Legislature(2021 - 2022)SENATE FINANCE 532

04/07/2021 09:00 AM Senate FINANCE

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* first hearing in first committee of referral
+ teleconferenced
= bill was previously heard/scheduled
+ SB 95 SEARCH AND RESCUE SURPLUS STATE PROPERTY TELECONFERENCED
Heard & Held
-- Invited & Public Testimony --
-- <Time Limit May Be Set> --
+ SB 89 ASSISTED LIVING HOMES: HOUSE RULES TELECONFERENCED
Heard & Held
-- Invited & Public Testimony --
-- <Time Limit May Be Set> --
+ SB 98 ADULT FOSTER CARE FOR DISABLED TELECONFERENCED
Heard & Held
-- Invited & Public Testimony --
-- <Time Limit May Be Set> --
+ Bills Previously Heard/Scheduled TELECONFERENCED
SENATE BILL NO. 98                                                                                                            
                                                                                                                                
     "An Act  relating to medical assistance  for recipients                                                                    
     of adult  foster care  services; establishing  an adult                                                                    
     foster care home license  and procedures; and providing                                                                    
     for the  transition of individuals from  foster care to                                                                    
     adult foster care homes."                                                                                                  
                                                                                                                                
9:54:56 AM                                                                                                                    
                                                                                                                                
Co-Chair Bishop introduced the bill.                                                                                            
                                                                                                                                
JOHN LEE, DIRECTOR, SENIOR AND DISABILITY SERVICES (via                                                                         
teleconference), spoke to the Sponsor Statement (copy on                                                                        
file).                                                                                                                          
                                                                                                                                
9:56:09 AM                                                                                                                    
                                                                                                                                
TONY  NEWMAN,  DEPUTY  DIRECTOR,   DIVISION  OF  SENIOR  AND                                                                    
DISABILITY SERVICES,  JUNEAU (via  teleconference), detailed                                                                    
the bill  with a  document title, "SB  98 Adult  Foster Care                                                                    
for Disabled One Page Summary" (copy on file):                                                                                  
                                                                                                                                
     What does this bill do?                                                                                                    
     This bill provides an  opportunity for enhanced support                                                                    
     for  caregivers of  individuals  with disabilities  who                                                                    
     are in  foster care  and aging out  of the  foster care                                                                    
     system.  This   bill  establishes  a   new  residential                                                                    
     setting category,  "adult foster  care home,"  in which                                                                    
     those youth  with disabilities who  are in  foster care                                                                    
     can continue  to live with their  current foster family                                                                    
     after leaving  state's custody. This bill  allows for a                                                                    
     continuity of care for the  individual and provides the                                                                    
     necessary support for the family  that is continuing to                                                                    
     provide this care, with decreased administrative                                                                           
     burden than is normally  required for an adult assisted                                                                    
     living home.                                                                                                               
                                                                                                                                
     Why is this bill needed?                                                                                                   
     Youth who experience  disabilities that would otherwise                                                                    
     require a level of care  provided in an institution can                                                                    
     qualify  for  waiver  services,  including  residential                                                                    
     services. In  these cases, a foster  parent can receive                                                                    
     a daily foster care stipend  or may become certified to                                                                    
     provide child  family home  habilitation to  the youth.                                                                    
     Payment  rates  for  both are  intended  to  cover  the                                                                    
     recipient's need for 24/7  care. In certain situations,                                                                    
     and if  justified in a  child's support  plan, personal                                                                    
     care services can also be  provided to the child in the                                                                    
     licensed home.                                                                                                             
                                                                                                                                
     When  youth transition  to adulthood,  the foster  care                                                                    
     payment is no longer available  because the youth is no                                                                    
     longer in  OCS custody. Other options  to support their                                                                    
     living   needs  either   pay   less   or  have   higher                                                                    
     requirements for  certification; do not  allow personal                                                                    
     care  services to  be provided;  and would  require the                                                                    
     foster  parent to  license their  home  as an  assisted                                                                    
     living home.  The bill aims  to create an  adult foster                                                                    
     care option  in statute  that allows  for the  youth to                                                                    
     remain in the  same home they have  been living; enable                                                                    
     the  foster  parent  to continue  to  receive  adequate                                                                    
     support to  provide 24/7 care; allow  for personal care                                                                    
     services if the  individual's support plan demonstrates                                                                    
     this  need; and  provide oversight  to ensure  that the                                                                    
     home  is  a safe  and  positive  setting in  which  the                                                                    
     individual's needs  can be met, without  requiring that                                                                    
     the  home setting  be licensed  as  an assisted  living                                                                    
     home.  This  bill  will provide  a  new  license  type,                                                                    
     similar to the current  child foster care home license,                                                                    
     that  will  provide   structured  services  and  family                                                                    
     continuity for  disabled youth after  aging out  of the                                                                    
     traditional  foster care  system.  The  bill also  will                                                                    
     create  a new  service,  adult foster  care, that  will                                                                    
     ensure  providers   are  qualified  and   supported  in                                                                    
     providing care to these individuals.                                                                                       
                                                                                                                                
