Legislature(1997 - 1998)
04/01/1997 03:03 PM House HES
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* first hearing in first committee of referral
+ teleconferenced
= bill was previously heard/scheduled
+ teleconferenced
= bill was previously heard/scheduled
HOUSE HEALTH, EDUCATION AND SOCIAL
SERVICES STANDING COMMITTEE
April 1, 1997
3:03 p.m.
MEMBERS PRESENT
Representative Con Bunde, Chairman
Representative Joe Green, Vice Chairman
Representative Al Vezey
Representative J. Allen Kemplen
Representative Tom Brice
MEMBERS ABSENT
Representative Brian Porter
Representative Fred Dyson
COMMITTEE CALENDAR
HOUSE BILL NO. 170
"An Act relating to interference with the rights of physically and
mentally challenged persons; and relating to service animals during
their training period."
- MOVED CSHB 170(HES) OUT OF COMMITTEE
HOUSE BILL NO. 197
"An Act relating to libraries."
- MOVED HB 197 OUT OF COMMITTEE
HOUSE BILL NO. 153
"An Act relating to the eligibility of aliens for state public
assistance and medical assistance programs affected by federal
welfare reform legislation; and providing for an effective date."
- HEARD AND HELD
(* First public hearing)
PREVIOUS ACTION
BILL: HB 170
SHORT TITLE: PHYS/MENTALLY CHALLENGED/ SERVICE ANIMALS
SPONSOR(S): REPRESENTATIVE(S) BRICE
JRN-DATE JRN-DATE ACTION
03/05/97 545 (H) READ THE FIRST TIME - REFERRAL(S)
03/05/97 545 (H) HES, JUDICIARY, FINANCE
03/25/97 (H) HES AT 3:00 PM CAPITOL 106
04/01/97 (H) HES AT 3:00 PM CAPITOL 106
BILL: HB 197
SHORT TITLE: PUBLIC LIBRARIES
SPONSOR(S): HEALTH, EDUCATION & SOCIAL SERVICES BY REQUEST
JRN-DATE JRN-DATE ACTION
03/14/97 668 (H) READ THE FIRST TIME - REFERRAL(S)
03/14/97 668 (H) HES
03/25/97 (H) HES AT 3:00 PM CAPITOL 106
03/25/97 (H) MINUTE(HES)
04/01/97 (H) HES AT 3:00 PM CAPITOL 106
BILL: HB 153
SHORT TITLE: ALIENS AND ASSISTANCE PROGRAMS
SPONSOR(S): RULES BY REQUEST OF THE GOVERNOR
JRN-DATE JRN-DATE ACTION
02/24/97 442 (H) READ THE FIRST TIME - REFERRAL(S)
02/24/97 442 (H) STATE AFFAIRS, HES, FINANCE
02/24/97 442 (H) 3 FISCAL NOTES (DHSS)
02/24/97 442 (H) 2 ZERO FISCAL NOTES (DHSS)
02/24/97 442 (H) GOVERNOR'S TRANSMITTAL LETTER
03/11/97 (H) STA AT 8:00 AM CAPITOL 102
03/11/97 (H) MINUTE(STA)
03/13/97 (H) STA AT 8:00 AM CAPITOL 102
03/13/97 (H) MINUTE(STA)
03/15/97 (H) STA AT 11:00 AM CAPITOL 102
03/15/97 (H) MINUTE(STA)
03/17/97 690 (H) STA RPT 4DP 2NR
03/17/97 690 (H) DP: JAMES, ELTON, BERKOWITZ, DYSON
03/17/97 690 (H) NR: HODGINS, VEZEY
03/17/97 690 (H) 3 FNS (DHSS) 2/24/97
03/17/97 690 (H) 2 ZERO FNS (DHSS) 2/24/97
03/17/97 690 (H) REFERRED TO HES
03/25/97 (H) HES AT 3:00 PM CAPITOL 106
03/25/97 (H) MINUTE(HES)
04/01/97 (H) HES AT 3:00 PM CAPITOL 106
WITNESS REGISTER
JAY LIVEY, Deputy Commissioner
Office of the Commissioner
Department of Health and Social Services
P.O. Box 110601
Juneau, Alaska 99811-0601
Telephone: (907) 465-3030
POSITION STATEMENT: Testified on HB 153
RICK TESSANDORE, Director
Disability Law Center
615 East 82 Street, Number 101
Anchorage, Alaska 99518
Telephone: (907) 344-1002
POSITION STATEMENT: Testified in support of HB 153
SUZANNE GOODRICH, Executive Director
Catholic Social Services
225 Cordova Street
Anchorage, Alaska 99501
Telephone: (907) 277-2554
POSITION STATEMENT: Testified in support of HB 153
JANET OATES, Representative
Providence Health System
P.O. Box 196609
Anchorage, Alaska 99519
Telephone: (907) 261-4946
POSITION STATEMENT: Testified in support of HB 153
ACTION NARRATIVE
TAPE 97-25, SIDE A
Number 0000
CHAIRMAN CON BUNDE called the House Health, Education and Social
Services Standing Committee meeting to order at 3:03 p.m. Members
present at the call to order were Representatives Bunde, Green,
Kemplen and Brice. Representative Vezey joined the committee at
3:05 p.m. Representatives Dyson and Porter were absent. This
meeting was teleconferenced to Anchorage.
