Legislature(2021 - 2022)SENATE FINANCE 532

04/05/2022 09:00 AM Senate FINANCE

Note: the audio and video recordings are distinct records and are obtained from different sources. As such there may be key differences between the two. The audio recordings are captured by our records offices as the official record of the meeting and will have more accurate timestamps. Use the icons to switch between them.

Download Mp3. <- Right click and save file as

* first hearing in first committee of referral
+ teleconferenced
= bill was previously heard/scheduled
+= SB 173 DENTIST SPEC. LICENSE/RADIOLOGIC EQUIP TELECONFERENCED
Moved CSSB 173(FIN) Out of Committee
+= SB 193 EXTEND BOARD OF CHIROPRACTIC EXAMINERS TELECONFERENCED
Moved CSSB 193(FIN) Out of Committee
+= SB 204 HUNTING PERMIT/TAG AUCTIONS/RAFFLES TELECONFERENCED
Moved CSSB 204(RES) Out of Committee
+= HB 85 FINANCIAL INSTITUTIONS; LIABILITY TELECONFERENCED
Moved SCS CSHB 85(L&C) Out of Committee
+= SB 98 ADULT FOSTER CARE FOR DISABLED TELECONFERENCED
Heard & Held
+= SB 199 PERM FUND; PERMANENT FUND DIVIDEND TELECONFERENCED
Heard & Held
+ Bills Previously Heard/Scheduled TELECONFERENCED
**Streamed live on AKL.tv**
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."                                                                                                  
                                                                                                                                
9:25:04 AM                                                                                                                    
                                                                                                                                
Co-Chair Bishop relayed that it  was the first hearing of SB
98 during the  current session. The committee  had heard the                                                                    
bill and had opened and  closed public testimony on April 7,                                                                    
2021. The  committees  attention was to  consider a proposed                                                                    
CS,  hear  a bill  reintroduction,  and  then set  the  bill                                                                    
aside.                                                                                                                          
                                                                                                                                
Co-Chair   Stedman  MOVED   to   ADOPT  proposed   committee                                                                    
substitute  for  SB  98,   Work  Draft  32-GS1708\G  (Foote,                                                                    
4/2/22).                                                                                                                        
                                                                                                                                
Co-Chair Bishop OBJECTED for discussion.                                                                                        
                                                                                                                                
Ms. Shine  addressed explained that  the proposed CS  took a                                                                    
slightly different approach than Version  A of the bill that                                                                    
came to  committee. The CS  removed  adult foster  home  and                                                                    
added  adult  home care,   which would  extend opportunities                                                                    
for  participation beyond  individuals aging  out of  foster                                                                    
care to  include other adults with  disabilities. The change                                                                    
would also  add a new  service and a license  placement type                                                                    
of  adult  home  care  for   adults  with  disabilities  and                                                                    
seniors. The CS  also proposed to change  the  Department of                                                                    
Health and  Social Services  to  the  Department  of Health                                                                     
in  applicable  areas because  of  Executive  Order 121  [an                                                                    
order passed by  the governor in 2022 that  would divide the                                                                    
Department   of  Health   and  Social   Services  into   two                                                                    
departments aligned  by functionality].  The CS  proposed an                                                                    
effective  date  of  July  1, 2022,  to  coincide  with  the                                                                    
effective date of the executive order.                                                                                          
                                                                                                                                
Co-Chair  Bishop  WITHDREW  his OBJECTION.  There  being  NO                                                                    
further OBJECTION, it  was so ordered. The CS for  SB 98 was                                                                    
ADOPTED.                                                                                                                        
                                                                                                                                
9:26:53 AM                                                                                                                    
AT EASE                                                                                                                         
                                                                                                                                
9:27:01 AM                                                                                                                    
RECONVENED                                                                                                                      
                                                                                                                                
