Legislature(1997 - 1998)

04/16/1997 08:20 AM FIN

Audio Topic
* first hearing in first committee of referral
+ teleconferenced
= bill was previously heard/scheduled
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                     HOUSE FINANCE COMMITTEE                                   
                         APRIL 16, 1997                                        
                            8:20 A.M.                                          
                                                                               
  TAPE HFC 97 - 99, Side 1, #000 - end.                                        
  TAPE HFC 97 - 99, Side 2, #000 - #159.                                       
                                                                               
  CALL TO ORDER                                                                
                                                                               
  Co-Chair Gene Therriault called  the House Finance Committee                 
  meeting to order at 8:20 A.M.                                                
                                                                               
  PRESENT                                                                      
                                                                               
  Co-Chair Therriault           Representative Kelly                           
  Representative Grussendorf    Representative Martin                          
  Representative Davis          Representative Moses                           
  Representative Foster         Representative Mulder                          
                                                                               
  Representative Hanley, Kohring  and Davies were  not present                 
  for the meeting.                                                             
                                                                               
  ALSO PRESENT                                                                 
                                                                               
  Representative  Joe  Ryan;  Senator  Jerry  Mackie;  Ritchie                 
  Sonner, Executive Director, Hospice and Home Care of Juneau.                 
                                                                               
  SUMMARY                                                                      
                                                                               
  HB 152    An Act regulating hospice care.                                    
                                                                               
            CS HB 152 (HES) was reported out of Committee with                 
            "no recommendations" and with a fiscal note by the                 
            Department  of  Health and  Social  Services dated                 
            4/02/97.                                                           
                                                                               
  SB 64     An Act relating to the Shuyak Island State Park.                   
                                                                               
            CS SB 64 (FIN) was reported out  of Committee with                 
            "individual recommendations" and with fiscal notes                 
            by  the  Department  of  Natural  Resources  dated                 
            2/04/97 and the Department of  Public Safety dated                 
            2/04/97.                                                           
                                                                               
  SB 136    An  Act  relating  to  the  state  budget  and  to                 
            appropriation bills.                                               
                                                                               
            SB 136 was rescheduled for a later hearing.                        
  SENATE BILL 64                                                               
                                                                               
       "An Act relating to the Shuyak Island State Park."                      
                                                                               
                                1                                              
                                                                               
                                                                               
  SENATOR  JERRY  MACKIE  noted  that  he had  introduced  the                 
  legislation  at the request  of Mayor  Jerome Selby  and the                 
  Kodiak  Island  Borough  Assembly.    The  legislation would                 
  present  one  of the  final actions  of  a long  and complex                 
  effort by the State, federal  authority and locally affected                 
  municipalities to compensate  for the effects of  the Valdez                 
  oil spill.  The bill would add specific land and water areas                 
  to the  Shuyak Island  State Park.   Shuyak  Island was  the                 
  first part of the  borough that was heavily impacted  by the                 
  westward streaming oil  patches and tar balls  from the 1989                 
  accident.                                                                    
                                                                               
  The two large land owners on Shuyak Island are the State and                 
  the  Kodiak  Island  Borough.   Previous  litigation imposed                 
  management restrictions that required the State  to maintain                 
  wildlife  habitat and  public  recreation  values while  the                 
  borough   was  partially   prohibited  from   commercial  or                 
  industrial use on the lands.  In 1984, Shuyak State Park was                 
  established from part of the State's holdings to protect the                 
  area's  fish  and  wildlife  habitat and  public  recreation                 
  opportunities  while  maintaining   customary  hunting   and                 
  fishing uses.                                                                
                                                                               
  Senator  Mackie  concluded  that SB  64  would  complete the                 
  transaction by formally incorporating all State lands on the                 
  island into the Shuyak Island State Park.  The expanded park                 
  retains the management  goals, purposes, and allows  uses of                 
  the original park.                                                           
                                                                               
  Senator   Mackie   pointed  out   that   hunting,  trapping,                 
  commercial fishing  or subsistence would  not be  restricted                 
  through passage of  the proposed legislation.   The only way                 
  hunting  or  trapping could  be  closed would  be  through a                 
  "biological emergency", which would retain it for management                 
  purposes.  At  this time there are two  mining claims on the                 
  island which  will continue  to run  as specified under  the                 
  claim.                                                                       
                                                                               
  Co-Chair  Therriault  referenced the  Department  of Natural                 
  Resources  fiscal  note  and  asked   if  those  funds  were                 
  warranted, suggesting that  the Department absorb that  cost                 
  within their budget.  Senator Mackie noted that would depend                 
  on action taken  by the  Committee.  He  commented that  the                 
  fiscal note  reflected the Department's increased  costs for                 
  updating their management  plan manuals.      Representative                 
  Grussendorf spoke in  support of  the proposed fiscal  note,                 
  reminding  Committee  members   of  the  serious   cuts  the                 
  Department  is  currently  faced  with in  running  projects                 
  already in the system.                                                       
                                                                               
