Legislature(2005 - 2006)BUTROVICH 205

02/16/2005 01:30 PM Senate HEALTH, EDUCATION & SOCIAL SERVICES


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* first hearing in first committee of referral
+ teleconferenced
= bill was previously heard/scheduled
+= SB 82 CHILD PROTECTION INTERVIEW/TRANSPORT TELECONFERENCED
Moved CSSB 82(HES) Out of Committee
*+ SB 78 SENIOR CARE PROGRAM TELECONFERENCED
Heard & Held
*+ SB 79 MEDICAID FOR ADULT DENTAL SERVICES TELECONFERENCED
Moved CSSB 79(HES) Out of Committee
+ Bills Previously Heard/Scheduled TELECONFERENCED
            SB 79-MEDICAID FOR ADULT DENTAL SERVICES                                                                        
                                                                                                                                
CHAIR FRED DYSON announced SB 79 to be up for consideration.                                                                    
                                                                                                                                
3:08:43 PM                                                                                                                    
BRAD WHISTLER,  dental officer, Department  of Health  and Social                                                               
Services (DHSS), introduced himself.                                                                                            
                                                                                                                                
COMMISSIONER  JOEL GILBERTSON,  Department of  Health and  Social                                                               
Services  (DHSS), explained  this  is a  Governor proposal  under                                                               
Medicaid. It would provide  capped preventative dental healthcare                                                               
benefit to all low-income adults in Alaska.                                                                                     
                                                                                                                                
Currently, Medicaid  dental coverage  for people  over age  21 is                                                               
restricted to  emergency dental  services, which  basically means                                                               
pulling a  tooth if a problem  arises. SB 79 proposes  to enhance                                                               
the  emergency dental  Medicaid  services for  adults to  include                                                               
preventative  and/or restorative  care.  Because of  the lack  of                                                               
preventative Medicaid  dental services  in years past,  a backlog                                                               
exists,  which  justifies the  proposed  annual  benefit cap  for                                                               
preventative  services to  $1,150  per client.  The annual  limit                                                               
amounts  to what  it  would cost  to replace  an  upper or  lower                                                               
denture so  that a  senior could  replace a  full denture  over a                                                               
two-year period.                                                                                                                
                                                                                                                                
He noted currently there are  about 41,000 Medicaid beneficiaries                                                               
in Alaska.                                                                                                                      
                                                                                                                                
3:11:09 PM                                                                                                                    
COMMISSIONER GILBERTSON said the  Mendenhall Trust Authority is a                                                               
partner in  the proposal and has  allocated some of its  money to                                                               
pay part  of the state  match. Recent  studies have shown  a link                                                               
between  oral   health  and  chronic   diseases  and   the  trust                                                               
recognizes  the trustees  have a  pressing need  for oral  health                                                               
care. "This  transition will  allow us  to position  the Medicaid                                                               
program around preventative services,  which is a good investment                                                               
for the state."                                                                                                                 
                                                                                                                                
He noted  the associated  fiscal note  and explained  the general                                                               
fund match  is augmented with  Mental Health Trust money  for the                                                               
next six  years. There  are a number  of optional  services under                                                               
Medicaid  and this  proposal is  to  include preventative  dental                                                               
services.                                                                                                                       
                                                                                                                                
3:13:06 PM                                                                                                                    
SENATOR KIM  ELTON asked  the number of  Alaska dentists  that do                                                               
Medicaid services.                                                                                                              
                                                                                                                                
COMMISSIONER GILBERTSON acknowledged access has been an issue.                                                                  
                                                                                                                                
MR. WHISTLER  said access  varies across  the state  but overall,                                                               
about 85 percent of Alaska  dentists are enrolled in the Medicaid                                                               
program. Although he didn't know  how many dentists are accepting                                                               
new Medicaid clients he did  acknowledge the real access issue is                                                               
when new clients  who are enrolled in Medicaid go  for care. With                                                               
regard  to the  adult  program, the  proposal  would augment  the                                                               
tribal dental programs that are already serving adults.                                                                         
                                                                                                                                