JOHN   LEE,  DIRECTOR,   SENIOR  AND   DISABILITY  SERVICES,                                                                    
DEPARTMENT    OF   HEALTH    AND   SOCIAL    SERVICES   (via                                                                    
teleconference), spoke  in support  of the bill.  He thanked                                                                    
the  committee for  hearing the  bill.  He thanked  Co-Chair                                                                    
Bishop's office for  working to amend the bill  in ways that                                                                    
he  thought   would  strengthen  home   and  community-based                                                                    
services. He discussed working  towards increasing the reach                                                                    
of  the  bill  to  more individuals  with  disabilities.  He                                                                    
discussed  working  with  stakeholders  on  the  concept  of                                                                    
expanding  the  bill  to  include  others  and  create  more                                                                    
options to remain in home and community-based settings.                                                                         
                                                                                                                                
Mr. Lee  continued his testimony. He  suggested that changes                                                                    
would make  services less expensive,  have a  less demanding                                                                    
workforce expectation, and would  be open to more providers.                                                                    
He noted  that there was work  to be done on  regulation and                                                                    
he was  confident that  the bill would  create a  setting to                                                                    
serve the  population as well  as allow for many  seniors to                                                                    
stay  in local  communities. He  summarized that  the change                                                                    
would create  a small  economic opportunity in  rural areas.                                                                    
He  noted that  the new  adult home  care services  would be                                                                    
less expensive  than some services, but  more expensive than                                                                    
others. He  emphasized that aside from  new additional staff                                                                    
needed to  monitor the  new service,  the amendments  to the                                                                    
bill   were  cost   neutral.  Research   conducted  by   the                                                                    
department  had  shown  that savings  from  the  bill  would                                                                    
offset additional costs.                                                                                                        
                                                                                                                                
9:31:30 AM                                                                                                                    
                                                                                                                                
ANTHONY  NEWMAN,  DEPUTY  DIRECTOR,  SENIOR  AND  DISABILITY                                                                    
SERVICES,  DEPARTMENT OF  HEALTH  AND  SOCIAL SERVICES  (via                                                                    
teleconference),  addressed a  Sectional  Analysis (copy  on                                                                    
file):                                                                                                                          
                                                                                                                                
     Section 1:  Adds a  new section  to AS  47.07, Medicaid                                                                    
     Assistance for Needy Persons, to  create a new program-                                                                    
     adult home  care services  for individuals.  Adult home                                                                    
     care  services will  be  available  for individuals  at                                                                    
     least 18  years of age or  older who are enrolled  in a                                                                    
     home and community-based waiver.                                                                                           
                                                                                                                                
     The  Department  of  Health  will  develop  regulations                                                                    
     establishing  the standards  and rates  of the  program                                                                    
     and providing  an efficient  process to  allow existing                                                                    
     foster  homes to  transition into  the  new adult  home                                                                    
     care license.                                                                                                              
                                                                                                                                
     Section  2:  Amends  AS  47.32.010(b)   to  add  a  new                                                                    
     setting,  "adult  home  care   homes,"  that  shall  be                                                                    
     subject to  the centralized licensing functions  of the                                                                    
     Department of Health.                                                                                                      
                                                                                                                                
     Section 3: Adds a new  section to AS 47.32 that defines                                                                    
     the conditions  under which the department  may license                                                                    
     an adult  home care home.  A person may be  licensed to                                                                    
     operate such  a home for up  to two persons aged  18 or                                                                    
     older  who are  enrolled  in  home and  community-based                                                                    
     waiver services.  This section requires  the department                                                                    
     to  streamline the  application  process necessary  for                                                                    
     the person  to be approved  as an adult home  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  uncodified law  by  adding  a  new                                                                    
     section  that  requires  the Department  of  Health  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 come  care services  and                                                                    
     other   long-term   care    services   that   are   not                                                                    
     duplicative.                                                                                                               
                                                                                                                                
     Section 5:  Amends uncodified law adding  a new section                                                                    
     related to the conditional effect  of section 4 and the                                                                    
     required state plan amendments  submitted to the United                                                                    
     States  Department  of   Health  and  Social  Services.                                                                    
     Requires  the  department  to  notify  the  revisor  of                                                                    
    statutes of the approval of state plan amendments.                                                                          
                                                                                                                                