  Co-Chair  Therriault  questioned  the  restrictions  to  the                 
                                                                               
                                2                                              
                                                                               
                                                                               
  Kodiak Borough Lands.   Senator  Mackie clarified that  area                 
  currently is owned in conjunction  with the State of Alaska.                 
  He  pointed  out  that  there   is  no  opposition  to   the                 
  legislation in Kodiak.   The  legislation would provide  the                 
  final  piece of  a purchase  review made by  the Legislative                 
  Budget and Audit Committee (LBA) last year.  It was intended                 
  to be placed into the Department, a decision which currently                 
  will be made by the Legislature.                                             
                                                                               
  Representative Martin MOVED to report CS  SB 64 (FIN) out of                 
  Committee  with  individual  recommendations  and  with  the                 
  accompanying fiscal notes.  There being NO OBJECTION, it was                 
  so ordered.                                                                  
                                                                               
  CS SB 64 (FIN) was reported out of Committee with individual                 
  recommendations and with a fiscal note  by the Department of                 
  Natural Resources dated 2/4/97 and a zero fiscal note by the                 
  Department of Public Safety dated 2/4/97.                                    
  HOUSE BILL 152                                                               
                                                                               
       "An Act regulating hospice care."                                       
                                                                               
  REPRESENTATIVE JOE RYAN stated that HB 152 would provide for                 
  licensing of hospice care programs  in Alaska, ensuring that                 
  terminally ill  persons receive  comfort, support,  and care                 
  consistent  with hospice  philosophy and concepts  through a                 
  uniform level of services.  There are no federal regulations                 
  or licensing  requirements for either certified or volunteer                 
  hospice  programs.  As  of the  January, 1997,  forty states                 
  have  regulated   hospice  programs.    The   licensing  and                 
  appropriate regulation  of volunteer  and certified  hospice                 
  programs  in  Alaska  will assure  consumers  of  consistent                 
  standards in the delivery of hospice services.                               
                                                                               
  Representative Ryan noted that hospice is a unique component                 
  of a health care delivery system,  one that has evolved over                 
  the  past  twenty  years  in the  United  States.    Hospice                 
  provides care and support for  people with terminal illness.                 
  The  goal of hospice  care is to enable  patients to live an                 
  alert,  pain-free life  and to  manage symptoms so  that the                 
  last  weeks and months of  life may be  spent in dignity and                 
  peace.                                                                       
                                                                               
  The annual  growth in  the hospice  programs averaged  about                 
  eight percent in the early 1990's.  In the  last five years,                 
  growth has averaged seventeen percent.  Hospice services are                 
  provided through a  variety of  means.  Representative  Ryan                 
  continued, the rapid  growth of hospice  programs is due  to                 
  increased  demand  for  home care  services,  the  desire of                 
  terminally ill persons to keep control over the remainder of                 
  their lives, and a trend towards reimbursement for home-care                 
                                                                               
                                3                                              
                                                                               
                                                                               
  services.                                                                    
                                                                               
  Representative Ryan noted that passage of HB  152 would help                 
  to standardize hospice care and guarantee the Alaskan public                 
  the opportunity  to access  quality hospice  care from  both                 
  volunteer and certified hospice programs.                                    
                                                                               
  Representative  Ryan  stated  that  the  fiscal  note  would                 
  provide  for the travel  costs associated  with establishing                 
  licensure  of   six  new   hospice  facilities   outside  of                 
  Anchorage.                                                                   
                                                                               
  Representative Mulder  inquired  if  the  licensure  of  the                 
  volunteer program would make it difficult for the volunteers                 
  to achieve  the necessary requirements.  Representative Ryan                 
  replied that the volunteer programs in  Alaska adhere to the                 
  national hospice standard.  The  legislation would create an                 
  uniformity of those care standards.                                          
                                                                               
  Representative Martin expressed his hesitation of government                 
  becoming involved with  a system that currently  works well.                 
  He  asked  if  the  legislation  would  increase  the  costs                 
  associated  with the program.   Representative  Ryan replied                 
  that the legislation would provide  oversight that the dying                 
  person is not  taken advantage of.   A standard has  already                 
  been determined and the legislation  would not create micro-                 
  management.                                                                  
                                                                               
  Co-Chair  Therriault   referenced  language   in  the   bill                 
  referring to a  "temporary" license.   He asked why would  a                 
  temporary license  be given  before  an agency  had met  the                 
  requirements.     Representative  Ryan   replied  that   the                 
  temporary license  would be  provided if  a problem  existed                 
  which needed to be corrected during the time the program was                 
  being brought up to meet the standard.                                       
                                                                               
