Legislature(2019 - 2020)BUTROVICH 205
03/01/2019 01:30 PM Senate HEALTH & SOCIAL SERVICES
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.
| Audio | Topic |
|---|---|
| Start | |
| SB7 | |
| Adjourn |
* first hearing in first committee of referral
+ teleconferenced
= bill was previously heard/scheduled
+ teleconferenced
= bill was previously heard/scheduled
| += | SB 7 | TELECONFERENCED | |
| + | TELECONFERENCED |
SB 7-MED. ASSISTANCE WORK REQUIREMENT
1:31:16 PM
CHAIR WILSON announced that the only order of business would be
SB 7, SENATE BILL NO. 7, "An Act requiring the Department of
Health and Social Services to apply for a waiver to establish
work requirements for certain adults who are eligible for the
state medical assistance program."
SENATOR WILSON asked the Alaska Housing Finance Corporation
representative to talk about their rent reform program.
1:32:22 PM
CATHY STONE, Director, Public Housing, Alaska Housing Finance
Corporation (AHFC), Anchorage, said AHFC's Public Housing
Division launched a rent reform program in 2014. The program
took recipients for public housing voucher programs and split
them into two groups. AHFC created a classic program for the
elderly and disabled and continued housing assistance for them
at the same levels. AHFC created a path to incentivize people to
work or increase their educational opportunities. Under the Step
Program, their public assistance would run out after five years.
The process included stepping down the rental assistance with
the expectation that recipients would pay more of their income
in rent. AHFC provided significant support to recipients through
a program called Jumpstart, including case management to help
provide recipients with incentives to work, to increase their
education, save money, and increase their financial literacy.
MS. STONE said the program has had excellent outcomes. The
program recipients are not yet in the fifth and final year, when
assistance will end. Since 2014, AHFC has seen recipients'
annual gross income increase dramatically, from $19,000 to
$29,000 and annual earned income also increased. The percentage
of people working 32 or more hours per week went from 40 percent
to 56 percent. When participants earn more it frees up money for
AHFC to use to help more people. Because subsidies are
decreasing, AHFC can add more vouchers into the community. AHFC
has seen an increase of almost a thousand vouchers throughout
the state. The program has had positive outcomes and has been
successful due to the program's additional case management and
support, which has helped people increase their self-
sufficiency.
1:35:42 PM
SENATOR BEGICH asked what percentage of recipients are working
32 hours or more per week.
MS. STONE said that 58 percent of program recipients are working
32 hours or more per week.
SENATOR BEGICH asked what the connection is between this
information and SB 7.
CHAIR WILSON said that at the February 20, 2019 hearing, the
committee discussed how this program is similar to SB 7 in terms
of the work requirements. He surmised that a correlation might
exist between people who are on housing vouchers and those who
may be affected by SB 7.
1:37:08 PM
SENATOR BEGICH asked about the paperwork requirements for the
program and the type of support AHFC provides to help families
in the rent reform program achieve self-sufficiency.
1:37:40 PM
MS. STONE answered that people coming into the housing program
fill out the same type of paperwork used when signing up for
assistance. Once the applicant is classified as a "work-able"
family member, the person would be referred to a "Jumpstart"
specialist for case management. The case manager reviews
information, including income, budget, education, housing needs
and goals. All AHFC requires is that the case managers include
the data in the main database used for housing and to report to
the U.S. Department of Housing and Urban Development (HUD). Case
management software is used to track how clients are
progressing, their housing needs, income, and incentives.
SENATOR BEGICH asked if a Jumpstart specialist is a fulltime
AHFC employee and how many staff work in that capacity.
MS. STONE said that AHFC hired eight Jumpstart specialists that
serve the entire state, with five specialists in Anchorage, two
in Juneau, and one in Fairbanks.
SENATOR BEGICH asked how many clients are served in the program.
MS. STONE answered that 750 people are enrolled in level one,
which is the highest-needs population. Level two is open to
everyone, which is tracked less strenuously. She estimated that
approximately 3,000 people participate in the Step program
across the state. Of those, about half receive Jumpstart
assistance, she said.
1:40:40 PM
SENATOR BEGICH related his understanding that about 1,500 people
get services from the eight Jumpstart specialists.
MS. STONE agreed.
1:41:13 PM
STACY BARNES, Director, Governmental Relations and Public
Affairs, Alaska Housing Finance Corporation (AHFC), Anchorage,
said that under federal law AHFC is designated as a moving-to-
work agency, which is why it is able to do this work. She
explained that the late U.S. Senator Ted Stevens had worked on
this a number of years ago. AHFC receives federal funding under
a block grant that allows them the flexibility to provide
housing and resources in communities.