HB 170 - PHYS/MENTALLY CHALLENGED/ SERVICE ANIMALS
Number 0050
CHAIRMAN BUNDE announced the first item on the agenda was HB 170,
"An Act relating to interference with the rights of physically and
mentally challenged persons; and relating to service animals during
their training period." He stated that the committee had adopted
a committee substitute the last time the bill was heard.
Number 0089
REPRESENTATIVE TOM BRICE said CSHB 170(HES) addresses a need.
People in the disabled community, who rely on service animals for
their independence, need to have properly trained service animals.
Number 0133
CHAIRMAN BUNDE commented that these animals are worth $50,000 a
piece and stated that he is sure they will be carefully cared for
by their trainers.
Number 0154
REPRESENTATIVE BRICE made a motion to move CSHB 170(HES) with
individual recommendations and zero fiscal notes. Hearing no
objection CSHB 170(HES) was moved from the House Health, Education
and Social Services Standing Committee.
HB 197 - PUBLIC LIBRARIES
Number 0231
CHAIRMAN BUNDE announced the next item on the agenda was HB 197,
"An Act relating to libraries." He noted that Representative Vezey
had joined the committee meeting.
Number 0305
REPRESENTATIVE BRICE made a motion to move HB 197 with individual
recommendations and accompanying fiscal note. Hearing no objection
HB 197 was moved from the House Health, Education and Social
Services Standing Committee.
HB 153 - ALIENS AND ASSISTANCE PROGRAMS
Number 0363
CHAIRMAN BUNDE announced the next item on the agenda as HB 153, "An
Act relating to the eligibility of aliens for state public
assistance and medical assistance programs affected by federal
welfare reform legislation; and providing for an effective date."
Number 0421
JAY LIVEY, Deputy Commissioner, Office of the Commissioner,
Department of Health and Social Services, said he was here to
answer any questions.
RICK TESSANDORE, Director, Disability Law Center, testified next
via teleconference from Anchorage. He was in support of HB 153.
The Disability Law Center provides legal services to people with
disabilities. There are approximately 800 individuals who are
scheduled to lose their benefits sometime between now and the
beginning of the fiscal year. Many of these people have worked and
lived in Alaska for many years. Some are now so disabled that they
would not be able to pass any type of citizenship exam, using the
same process people are accustomed to seeing during naturalization.
For those who may be able to pass the test, it is not a speedy
process. It takes a number of weeks, sometimes longer, to conduct
all of the different background checks for these individuals so
that they can become naturalized if they are eligible. It is
difficult to find everyone because of geographical conditions and
the language barriers. The center has been trying to identify
individuals who are going to lose their benefits.
MR. TESSANDORE explained that the Disability Law Center is
partnered with the Catholic Social Services organization here in
Anchorage, the Department of Health and Social Services (DHSS)
through the Division of Public Assistance and with the Mental
Health Trust Authority to try to help those people who are
considered eligible for Supplemental Security Insurance (SSI) and
are scheduled to lose those benefits. Many of those people are
elderly people with dementia as well as other vulnerable adults who
are attempting to become naturalized and need our help. The center
is searching assisted living homes and nursing homes in order to
find people who are incapacitated and unable to pass the civic or
English exams. The center will help those individuals become
naturalized using a waiver process, which was only approved last
week. The center is struggling with a timeline and a crunch to get
people naturalized whenever possible and to get waivers for those
people who cannot pass the same naturalization test.