     Section 6:  Effective date  related to  the requirement                                                                    
     for  the  department  to provide  notification  of  the                                                                    
     revisor  of   statutes  of   approval  of   state  plan                                                                    
     amendments.                                                                                                                
                                                                                                                                
     Section 7: Provides  for a July 1,  2022 effective date                                                                    
     to  align with  the effective  date of  Executive Order                                                                    
     121 and the change of  the applicable department to the                                                                    
     Department of Health.                                                                                                      
                                                                                                                                
9:34:24 AM                                                                                                                    
                                                                                                                                
LIZETTE STIEHR,  EXECUTIVE DIRECTOR, ALASKA  ASSOCIATION FOR                                                                    
DEVELOPMENTAL  DISABILITIES,  CHUGIAK (via  teleconference),                                                                    
spoke in  support of the  bill. She expressed  gratitude for                                                                    
the committee's  inquiry about expanding  the bill  to serve                                                                    
more people.  She described that her  organization had asked                                                                    
the same question. She explained  that currently group homes                                                                    
that were  allowed to  provide services  must meet  the same                                                                    
licensing that  applied to group and  assisted living homes.                                                                    
She strongly  supported a shared  vision that believed  in a                                                                    
flexible  system that  supported  individuals toward  having                                                                    
meaningful  lives and  choice.  She thought  the bill  would                                                                    
expand   living   options   for  people   that   experienced                                                                    
developmental  disabilities. She  loved  the  fact that  the                                                                    
bill  would allow  foster  children to  remain  in the  same                                                                    
home.                                                                                                                           
                                                                                                                                
9:36:20 AM                                                                                                                    
                                                                                                                                
MICHELE  GIRAULT,  BOARD  RESIDENT   OF  KEY  COALITION  AND                                                                    
EXECUTIVE  DIRECTOR,  HOPE  COMMUNITY  RESOURCES,  ANCHORAGE                                                                    
(via teleconference), testified in  support of the bill. She                                                                    
thought the  bill aligned with  the shared  vision mentioned                                                                    
by  Ms. Stiehr  and provided  greater flexibility  for those                                                                    
providing   services  to   youth   with  disabilities.   She                                                                    
discussed current  statute and the administrative  burden it                                                                    
caused.  She  explained that  the  bill  would simplify  the                                                                    
process  of allowing  a family  to transition  from a  child                                                                    
license  to  an adult  home  care  license with  the  likely                                                                    
outcome of  youth being able to  stay in the same  home. She                                                                    
thought the  bill would allow  for youth to  have continuity                                                                    
of care.                                                                                                                        
                                                                                                                                
Ms. Girault  continued her testimony.  She noted  that youth                                                                    
with disabilities had  options to stay in  the public school                                                                    
system  until the  age of  20.  She urged  the committee  to                                                                    
support the bill.  She thought the expanded  outreach of the                                                                    
bill  to  support  additional   adults  would  also  provide                                                                    
benefits.                                                                                                                       
                                                                                                                                
Senator Wielechowski  understood that the statute  for long-                                                                    
term care only included authority  for homes for people over                                                                    
60  and  asked if  the  bill  should  amend the  statute  to                                                                    
include the homes.                                                                                                              
                                                                                                                                
Mr.  Lee  did  not  think the  change  Senator  Wielechowski                                                                    
described  needed  to  be  made.  He  asked  for  additional                                                                    
testifiers to weigh in on the matter.                                                                                           
                                                                                                                                
Co-Chair Bishop asked if department  staff could address the                                                                    
question.                                                                                                                       
                                                                                                                                
9:40:17 AM                                                                                                                    
                                                                                                                                
CRAIG  BAXTER,   PROGRAM  MANAGER,   RESIDENTIAL  LICENSING,                                                                    
DIVISION  OF BEHAVIORAL  HEALTH,  DEPARTMENT  OF HEALTH  AND                                                                    
SOCIAL  SERVICES  (via  teleconference),  addressed  Senator                                                                    
Wielechowski's  question. He  did  not  believe the  statute                                                                    
needed to be  amended. He thought it might  be beneficial to                                                                    
reach out to someone that dealt with long-term care.                                                                            
                                                                                                                                