1:41:53 PM
CHAIR WILSON solicited a motion to adopt the proposed committee
substitute for SB 7.
SENATOR COGHILL moved to adopt the committee substitute (CS) for
SB 7, work order 31-LS0196\M, as the working document.
SENATOR GIESSEL objected for purposes of discussion.
1:42:15 PM
CHAIR WILSON reviewed the changes made in the committee
substitute for SB 7, Version M:
On page 1, line 7: Adds a short title, "This Act may
be known as the Medicaid Work Opportunities Act."
(Requested by Senator Wilson.)
On page 2, line 1: Changes the minimum work
requirement from 20 hours per week to 80 hours per
month, to allow more flexibility. (Requested by the
sponsor.)
On page 2, line 3: Adds postsecondary and vocational
programs to the list of activities a recipient can
participate in. (Requested by Senator Wilson.)
On page 2, line 12: Changes the ages permitted under
exemptions from 18 to 19 and from 65 to 60 years of
age. (Requested by the sponsor.)
One page 2, line 13: Changes the age of a dependent
child from 12 months (one year) to six years. This
change will now exempt parents or caretakers of
dependent children up to six years of age. (Requested
by Senator Wilson.)
1:44:14 PM
On page 3, lines 4 through 11: Subsection 6 has been
rewritten to provide for notification of all
recipients of work requirements as soon as the waiver
is approved and, not less than 90 days after providing
notice, termination of medical assistance for those
who become ineligible. This section also requires DHSS
to provide information for the Department of Labor and
Workforce Development and its employment-related
training programs. (Requested by the sponsor.)
On page 3, lines 12 through 15: This is new language
that provides for a bridge of up to 12 months if the
recipient meets the work requirements but his or her
additional earnings make that recipient ineligible for
assistance. (Requested by the sponsor.)
Page 3, line 16: This is new language which adds a
Section 3 and an immediate effective date clause.
(Requested by Senator Wilson.)
1:45:32 PM
SENATOR BEGICH referred to correspondence from Laura Lucas, MSW,
Laura Keller and Sherri Roberds with the American Diabetes
Association, and Jessie Menkens with the Alaska Primary Care
Association. In his own review of the chart, Arkansas appears to
be the only one actively using the work requirements. He
reported that 18,000 or approximately 23 percent have been
removed from Medicaid as a result of the work requirements.
Arkansas uses a flexible three-month time period for work
reporting. He pointed out the proposed committee substitute for
SB 7 goes from 20 hours a week to 80 hours for the timeframe of
one month.
He said that rural Alaska suffers from chronic unemployment. In
some villages it is half the population of the village. He
related his understanding that considerations were made for
subsistence activities, but he is deeply concerned about the
burden this will place on people who need health care. He
reiterated his concern is whether the state will be able to
provide health care as part of its commitment to public health.
He said that testimony provided by Alaskans underscores and
reinforces that concern. He has met with members from the Alaska
State Hospital and Nursing Home Association (ASHNHA), emergency
room doctors, and other groups. He has been receiving
significant levels of concern about this bill. He is not sure
what the long-term aim goal is and whether it will have the
consequences the sponsor and committee intended.
SENATOR BEGICH expressed an interest in the new fiscal notes
because of the changes made in Version M. He said the changes
made by Senator Micciche and Senator Wilson's office are good
ones. The changes in eligibility age may reduce the fiscal note.
He asked what level of support will be needed from the
department to match the Jumpstart specialists' effort.
CHAIR WILSON said that he still has concerns about
implementation. He wondered what changes could be made in the
bill to help the majority of Alaskans. He acknowledged that the
new fiscal note will not be updated until the bill moves
forward. However, he asked whether Ms. O'Brien could speak to
some of the potential impacts.
1:49:57 PM
SHAWNDA O'BRIEN, Director, Division of Public Assistance,
Department of Health and Social Services (DHSS), Juneau, said
the department has not done any new calculations, but she
anticipated forthcoming changes due to the number of people
included or excluded.
CHAIR WILSON asked if the changes in the age exemptions would
increase or decrease the fiscal note.
MS. O'BRIEN said she does not have the data today to reflect the
changes made in the committee substitute. She was unsure of how
many recipients were over the age of 60 or the effect of raising
the requirement age from 18 to 19 years old. The department has
also been cross matching data with health care services to
determine the recipients who are designated for substance abuse
or mental health treatment. She acknowledged that the figure
would likely be revised slightly for that.