Number 0601
MR. TESSANDORE referred to articles from the Anchorage Daily News
explaining the plight of some of these people. He encouraged the
committee to contact him if they had any questions. The center
will continue to find people and get them through this process.
The greatest fear of those people and families, who are going to
lose their benefits, is the loss of the Medicaid benefits. People
are relying on Medicaid for their essential health and are
frightened that they will not receive it. This is especially true
for family members who are incapacitated and possibly living in
facilities now who wonder what they will do after the date passes.
He urged support for HB 153.
Number 0670
REPRESENTATIVE AL VEZEY asked for an explanation of the Disability
Law Center.
Number 0687
MR. TESSANDORE said the center is a statewide organization created
in federal law in the 1970s to provide legal services to people
with disabilities throughout Alaska. They can receive this legal
assistance when one of the problem legal areas is based on their
disability.
Number 0704
REPRESENTATIVE VEZEY stated that he did not think anybody had the
desire to take away a benefit available to most citizens just
because a person becomes, through mental incapacitation, unable to
meet current citizenship requirements. He asked how many of these
people have family of the first or second degree of kindred which
is part of their extended family here in Alaska.
Number 0751
MR. TESSANDORE did not know the answer to this question. He has
not talked to the family members. The center is searching out the
individuals with disabilities in hopes that their family members
have either contacted the immigration lawyers at Catholic Social
Services or contacted the center.
Number 0773
CHAIRMAN BUNDE questioned why the center was searching for those
individuals. He thought that those people, scheduled to lose their
benefits, would be proactive.
Number 0798
MR. TESSANDORE explained that it is a combination of both. Those
people are contacting the Division of Public Assistance and nursing
home case managers who are then contacting the center. The center
has recently spoken with Providence Extended Care who has indicated
that a number of people have come to them with concerns.
Number 0820
REPRESENTATIVE VEZEY asked him how he would feel if HB 153 were
amended to exclude persons who have family members of the first
degree of kindred. One of the things our welfare program assumes
is that it is the government's responsibility to take care of our
elders, rather than the family's responsibility. He reiterated the
question that if people who had family of the first degree of
kindred, who were capable of providing support, could be excluded
from this program through an amendment to HB 153.
Number 0855
MR. TESSANDORE responded that, not really knowing everyone's
situation, he would make the assumption that families are doing all
they can now. One of the areas which is of great concern, is that
even those resources which are currently being used by the families
are going to be cut more than in half because they will lose their
federal cash assistance benefits. If HB 153 is passed, at least
those who were here prior to August 22, 1996, will receive their
medical benefits which are the most expensive benefits and would
probably not be able to be provided by family members. He
reiterated that losing these benefits has been the greatest concern
to those people scheduled to lose their benefits.
Number 0911
SUZANNE GOODRICH, Executive Director, Catholic Social Services
(CSS), testified next via teleconference from Anchorage. She
explained that there are two distinct groups of immigrants who are
affected by welfare reform. The first group are those who are
currently receiving some form of public assistance and whose
benefits will be cut off. The second group includes those people
who may have entered the country after August 22, 1996, and will
not receive any assistance from federally funded health aid
programs for five years. It is important to note that the
immigrants being cut off assistance are lawful, permanent
residents. They are in the country lawfully, they may have worked
in the United States for many years, they may have families here,
paid into social security and taxes. The immigrants affected are
those who are lawful, but are not yet citizens of the United
States.
MS. GOODRICH said there may be many reasons why a lawful, permanent
resident has not become a citizen. Citizenship is an emotional,
lengthy and difficult process, especially for someone with a
language barrier, a disability or another challenge.
MS. GOODRICH stated there are 2,105 individuals who are currently
receiving assistance, but are being cut off by the federal
government. Within this group are 439 children under the age of
18, 641 over the age of 64. There are 801 aged, blind or disabled
individuals.
Number 1048
MS. GOODRICH explained that CSS has been assisting municipalities
with a survey of immigrants who will be losing their assistance.
The survey is not completed, but among those who have been spoken:
a young man from Nicaragua with a wife and two children who are
United States citizens; a 77-year-old woman from Poland who has not
yet become a citizen although she has lived here many years; a
young woman from Cambodia who has lived in the country 17 years;
another from Tonga; and a 70-year-old woman from the Philippines
who volunteers in a senior companion program in Anchorage.
