Legislature(1995 - 1996)

03/28/1995 03:35 PM STA

Audio Topic
* first hearing in first committee of referral
+ teleconferenced
= bill was previously heard/scheduled
txt
 SSTA - 3/28/95                                                                
                                                                               
            SB 120 STATE VETERANS' HOME FACILITIES                           
                                                                               
 SENATOR SHARP brings up SB 120 as the next order of business before           
 the Senate State Affairs Committee and calls the first witness.               
                                                                               
 Number 451                                                                    
                                                                               
 SENATOR TORGERSON relays information contained in the sponsor                 
 statement for SB 120 to the committee.  Senator Torgerson expresses           
 surprise at the amount of the fiscal note, and asserts SB 120 will            
 have no fiscal impact on the State of Alaska.                                 
                                                                               
 Number 423                                                                    
                                                                               
 CHAIRMAN SHARP asks Senator Torgerson to confirm that SB 120 will             
 simply modify existing law to state veteran's facilities would not            
 just be housing facilities, but would also have nursing care.                 
                                                                               
 SENATOR TORGERSON responds that is the intent.                                
                                                                               
 CHAIRMAN SHARP asks if he is correct in his belief that there are             
 currently no veteran's homes in the state, and that SB 120 does               
 nothing but set up enabling legislation.                                      
                                                                               
 SENATOR TORGERSON replies that is his understanding.                          
                                                                               
 Number 408                                                                    
                                                                               
 JEFF MORRISON, Legislative Liaison, Department of Military &                  
 Veterans' Affairs, states one of the department's duties is to                
 advise the legislature what we believe veterans would want.  He               
 thinks it would be safe to say veterans would support SB 120.                 
                                                                               
 Number 392                                                                    
                                                                               
 JIM KOHN, Deputy Director, Division of Senior Services, Department            
 of Administration, states the change made by SB 120 would not be              
 just a technical amendment to an existing law, which makes the                
 existing law operational.  The state law will remain, even with               
 passage of SB 120, incompatible with the federal veterans' program            
 requirements.  The present statute requires that the veterans'                
 homes be operated without state subsidy.  Nothing in SB 120 changes           
 that.  The Veterans' Administration (VA) requires that a state                
 receiving a construction grant for construction of a state                    
 veterans' home provide assurance that the state will be responsible           
 for the operating costs of that facility.  When the VA contributes            
 65% of the construction costs, and the state contributes 35%, the             
 agreement up front is that the state will provide assurance they              
 will foot the future operating costs, as well as maintaining the              
 building.                                                                     
                                                                               
 MR. KOHN states that replacing the term "domiciliary care" with the           
 term "nursing care" has only one effect: it increases the daily               
 rate paid by the VA from approximately $10.83 to $25.35 for                   
 eligible veterans.  Since the cost of a nursing home bed in Alaska            
 is approximately $250 per day, a resident without state subsidy               
 would be responsible for the difference.  On a yearly basis, the VA           
 would pay approximately $10,000 of these costs, while the resident            
 would be required to pay approximately $80,000.  Understandably,              
 few residents would be able to pay the costs involved.  Yet it                
 would be required by the agreement with the VA that 75% of all                
 residents in a nursing home be eligible veterans, which means that            
 their income would have to be lower than the appropriate maximum              
 allowed.  That puts them in the position of being unable to pay for           
 their care.                                                                   
                                                                               
 MR. KOHN reminds the committee that in Alaska there is a VA                   
 community nursing home program right now.  Under this program, the            
 federal government is obligated to pay the total costs of the care          
 of veterans placed in community nursing homes by the VA.  We need             
 to realize, that if a veterans' home is opened, the state will be             
 exchanging federal money for state obligations.  In addition,                 
 though he understands that veterans' organizations would like to              
 see a veterans' home, he is not sure that individual veterans would           
 be favorably impressed when faced with the bill.  At present,                 
 veterans can enter nursing care homes in their own communities, and           
 continue to have their families nearby.   If a centralized                    
 veterans' home is created, people will have to move to that central           
 location to get any subsidy.                                                  
                                                                               
 Number 310                                                                    
                                                                               
 MR. KOHN explains that the large fiscal note is to make disclosure            
 of costs, rather than following the actual law.  The fiscal note              
 does not follow the law, because under the law, it is not possible            
 to even construct the home, or make the deal with the VA.  The                
 fiscal note is based on the costs associated with building a home             
 similar to the Juneau Pioneer Home, with staff similar to the                 
 Juneau Pioneer Home.                                                          
                                                                               
 Number 332                                                                    
                                                                               
 CHAIRMAN SHARP asks Mr. Kohn if the veterans' homes in the rest of            
 the country all operate with only $25 a day from the federal                  
 government.                                                                   
                                                                               
 MR. KOHN replies that is correct.                                             
                                                                               
 CHAIRMAN SHARP asks if that has always been the case.  He thought             
 the federal government paid nearly all the costs associated with              
 veterans' homes.                                                              
                                                                               
 MR. KOHN responds that since there is no veterans' home in Alaska,            
 the VA does pay the full cost of the care of eligible veterans                
 placed in a community nursing home.  Eligibility is based upon                
 total income and assets.  The VA also requires that 75% of the                
 residents in a veterans' home be of that eligible income status.              
 There is therefore the possibility that the costs to other veterans           
 ineligible for subsidy residing in the home will be increased, in             
 order to offset the loss caused by those unable to pay.                       
                                                                               
 Number 298                                                                    
                                                                               
 DAVE WILLIAMS, Director, Division of Medical Assistance, Department           
 of Health & Social Services, states the division has followed the             
 development of home care for many years, and SB 120 seems to take             
 things in the opposite direction.  The division is also aware that            
 many nursing home beds are pending construction.  A home care                 
 system is being set up in this state, and money will all come from            
 the same direction.  If money is put into facilities, it will be              
 harder to develop a home care system.  Also, when an eligible                 
 veteran comes out of a hospital and placed in a nursing home, that            
 veteran will have 90 days of benefits in the nursing home.  If care           
 goes beyond that, and a veteran is eligible for medicaid, then                
 medicaid pays the bill.  In a state veterans' home, the home would            
 be eligible as a medicaid provider.  The Department of Health &               
 Social Services has no position on SB 120, but the state will be              
 liable for 50% of the cost of care, under the medicaid program.               
                                                                               
 Number 268                                                                    
                                                                               
 SENATOR LEMAN asks Mr. Williams to explain his statement that the             
 money will come from the same direction.                                      
                                                                               
 MR. WILLIAMS responds there is a limited amount of money available            
 for long-term care.  If that money is spent on nursing home care,             
 he assumes it will be more difficult to fund a home-care system.              
                                                                               
 Number 235                                                                    
                                                                               
 SENATOR TORGERSON reasserts that SB 120 does not build any                    
 facilities or appropriate any money.  It will give veterans in the            
 state the opportunity to build a nursing home.                                
                                                                               
 Number 220                                                                    
                                                                               
 SENATOR RANDY PHILLIPS makes a motion to discharge SB 120 from the            
 Senate State Affairs Committee with individual recommendations.               
                                                                               
 CHAIRMAN SHARP, hearing no objection, orders SB 120 released from             
 committee with individual recommendations.                                    

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