3:15:32 PM                                                                                                                    
SENATOR ELTON referenced  the fee information in  the fiscal note                                                               
and  said it  would  be helpful  to  have a  list  of the  Juneau                                                               
dentists that  provide two cleanings  a year for $250  because he                                                               
pays considerably more.                                                                                                         
                                                                                                                                
MR.  WHISTLER  replied  the  fiscal note  is  based  on  Medicaid                                                               
reimbursement rates and private rates would be higher.                                                                          
                                                                                                                                
CHAIR  DYSON commented  most medical  practitioners aren't  happy                                                               
with the Medicaid  reimbursement rates. He was  curious about the                                                               
view dentists might have.                                                                                                       
                                                                                                                                
MR.  WHISTLER replied  most dental  practices wouldn't  have more                                                               
than 5  to 10 percent of  its clients in the  Medicaid program so                                                               
dentists  don't  typically rely  on  those  clients for  practice                                                               
income.  He suggested  it might  make dentists  more vocal  about                                                               
reimbursement   rates.  The   program  has   tried  to   maintain                                                               
reimbursement at  between 70  and 80  percent of  usual customary                                                               
reasonable fees.                                                                                                                
                                                                                                                                
COMMISSIONER  GILBERTSON added  the  department  has always  been                                                               
concerned about  provider participation in the  Medicaid program.                                                               
Across  the board,  between 55  and  60 percent  of the  licensed                                                               
providers  in the  state  accept  Medicaid as  a  portion of  the                                                               
insurance they accept.                                                                                                          
                                                                                                                                
3:18:04 PM                                                                                                                    
SENATOR DONNY  OLSON noted chronic  diseases were  addressed, but                                                               
he  saw no  mention  of  acute diseases  such  as gingivitis  and                                                               
resultant septicemia. He  was curious how the  bill would address                                                               
those issues.                                                                                                                   
                                                                                                                                
MR.  WHISTLER said  that  sort  of case  would  fit an  emergency                                                               
dental service,  which would be  covered in the  current program.                                                               
This  bill proposes  to cover  preventive and  restorative dental                                                               
services in  addition to the  emergency services.  Hopefully this                                                               
would augment  existing services so  fewer people would  get into                                                               
an acute condition.                                                                                                             
                                                                                                                                
COMMISSIONER GILBERTSON restated Mr. Whistler's response.                                                                       
                                                                                                                                
3:19:22 PM                                                                                                                    
CHAIR  DYSON  recognized Mr.  Jessie  and  asked whether  he  was                                                               
testifying that the Mental Health  Board agrees with the bill and                                                               
the funding provided by the Mental Health Trust.                                                                                
                                                                                                                                
JEFF JESSIE said  that is correct. He informed  members the trust                                                               
issues over $1  million per year in mini grants  paid directly to                                                               
beneficiaries  and nearly  70  percent of  the  requests are  for                                                               
dental needs  that aren't covered  by Medicaid. It's  clear there                                                               
is need in this area.                                                                                                           
                                                                                                                                
PAT LUBY, AARP representative, testified in of SB 79.                                                                           
                                                                                                                                
ROSEMARY   HAGEVIG,   executive  director,   Catholic   Community                                                               
Services, testified in  strong support of SB 79.  She pointed out                                                               
that providing dental  care would help many people  get back into                                                               
the workforce so they see this as a workplace issue.                                                                            
                                                                                                                                
3:23:26 PM                                                                                                                    
CHAIR DYSON asked for the will of the committee.                                                                                
                                                                                                                                
SENATOR ELTON moved CSSB 79(HES)  \G version, and attached fiscal                                                               
note from committee with  individual recommendations. There being                                                               
no objection, it was so ordered.                                                                                                

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