Number 1086
MS. GOODRICH commented that the second group includes those who
will be coming into the country, who would have previously been
eligible for assistance. One of the CSS programs is a shelter for
women and women with children. Previously, when a young mother
arrived at the shelter and was in need of some form of assistance
in order to move into housing, obtain a job or receive food stamps,
she would be referred out to the various federal or state agencies
who could be of assistance to her. Under the new laws that are
coming into play, CSS will no longer have those options available
to them as a resource for referral. This creates a significant
concern, especially among those agencies who provide shelter. In
addition, there are those individuals who will be coming into the
country now, or are in the country now but have not lived here for
five years.
Number 1162
MS. GOODRICH said the committee is considering legislation
affecting immigrants. It is critical to consider the overall
impact of welfare reform. At CSS, there is a commitment to doing
more; to raise more money, to increase the amount of volunteers in
order to pick up some of the responsibility in local communities,
but they cannot do it all. In addition to the immigrant provisions
mentioned, the total welfare reform package from the federal
government affects an unduplicated 4,805 individuals. In addition
to those 4,805 individuals who will lose some form of assistance
across the state, we will have the responsibility to place in a
work or work-related activity over 7,000 individuals in the next
two years. Correspondingly, we will have a responsibility for the
associated child care.
Number 1210
MS. GOODRICH explained that time was needed to transition the
myriad of changes as a result of the federal welfare reform and the
current state reform. It is important to point out that CSS
recognizes that some of the immigrants and others will find jobs,
some may leave the state and some will have no resources. In order
for our local communities to transition into the full impact of
welfare reform, the state should consider its option to continue
benefits for our Alaskan immigrants.
MS. GOODRICH referred to an article written by Robert Karacker
(Ph.) in the New York Times National, Sunday, February 23, 1997.
This article discusses 40 states who have submitted state welfare
plans to the federal government, specifically about immigrants.
She quoted the article, "A surprisingly large number of states, 37
out the 40 filing states, said they would continue providing cash,
welfare benefits to impoverished legal immigrants who have not yet
become citizens, but were in the United States before August 22,
when President Clinton signed the welfare bill. Only Alabama,
South Carolina and Wyoming said they would not provide benefits to
immigrants already in the country. Those who arrive on or after
August 22, are generally ineligible for federal welfare benefits
for five years."
Number 1287
MS. GOODRICH said, in closing, please consider the full impact of
welfare reform as the committee considers the continuation of
benefits for immigrants.
Number 1300
CHAIRMAN BUNDE commented that the committee appreciated all the
good work that CSS has done in the past and continues to do. The
legislature wishes to encourage as much responsibility for family
members and sponsors when possible.
Number 1322
REPRESENTATIVE VEZEY asked if CSS worked directly with the
immigrants who would be affected.
Number 1338
MS. GOODRICH said CSS has a program, the Immigration\Refugee
Program. It is a program which exists among many of the Catholic
charities organizations nationwide.
Number 1351
REPRESENTATIVE VEZEY asked what degree of family involvement was
seen. He asked if the immigrants were without immediate family or
was it that their family was unable to offer assistance.
Number 1371
MS. GOODRICH agreed with Mr. Tessandore's remarks that generally
the experience has been that the extended families are doing as
much as they can in order to support family members who are here.
Number 1395
REPRESENTATIVE GREEN expressed confusion that we are extending
services that would otherwise be cut off, yet the fiscal note in
every case shows a savings. He asked how long we would continue
services to immigrants.
Number 1418
CHAIRMAN BUNDE guessed that it was a decrease in the rate of
increase.
Number 1428
MR. LIVEY explained that the fiscal notes are negative because it
looks over time. If this bill were to pass, no new immigrants
would come onto these programs for at least five years. This
creates a static pool of people from which some people, in future
years, will come out by moving away, some may die, some may get a
job or something might happen to them and they will no longer be in
the program. There are some potential savings in the future as
people come off. In addition, there is nobody new coming into the
program. It is really a combination of those two things, but the
numbers in the fiscal note are based on an established pool of
people that through attrition will become smaller over time.
Number 1466
REPRESENTATIVE GREEN asked how this would correspond to not passing
the bill.
Number 1472
MR. LIVEY suggested that if HB 153 did not pass and a substitute
bill were not introduced and passed, in other words there was no
legislation, then Adult Public Assistance benefits would continue
to be paid for those currently on the program as well as those
individuals who came into the country after August 22, 1996. This
is because the state has to go in and affirmatively change the law
under Adult Public Assistance because currently there is no
eligibility criteria under current law regarding immigration
status. Under Adult Public Assistance it would cost the state more
money.