     How many individuals will this bill affect?                                                                                
     On  March 1,  2021, 50  foster care  youth were  either                                                                    
     placed  on a  home and  community-based waiver  or were                                                                    
     waiting  to  receive  these  services.  The  Office  of                                                                    
     Children's Services  estimates that a maximum  of 10 of                                                                    
     these  youth will  age out  of the  foster care  system                                                                    
     each year.                                                                                                                 
                                                                                                                                
9:59:37 AM                                                                                                                    
                                                                                                                                
Mr. Newman addressed  a graphic on display  in the committee                                                                    
room (copy not on file).                                                                                                        
                                                                                                                                
10:04:53 AM                                                                                                                   
                                                                                                                                
Senator Wielechowski  queried the estimate of  the number of                                                                    
people impacted and the total cost.                                                                                             
                                                                                                                                
Mr. Newman replied that there  were roughly 20 children that                                                                    
were on  a Medicaid Home  and Community Based waiver  and in                                                                    
foster  care. He  stated that  there  was an  estimate of  a                                                                    
maximum  of  ten  youth  per  year  transitioning  into  the                                                                    
service. He could provide an overview of the fiscal notes.                                                                      
                                                                                                                                
Co-Chair  Bishop  stated  that  the fiscal  notes  would  be                                                                    
covered later.                                                                                                                  
                                                                                                                                
10:05:42 AM                                                                                                                   
                                                                                                                                
Senator  Olson queried  the difference  between an  assisted                                                                    
living home license and an adult foster care license.                                                                           
                                                                                                                                
Mr.  Newman replied  that  the bill  would  create an  adult                                                                    
foster care  license, and then  regulation would  define the                                                                    
details of what an adult foster home license.                                                                                   
                                                                                                                                
Senator  Olson queried  the difference  between an  assisted                                                                    
living home license and an adult foster care license.                                                                           
                                                                                                                                
Mr. Newman  replied that the  intention of the bill  made it                                                                    
clear  that  the  goal  was to  provide  for  a  streamlined                                                                    
transition  from a  child foster  home license  to an  adult                                                                    
foster home license.                                                                                                            
                                                                                                                                
Senator  Olson asked  why there  was not  more for  personal                                                                    
care services.                                                                                                                  
                                                                                                                                
Mr.  Newman  responded  that  he  wanted  to  represent  the                                                                    
specific services. He furthered  that personal care services                                                                    
would be a separate, and additional cost.                                                                                       
                                                                                                                                
Senator  Wielechowski  stated  that he  had  some  questions                                                                    
about the fiscal note.                                                                                                          
                                                                                                                                
10:09:09 AM                                                                                                                   
                                                                                                                                
Mr. Newman addressed the Sectional Analysis (copy on file):                                                                     
                                                                                                                                
     Section 1:  Adds a  new section  to AS  47.07, Medicaid                                                                    
     Assistance  for  Needy  Persons, to  declare  that  the                                                                    
     state's  policy is  to support  individuals who  are or                                                                    
     were in the custody of  the state under AS 47.10 (Child                                                                    
     in Need  of Aid),  residing in  a licensed  foster care                                                                    
     home, and eligible for  home and community-based waiver                                                                    
     services by  providing the means  for an  individual to                                                                    
     remain  in the  same home  and with  the same  families                                                                    
     when  they  are  released   from  state  custody  after                                                                    
     turning 18 years of age.                                                                                                   
                                                                                                                                
     This   section   requires   the  department   to   make                                                                    
     reasonable  efforts  to  implement  adult  foster  care                                                                    
     services in a streamlined manner.                                                                                          
                                                                                                                                
     This section creates a new  section, AS 47.07.048, that                                                                    
     sets out  the provision of adult  foster care services,                                                                    
     and requires  the department to: assist  foster parents                                                                    
     with  transitioning from  a foster  care license  to an                                                                    
     adult  foster  care  home  license;  pay  the  cost  of                                                                    
     maintenance necessary  to assure  adequate care  for an                                                                    
     adult foster  care recipient through  a daily  rate set                                                                    
     by  the department;  allow  the  individual to  receive                                                                    
     habilitative  and rehabilitative  care  in addition  to                                                                    
     the adult  foster care  service; and  adopt regulations                                                                    
     to implement this section.                                                                                                 
                                                                                                                                
     Section 2: amends AS 47.32.010(b)  to add a new entity,                                                                    
     "adult  foster care  homes," that  shall be  subject to                                                                    
     the centralized licensing functions of the department.                                                                     
                                                                                                                                