Co-Chair  Bishop suggested  that Mr.  Lee provide  a written                                                                    
response  to  Senator  Wielechowski's before  the  bill  was                                                                    
heard in committee again.                                                                                                       
                                                                                                                                
Mr. Lee agreed to provide the information.                                                                                      
                                                                                                                                
Co-Chair Stedman  considered the  fiscal notes  and observed                                                                    
that there was an increase  in Medicaid services of $168,000                                                                    
per year. He was curious as  to how the department would cap                                                                    
the  amount so  that it  did  not continue  to escalate.  He                                                                    
mentioned  the  slight  decrease  in  state  population.  He                                                                    
acknowledged  problems  controlling   costs  in  health  and                                                                    
social services in the state over the last decade.                                                                              
                                                                                                                                
Mr. Baxter thought  Co-Chair Stedman might be  looking at an                                                                    
old fiscal note  as the current fiscal note  did not project                                                                    
any cost increases to Medicaid services.                                                                                        
                                                                                                                                
9:42:28 AM                                                                                                                    
AT EASE                                                                                                                         
                                                                                                                                
9:42:47 AM                                                                                                                    
RECONVENED                                                                                                                      
                                                                                                                                
Co-Chair  Bishop asked  if Mr.  Lee anticipated  forthcoming                                                                    
updated fiscal notes for the proposed CS.                                                                                       
                                                                                                                                
Mr. Lee answered in the affirmative.                                                                                            
                                                                                                                                
Co-Chair Stedman observed that the  fiscal notes in front of                                                                    
him were  dated from March  of the previous year.  He wanted                                                                    
to see  updated fiscal  notes and expressed  concerned about                                                                    
the growth  of the department.  He mentioned the  budget for                                                                    
the Department of Corrections as an area of concern.                                                                            
                                                                                                                                
Senator von  Imhof thought the  bill represented  an age-old                                                                    
conundrum, particularly  with legislation related  to social                                                                    
services.  She  compared  the  cost of  the  bill  with  the                                                                    
alternatives  and considered  that sometimes  up-front costs                                                                    
saved  more money  in the  future. She  emphasized that  the                                                                    
bill would  put people in  stable homes. She  looked forward                                                                    
to updated fiscal notes. She  was worried about the costs to                                                                    
the  department  but  also   thought  the  committee  should                                                                    
consider the cost of not passing such legislation.                                                                              
                                                                                                                                
SB  98  was   HEARD  and  HELD  in   committee  for  further                                                                    
consideration.                                                                                                                  
                                                                                                                                
9:44:53 AM                                                                                                                    
AT EASE                                                                                                                         
                                                                                                                                
9:45:11 AM                                                                                                                    
RECONVENED                                                                                                                      
                                                                                                                                

Document Name Date/Time Subjects
SB 98 Explanation of Changes ver A to G 4.2.22.pdf SFIN 4/5/2022 9:00:00 AM
SB 98
SB 98 Work Draft ver. G 4.2.22.pdf SFIN 4/5/2022 9:00:00 AM
SB 98
SB 98 Sectional Analysis Version ver. G 4.2.22.pdf SFIN 4/5/2022 9:00:00 AM
SB 98
SB 193 Explanation of Changes ver. I to G 03.30.2022.pdf HL&C 4/25/2022 3:15:00 PM
SFIN 4/5/2022 9:00:00 AM
SB 193
SB 193 Work Draft ver. G 03.30.22.pdf SFIN 4/5/2022 9:00:00 AM
SB 193
SB 199 Sectional Analysis ver. I 3.25.22.pdf SFIN 4/5/2022 9:00:00 AM
SB 199
SB 199 Work Draft ver. I 3.25.22.pdf SFIN 4/5/2022 9:00:00 AM
SB 199
SB 199 Opposition Asplund.pdf SFIN 4/5/2022 9:00:00 AM
SB 199