans' home facilities" would tighten the title. CHAIR JAMES said she does not have a problem with the wording. She asked if anybody else had a problem with the wording. REPRESENTATIVE HODGINS said he has a problem. He said he believes the title should remain in its current form as he likes the title. CHAIR JAMES referred to veterans' issues and said it has been her opinion and experience, in the six years she has been coming to Juneau, that she has not wanted to see people wanting to play with the issue. She said it seems to her that it is a pretty straight forward issue. Chair James said it seems to her that veterans are the champion of the day today and people were going to yield to what they have to say. She said she doesn't have a problem with the current title, nor does she have a problem with Representative Berkowitz's suggestion. She said she will leave it up to the committee members to decide whether they want to change the title. She pointed out that it could read, "An Act relating to state veterans' home facilities, including nursing home care with related medical services." She said, "If we just, at the end, put 'including' and leave off the 'and' and put all the rest of the underlined and we could... Do we have something else here? Okay, Mr. Streeper wants to respond." Number 661 TOM STREEPER testified via teleconference from Ketchikan. He said two years ago he visited the veterans' home in Boise, Idaho, for the purpose of seeing what Alaska would need in order to institute a home. One of the things that was brought to his attention was the fact that without the nursing care, we're going to have some horrendous problems. You would not have the Medicare, Medicaid or other insurance programs that could be utilized to help with the funding of keeping a home on an even keel without having additional funds from the state coming in. He said, "They were the first ones to hold a 20-bed facility for Alzheimer. I am told that within our state homes that they have for the so called pioneer homes - that before many years expire, and that's very soon, it will be 100 percent almost in Alzheimer cases. I would encourage you to please leave this as -- well the sponsor statement that I'm looking at here right at this moment. And I thank you for allowing me to come in late." CHAIR JAMES said, "The motion on the floor then is to amend the title on line 1 to add at the end, 'including nursing home care with related medical services.' There is an objection to that motion so then we'll call the roll." A roll call vote was taken. Representatives Berkowitz, Elton, Ivan and James voted in favor of amending the title. Representatives Ryan and Hodgins voted against amending the title. So the amendment was adopted. Number 689 REPRESENTATIVE RYAN noted concern with people having to come from the rural communities, in their final years, to a facility far away from family and friends and to be stuck there. He said, "I even envision them putting here in Juneau, so in my final years I come down here and pay a bloody sales tax to be at home. That is the only distrust I have with this bill. I'm going to support it, but I'm going to watch it very very closely." REPRESENTATIVE ELTON made a motion to move HB 464, as amended, with an attached zero fiscal note and with individual recommendations out of committee. CHAIR JAMES indicated there is a motion to move HB 464, as amended, out of committee with a zero fiscal note from the Department of Health and Social Services. She noted the committee would either prepare a zero fiscal note from the Department of Administration or they may submit one. There being no objection, CSHB 464(STA) moved out of the House State Affairs Standing Committee. TAPE 98-43, SIDE B
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