     Section 3: adds a new  section to AS 47.32 that defines                                                                    
     the conditions  under which the department  may license                                                                    
     an adult foster care home.  A person may be licensed to                                                                    
     operate such  a home for  a minor when the  minor turns                                                                    
     18 if the person holds  a license under this chapter to                                                                    
     operate a foster  home at the time  of application; and                                                                    
     is providing  care for a minor  who is, or who  was, at                                                                    
     the time  of turning  18, in the  custody of  the state                                                                    
     and residing in the  person's licensed foster care home                                                                    
     and  was  receiving  home  and  community-based  waiver                                                                    
     services under AS 47.07.045.                                                                                               
                                                                                                                                
     This section requires the  department to streamline the                                                                    
     application  process necessary  for  the  person to  be                                                                    
     approved  as an  adult  foster care  home provider  and                                                                    
     requires  that  the  department  approve  variances  of                                                                    
     building code  requirements to the extent  permitted by                                                                    
     state, local, or federal law.                                                                                              
                                                                                                                                
     Section  4: amends  AS 47.32.900  to add  new paragraph                                                                    
     (23) defining  "adult foster care home"  as a residence                                                                    
     where an adult head  of household provides 24-hour care                                                                    
     for  not  more  than  two adults  for  compensation  or                                                                    
     reimbursement under the adult  foster care service; and                                                                    
     defines "care"  as providing for the  physical, mental,                                                                    
     and social needs of an individual.                                                                                         
                                                                                                                                
     Section  5:  amends  uncodified law  by  adding  a  new                                                                    
     section  that requires  the  Department  of Health  and                                                                    
     Social Services  to submit for  approval by  the United                                                                    
     States  Department  of  Health and  Human  Services  an                                                                    
     amendment  to   the  state  medical   assistance  plan,                                                                    
     waivers, or  an 1115 demonstration waiver  as necessary                                                                    
     to allow  eligible individuals to receive  adult foster                                                                    
     care services  and other  long-term care  services that                                                                    
     are not duplicative.                                                                                                       
                                                                                                                                
     Section   6:   amends    uncodified   law   by   adding                                                                    
     instructions to the revisor of  statutes to give effect                                                                    
     to the provisions of this  bill by changing "Department                                                                    
     Health and  Social Services" to "Department  of Health"                                                                    
     as  proposed under  the Governor's  Executive Order  to                                                                    
     reorganize the  department if both the  Executive Order                                                                    
     and this bill  are enacted into law.  This section also                                                                    
     requests that,  if this bill and  another bill amending                                                                    
     the   term  "crisis   stabilization  center"   to  read                                                                    
     "subacute mental health facility"  both become law, the                                                                    
     revisor  of statutes  give effect  to  both changes  of                                                                    
     terms.                                                                                                                     
                                                                                                                                
Senator Wielechowski looked at the fiscal note OMB number                                                                       
3234, and wondered whether there was a concurrent decrement                                                                     
for the $126 per day that the state was currently paying.                                                                       
                                                                                                                                
Mr. Newman replied that the bill was a potentially lower                                                                        
cost alternative.                                                                                                               
                                                                                                                                
Senator Wielechowski felt that the fiscal note should                                                                           
reflect a decrement.                                                                                                            
                                                                                                                                
Mr.  Newman  agreed to  take  a  closer examination  at  the                                                                    
fiscal  note and  provide the  committee with  any potential                                                                    
savings.                                                                                                                        
                                                                                                                                
10:14:59 AM                                                                                                                   
                                                                                                                                
Senator von  Imhof stressed that  it was difficult  to fully                                                                    
determine the fiscal note.                                                                                                      
                                                                                                                                
Senator Hoffman  requested that  the department  provide the                                                                    
population base  of 15-, 16-, and  17-year-olds by community                                                                    
to see where the need is throughout the state.                                                                                  
                                                                                                                                
Mr. Newman agreed to provide that information.                                                                                  
                                                                                                                                
Co-Chair Bishop  agreed with the  comments about  the fiscal                                                                    
note from Senator  von Imhof. He wondered  whether there was                                                                    
confidence in approval of the waiver.                                                                                           
                                                                                                                                
Mr. Newman  replied in the affirmative  because other states                                                                    
had an adult foster home service.                                                                                               
                                                                                                                                
Senator  Wilson   wondered  whether  the   department  could                                                                    
provide  the  number of  children  that  choose to  stay  in                                                                    
foster care up to age 21.                                                                                                       
                                                                                                                                
Mr. Newman agreed to provide that information.                                                                                  
                                                                                                                                
10:20:40 AM                                                                                                                   
                                                                                                                                
Senator Wielechowski wondered whether  there was a provision                                                                    
for  a  disabled adult,  not  under  foster care,  could  be                                                                    
considered under the proposed program.                                                                                          
                                                                                                                                
