Legislature(1999 - 2000)
03/03/1999 01:35 PM HES
* first hearing in first committee of referral
= bill was previously heard/scheduled
= bill was previously heard/scheduled
SB 58-SERVICES FOR ADULTS WITH LONG-TERM NEEDS VICE-CHAIRMAN KELLY brought up SB 58 and invited Deputy Commissioner Alison Elgee to provide an overview for the committee. MS. ELGEE stated SB 58 creates a new program for home and community based care for people who, for two reasons, may not meet the Medicaid eligibility requirements. People either do not meet the financial criteria to make them eligible for Medicaid, or they do not meet the level of need determination to be eligible for the department's home and community based care waivers. The level of need under the waiver programs requires an individual to need nursing home level of care. A number of older Alaskans who are struggling to retain their independence and stay at home have some financial resources that are not significant enough to cover the cost of their home care. These individuals have not reached the nursing home level of care, but they will end up in a nursing home without some inter- vention and early supports. This legislation establishes a "new pot of money" to be available to people in those circumstances. MS. ELGEE continued, stating it is not intended to supplement or supplant existing state programs. It would be available to those people who have no other public financing mechanisms. It is not an entitlement program and would only operate to the degree that the department has money to provide assistance to people. The department would look first at an individual's personal resources, including insurance and other third-party payment sources, before making available the monies in this fund. Number 318 SENATOR WILKEN noted that this bill relates to Recommendation #13 in the LTCTF final report and it carries a $425.0 fiscal note. He said that of the four bills, SB 58 will require the most caution in financing so that it does not balloon out of proportion. Nonetheless, the task force felt that the state should help people to stay in their homes without financial burden. SENATOR WILKEN stated this bill will require a lot of work. VICE-CHAIRMAN KELLY asked for a clarification of the level of services needed by people who would not qualify for Medicaid. MS. ELGEE explained that participation in the Choice Waiver for the Elderly and the Adult with Physical Disabilities Waiver requires meeting two eligibility criteria including income and level of need, e.g., nursing home level of care. Number 362 VICE-CHAIRMAN KELLY asked how the state gets around the Medicaid criteria to allow those who don't normally qualify to receive it. MS. ELGEE repeated that this legislation proposes a new program and new funding that would be available to people who don't qualify for Medicaid. SENATOR ELTON asked if this client base is being served in any other way now, or will these be new clients. MS. ELGEE replied that the senior population is rapidly expand- ing. The department is presently serving those who meet the Medicaid eligibility or who are in the Pioneer Homes. Beyond that, the department has few public resources to provide to seniors. Frequently those who need this kind of support and can't make it work at home are leaving the state to seek afford- able care elsewhere. This will allow the department to provide some supports for people who want to remain in Alaska. DOA also views it as cost avoidance because with early intervention, a number of people will never reach the nursing home level of care. Spending a little money early on will save a lot of money later. VICE-CHAIRMAN KELLY asked if the task force looked at ways of using private care givers to achieve this same end. SENATOR WILKEN replied private care givers are providing some of those services now to a group of people who are not Medicaid eligible yet under a financial strain to afford the services. MS. ELGEE explained the department would not directly provide these services with state employees, nor does it directly provide the waiver programs. DOA uses the services of nonprofits and private care givers, and it is providing a financing mechanism in this legislation.