  Co-Chair Therriault  continued,  Page 3,  Lines 3-12,  makes                 
  reference  to the  Department "suspending"  or "reducing"  a                 
  license.  He asked if clients would be required to move from                 
  the  facility  when  the  agency's  license  was  suspended.                 
  Representative Ryan  stated that he would assume that if the                 
  agency's license was  revoked, the facility would  no longer                 
  be able to operate.  To  revoke a license, conditions listed                 
  on Page 2 would need to exist.  Representative Ryan stressed                 
  the vulnerability of people needing hospice services.                        
                                                                               
  Representative  Kelly asked  if the  requirements listed  on                 
  Page 4, were  different from the procedures  currently used.                 
  Representative Ryan stated they were not.                                    
                                                                               
  RITCHIE SONNER, EXECUTIVE DIRECTOR, HOSPICE AND HOME CARE OF                 
  JUNEAU, noted that the proposed legislation was supported by                 
                                                                               
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  hospices throughout the  State of Alaska.   She stated  that                 
  the  bill adequately  differentiates  between the  certified                 
  hospice and the  volunteer hospice.  The  volunteer hospices                 
  are required to  fulfill a  minimum set of  standards.   The                 
  criteria listed on Pages 4, 5  & 6 of the bill would  not be                 
  required for  a voluntary hospice.   Page 7  establishes the                 
  criteria  that  a  voluntary  hospice  must  fulfill.    She                 
  stressed that  criteria recommended would not be financially                 
  or administratively burdensome for a hospice to meet.                        
                                                                               
  Ms.  Sonner   continued,  the  proposed   legislation  would                 
  prohibit any agency from calling itself a  hospice.  Hospice                 
  infers a  set of  a comprehensive  services as  well as  the                 
  ability to address the entire family's needs.                                
                                                                               
  She added, in Alaska there is  no specific hospice facility.                 
  Most  of the hospice care is done  in the home or in a home-                 
  like setting.   To  fit into the  certified criteria,  there                 
  needs to  be a facility available.   All the hospices in the                 
  State use only one or two beds designated in a hospital.  At                 
  this  time,  care  is provided  in  the  home  and must  fit                 
  established criteria.                                                        
                                                                               
  In  response to  Co-Chair Therriault's  query regarding  the                 
  confidentiality  statement,  Ms.  Sonner  replied  that  the                 
  confidentiality aspect  would guarantee that a  staff member                 
  or  volunteer  that   is  involved  in  a   patient's  home,                 
  understand the requirements of confidentiality regarding the                 
  client and family's personal issues.                                         
                                                                               
  Representative  Martin asked  if current  facilities in  the                 
  State would be grand-fathered  in.  Ms. Sonner replied  that                 
  every facility  would be  required to  fulfill the  criteria                 
  when  the  regulations  become  effective.    That  criteria                 
  guarantees anyone coming into the hospice fulfills the needs                 
  of what the consumer expects and deserves in the business.                   
                                                                               
  (Tape Change HFC 97-99, Side 2).                                             
                                                                               
  Ms.  Sonner explained  that most hospices  in the  State are                 
  small and depend on community funding.  She added, that with                 
  the exception  of one hospice,  the rest are  confident that                 
  the regulations imposed through the legislation would not be                 
  difficult to  incorporate.   This observation  was based  on                 
  hospice testimony from previous committee hearings.                          
                                                                               
  Representative  G.  Davis asked  if  there exists  a hospice                 
  international organization.  Ms. Sonner explained that there                 
  is   a   National   Hospice   Organization  with   voluntary                 
  membership.   They establish standards of excellence.  It is                 
  up to each individual hospice to  choose whether or not they                 
  fulfill  those  standards.    All  the hospices  which  have                 
                                                                               
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  testified in the past  few weeks have stated that  they meet                 
  and exceed the criteria established by that organization.                    
                                                                               
  Representative Martin warned that eventually  a fee would be                 
  charged by the  Department for  licensure; he stressed  that                 
  someone  will  be   responsible  to   pay  to  inspect   the                 
  facilities.  Ms.  Sonner could  not speak  to that  concern.                 
  Representative  G.   Davis  commented   that  the   proposed                 
  legislation would provide  an immediate return to  the State                 
  by taking care of our sick and dying population.                             
                                                                               
  Representative Foster MOVED to report CS HB 152 (HES) out of                 
  Committee  with  individual  recommendations  and  with  the                 
  accompanying fiscal  note.  There being NO OBJECTION, it was                 
  so ordered.                                                                  
                                                                               
  CS  HB  152 (HES)  was reported  out  of Committee  with "no                 
  recommendation"  and with a fiscal note by the Department of                 
  Health and Social Services dated 4/2/97.                                     
  ADJOURNMENT                                                                  
                                                                               
  The meeting adjourned at 9:10 A.M.                                           
                                                                               
                                                                               
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**FIN106PM                                                                     

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