Mr. Newman replied  that, currently the bill  was limited to                                                                    
people  who had  left  child foster  care,  but stated  that                                                                    
there had been discussions about that question.                                                                                 
                                                                                                                                
10:21:24 AM                                                                                                                   
                                                                                                                                
Co-Chair Bishop OPENED public testimony.                                                                                        
                                                                                                                                
10:22:03 AM                                                                                                                   
                                                                                                                                
MICHAEL  JAFFERY,  SELF,   UTQIAGVIK  (via  teleconference),                                                                    
testified in support of the legislation.                                                                                        
                                                                                                                                
10:24:15 AM                                                                                                                   
                                                                                                                                
LINDA GIANI, SELF, WASILLA (via teleconference), spoked in                                                                      
support of the bill.                                                                                                            
                                                                                                                                
10:28:13 AM                                                                                                                   
                                                                                                                                
LOIS   EPPERSON,    ADULT   FOSTER   CARE,    WASILLA   (via                                                                    
teleconference), testified in support of the legislation.                                                                       
                                                                                                                                
10:31:23 AM                                                                                                                   
                                                                                                                                
Co-Chair Bishop CLOSED public testimony.                                                                                        
                                                                                                                                
10:31:30 AM                                                                                                                   
AT EASE                                                                                                                         
                                                                                                                                
10:31:54 AM                                                                                                                   
RECONVENED                                                                                                                      
                                                                                                                                
Co-Chair Bishop stated that the day's afternoon meeting                                                                         
would be cancelled.                                                                                                             
                                                                                                                                
SB 98 was HEARD and HELD in committee for further                                                                               
consideration.                                                                                                                  
                                                                                                                                

Document Name Date/Time Subjects
SB 95 v. I Sectional Summary.pdf SFIN 4/7/2021 9:00:00 AM
SB 95
SB 95 v. I Sponsor Statement.pdf SFIN 4/7/2021 9:00:00 AM
SB 95
SB 95 Testimony Access to Surplus State Resources.pdf SFIN 4/7/2021 9:00:00 AM
SB 95
SB 95 Public Testimony.pdf SFIN 4/7/2021 9:00:00 AM
SB 95
SB 95 Exp. of Changes B-I.pdf SFIN 4/7/2021 9:00:00 AM
SB 95
SB 98 Transmittal Letter.pdf SFIN 4/7/2021 9:00:00 AM
SHSS 3/18/2021 1:30:00 PM
SB 98
SB 98 Sectional Analysis Version GS 1708 A.pdf SFIN 4/7/2021 9:00:00 AM
SFIN 3/31/2022 9:00:00 AM
SHSS 3/18/2021 1:30:00 PM
SB 98
SB 98 Adult Foster Care for Disabled Graphic.pdf SFIN 4/7/2021 9:00:00 AM
SHSS 3/18/2021 1:30:00 PM
SB 98
SB 98 Adult Foster Care Bill - One Page Summary.pdf SFIN 4/7/2021 9:00:00 AM
SB 98
SB 89 Sectional Analysis Version GS 1675 A.pdf HHSS 5/13/2021 3:00:00 PM
SFIN 4/7/2021 9:00:00 AM
SHSS 3/18/2021 1:30:00 PM
SB 89
SB 89 One Page Summary.pdf HHSS 4/29/2021 3:00:00 PM
HHSS 5/4/2021 3:00:00 PM
HHSS 5/13/2021 3:00:00 PM
SFIN 4/7/2021 9:00:00 AM
SHSS 3/18/2021 1:30:00 PM
SB 89
SB 89 Transmital Letter.pdf SFIN 4/7/2021 9:00:00 AM
SHSS 3/18/2021 1:30:00 PM
SB 89
SB 89 Settings Information webpage.pdf HHSS 4/29/2021 3:00:00 PM
SFIN 4/7/2021 9:00:00 AM
SHSS 3/18/2021 1:30:00 PM
SB 89
SB 89 Letters of Support.pdf SFIN 4/7/2021 9:00:00 AM
SB 89
SB 89 Final Rule 42 CFR 441.301c.pdf SFIN 4/7/2021 9:00:00 AM
SHSS 3/18/2021 1:30:00 PM
SB 89
SB 89 FAQ on Final Rule prepared by Coalition for Community Choice.pdf HHSS 4/29/2021 3:00:00 PM
HHSS 5/4/2021 3:00:00 PM
HHSS 5/13/2021 3:00:00 PM
SFIN 4/7/2021 9:00:00 AM
SHSS 3/18/2021 1:30:00 PM
SB 89
SB 89 AARP Support HB103 and SB89.pdf HHSS 4/13/2021 3:00:00 PM
HHSS 4/29/2021 3:00:00 PM
SFIN 4/7/2021 9:00:00 AM
HB 103
SB 89