Legislature(1999 - 2000)
03/22/1999 01:45 PM Senate HES
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* first hearing in first committee of referral
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= bill was previously heard/scheduled
+ teleconferenced
= bill was previously heard/scheduled
SB 73-ASSISTED LIVING FACILITIES
Number 026
MS. ALISON ELGEE, Deputy Commissioner for the Department of
Administration stated the department was asked to prepare draft
fiscal notes representing one scenario that would include paying a
geographic differential, and one scenario that would exclude paying
a geographic differential.
The four different fiscal notes in the committee packets include
two from the Division of Senior Services (DSS) and two from the
Department of Health and Social Services, Division of Mental Health
& Developmental Disabilities. She would speak to the DSS fiscal
notes, but stated the methodology is similar in both the
departments' fiscal notes.
At the present time the assisted living rate structure has a base
rate of $30, with the department providing a geographic
differential to recognize the difference in the cost of doing
business throughout the state. This is done on a regional basis,
with the geo-differential ranging from a zero base rate in
Anchorage and Southeast Alaska to a high of 38% in the rural parts
of the state. The Interior region is at 15%, Western Alaska is at
33%, with Northwestern the highest at 38%. The department
presently pays a .4% differential in the Palmer-Wasilla area.
The difference between the two notes marked "Draft" is the cost if
the geographic differential approach is continued with the new rate
structure, as proposed for a potential CS, and the cost if the
geographic differential were eliminated.
MS. ELGEE stated the committee needs to be aware of one anomaly
that at the proposed $50 rate for the first year, the department
would actually be paying less to the Northwest Alaska region than
it presently pays under a $30 base rate with a differential.
Number 075
MS. GINA MACDONALD, Division of Mental Health & Developmental
Disabilities, agreed that the fiscal note methodology was similar.
The only difference was that DHSS uses a personal allowance of $100
per person, while DOA uses a $75 personal allowance, which impacts
the amount of money that DHSS needs for the assisted living home
provider. She stated this needs to be clarified for a final fiscal
note.
Number 094
SENATOR ELTON asked the history of the rate differentials.
MS. ELGEE replied she was not sure but she thought the
differentials have been in place at least since the last rate
adjustment in 1984. DOA uses the geo differentials for the
statutory pay structure, except the pay structure includes many
more differentials than these fiscal notes. The department uses a
regional approach and the differential most appropriate for the
region. MS. MACDONALD said she did not know the history.
SENATOR ELTON commented there have been a lot of changes during the
last ten years.
Number 118
VICE-CHAIRMAN KELLY repeated that SB 73 would not be passing out
today. Senator Miller has not seen the fiscal notes yet, and he
wanted the committee to look at them today. SB 73 will be
rescheduled and the committee will go through the rest of the bill
at the next meeting. He said that Montafaye Lane is on-line in
Fairbanks to testify on SB 73.
Number 123
MS. MONTAFAYE LANE asked the committee where the state would get
the money to put a general relief client she doesn't want in her
assisted living home in a nursing home like Denali Center that
ranges in cost from $5600 to $9000 a month, depending on the level
of care. It's impossible for the small bed assisted living homes to
make a living and care for these people at the Fairbanks rate of
$34.50 a day. Even with the increase to $70, Alaska would still be
below the national average for cost of care. "I say we need the
$70 a day and we also need the differential added on because there
are parts of this state where it's very high for electricity and
fuel. I know, I paid $600 a month for fuel in Fairbanks."
The Pioneer Homes are subsidized by the state, with employees
getting insurance, retirement and vacation pay. MS. LANE said she
has none of that, and also no way to recover on damages and repair
bills to her home.
MS. LANE emphasized that if the rate increase is not voted in,
there's no way she can continue after July 1 on her budget to
provide this service to general relief clients. The division has
done a good job getting the providers more education and training.
But she's been in the business and licensed in Alaska since 1991,
and she griped about the rate then. They got a $3.50 increase,
bringing it to $34.50 a day. There's been nothing since then.
"Have you gone out lately and bought milk and butter? We feed these
people. You guys have got to understand why we need the rate
increase, and we need it now."
Number 205
VICE-CHAIRMAN KELLY told Ms. Lane that Senator Miller had not seen
the new fiscal note, and the three-year phase-in is just one
scenario being considered. He asked her to track the bill and said
that Sharon Clark would work with her. He felt the phase-in is a
legitimate discussion, as well as the disparity between what it
costs the state to care for these people and what the assisted
living homes get paid to do it. He understood her difficulties and
thanked her for her testimony.
MS. LANE added she appreciates the three-year phase-in but she
doesn't see that it's even a possibility. In caring for the
general relief clients, the homes are saving the state thousands
and even millions of dollars. If the bill passes, she could take
in a client for $2,000 a month, compared to $9,000 a month-- a
$7,000 a month savings for each person. She demanded, "What is the
problem here?"
Number 234
VICE-CHAIRMAN KELLY replied that all ideas have to work through the
process, and there is progress but whether it will come out exactly
as she wants it, no one can say. Everything she said is
legitimate and he agrees with a lot of it, yet sixty people down
here plus the Governor have to come to agreement on this bill.
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