SENATOR BEGICH said he looked forward to seeing those numbers.
1:51:26 PM
SENATOR COGHILL said there are other programs that allow for
extended work on Medicaid. He asked how this program will fit
in. He further asked for a description of other Medicaid
exceptions.
MS. O'BRIEN asked for clarification.
SENATOR COGHILL said he was interested in eligibility for
Medicaid. Some programs allow recipients who are ineligible for
Medicaid to obtain extensions. He asked her to explain how that
process will work with this bill.
MS. O'BRIEN offered to research this and report back to the
committee with more detail. If someone was eligible for Medicaid
but fell under one of the bill's exemptions, the recipient would
not be required to participate in the work requirement program.
She said that if Senator Coghill was asking whether the
department would change someone's eligibility determination
because of another program's rules, that she was not aware of
any provision. She pointed out that recipients lose eligibility
for Medicaid due to life changes, including being above income.
1:53:35 PM
SENATOR COGHILL recalled some opportunities for recipients who
became ineligible for Medicaid that had a timeframe to retain
assistance under certain circumstances, such as Denali Kid Care,
Title 20, and regular Medicaid.
MS. O'BRIEN answered that yes, there were some exemptions. She
offered to research the different categories that would allow
someone to remain eligible and report back to the committee.
SENATOR COGHILL said he thought that information should be
considered as the bills go forward because the criteria might be
disparate.
CHAIR WILSON asked the department to provide the list.
1:55:15 PM
SENATOR BEGICH said that AHFC provided information about
Jumpstart specialists. He asked whether the new positions were
assigned to help people work through this process.
MS. O'BRIEN replied yes, the fiscal note [from the Division of
Public Assistance] identified the division's needs in the first
year of implementation. The division also estimated the figures
for outgoing years, which would decline over the course of time.
She said that the positions needed would decrease incrementally
until the third year of implementation, when the activity would
likely level off.
1:56:06 PM
SENATOR GIESSEL removed her objection.
1:56:22 PM
CHAIR WILSON found no further objection and the CS for SB 7,
work order 31-LS0196\M, was adopted.
1:56:37 PM
EDRA MORLEDGE, Staff, Senator Peter Micciche, Alaska State
Legislature, Juneau, relayed that Senator Micciche appreciated
the committee's work on the bill and that he was ready to
continue the process.
1:57:12 PM
CHAIR WILSON solicited a motion.
1:57:15 PM
SENATOR COGHILL moved to report the committee substitute (CS)
for SB 7, Version M, from committee with individual
recommendations and attached fiscal note(s).
There being no objection, the CSSB 7(HSS) was reported from the
Senate Health and Social Services Standing Committee with the
understanding that Legislative Legal was authorized to make any
necessary technical or conforming adjustments.
| Document Name | Date/Time | Subjects |
|---|---|---|
| SB 7 Chart of States 1.pdf |
SHSS 3/1/2019 1:30:00 PM |
SB 7 |
| SB 7 What Other States are Doing.pdf |
SHSS 3/1/2019 1:30:00 PM |
SB 7 |
| SB 7 Chart of States 2.pdf |
SHSS 3/1/2019 1:30:00 PM |
SB 7 |
| SB 7 MACPAC Waiver Information.pdf |
SHSS 3/1/2019 1:30:00 PM |
SB 7 |
| SB 7 AHFC Step Program.pdf |
SHSS 3/1/2019 1:30:00 PM |
SB 7 |
| SB 7 AHFC 2017 Annual Rept Rent Reform.pdf |
SHSS 3/1/2019 1:30:00 PM |
SB 7 |
| SB 7 AHFC 2018 Annual Rept Rent Reform.pdf |
SHSS 3/1/2019 1:30:00 PM |
SB 7 |
| SB 7 Sectional Summary v M.pdf |
SHSS 3/1/2019 1:30:00 PM |
SB 7 |
| SB 7 Public Input 3.1.19.pdf |
SHSS 3/1/2019 1:30:00 PM |
SB 7 |
| APCA letter for submission - SB7 - Medical Assistance Work Requirement.pdf |
SHSS 3/1/2019 1:30:00 PM |
SB 7 |
| SB 7 - AHFC Public Housing Rent Reform Results FY 14 to Jan 2019.pdf |
SHSS 3/1/2019 1:30:00 PM |
SB 7 |