MR. LIVEY explained that under Alaska Temporary Assistance Program
(ATAP) the same explanation would apply. The state would have to
continue to provide benefits to individuals who came into the
country after August 22, 1996, as well as all those who were here
before that date which would result in additional costs to the
program because the state would be picking up all the new people
coming in after August 22, 1996. There is a twist to this, because
the federal government has placed a five year ban on paying for
means tested programs. For five years all of the payments made to
those ATAP recipients would be state general funds. The state
could not use any federal funds to match it because the federal
government has said this can't be done for five years. This would
be an increasing amount of money also.
Number 1543
MR. LIVEY stated that with Medicaid the situation is just the
opposite. Under Medicaid, if no bill passed, the state would not
be able to provide health care services to any of those legal
immigrants for five years whether they were in the country prior to
August 22, 1996, or whether they come into the country after August
22, 1996. This is because of the way the current eligibility is
written in state law for the Medicaid program. The eligibility is
one of inclusion, you have to be specifically written into the
statute to get a service and the Alaskan statute does not currently
have these immigrants listed as receiving a Medicaid service. On
the Medicaid side there would be some cost savings because all the
people currently on Medicaid would come off and no new people would
receive Medicaid.
MR. LIVEY stated that he has not done a calculation which would
generally sum up those two sides. The sum of the savings on the
Medicaid side are mitigated because the state would still have to
provide, under federal law, emergency medical services to all legal
immigrants even if the Medicaid program hasn't picked them for all
services. These services would include emergency room visits and
hospital room stays. He said there would be an expectation of a
cost shift from Medicaid to general relief medical which is the
non-Medicaid health care program for indigents.
Number 1643
CHAIRMAN BUNDE said that shortly before the last election there was
a significant rate of increase for people becoming citizens. The
election speeded up the process. He asked if there had been an
increase in attempts or interest in becoming naturalized citizens.
The federal reform bill passed August 22, 1996, and becomes
effective in Alaska the beginning of fiscal year 1997.
Number 1668
MR. LIVEY stated there have been nationwide stories in the news
about the skyrocketing number of people applying for
naturalization. They think that there will be a year waiting list
before Immigration and Naturalization Services (INS) will even be
able to get to applications.
Number 1692
CHAIRMAN BUNDE referred to a newspaper article where some
charitable program was working on citizenship.
Number 1702
MS. GOODRICH explained that CSS is working with Disability Law
Center and a number of grassroots organizations to help with
naturalization classes. They are actually working with a program
in Anchorage, they have also developed contacts and are developing
outreach programs in Kodiak, Juneau, Fairbanks, and across the
state. One of the challenges, specifically for the aged, blind,
disabled group is the timeframe challenge in terms of helping
individuals, especially those with disabilities, achieve their
citizenship status.
Number 1741
MR. TESSANDORE stated that it is true that the applications have
increased dramatically. He added that INS travel to locales across
the state as much as they can often isn't as timely as the
applicants would wish. The Disability Law Center is trying their
best to coordinate with INS to get as many people naturalized as
possible during the visits.
Number 1765
JANET OATES, Representative, Providence Health System, testified
next via teleconference from Anchorage. She was speaking in
support of HB 153. There are a number of individuals in the
extended care facilities who are being impacted, about 11 people.
Her organization is trying to assist them with obtaining
citizenship. She talked with staff in the financial counseling
area at the medical center who stated that there are two or three
cases pending. It is hard for them to come up with dollar amounts
and the implications. Her organization supports HB 153. It
obviously has a time limit to it, so it is not an open ended
expense.
MS. OATES explained that her organization worked very hard at the
federal level and was concerned, as a health organization, about
the effects of welfare reform. They did their utmost to express
their opinion there. In the future, her organization is going to
be one of the recipients of that cost shifting. They are going to
be people who fall through the gaps. This bill will help them a
little bit.
Number 1833
MS. OATES said that right now the involved people do not represent
big dollars and they think that they will be able to deal with it.
They are concerned that if these people aren't covered, then the
families will be pushed into the Medicaid area anyway and it will
be paid for in this way.
Number 1892
MR. LIVEY referred to the kinship responsibility. If an amendment
was added to HB 153 exempting those people who had a family member
within the first degree of kinship, the family is going lose more
than half of their current level of cash support even if this bill
passes. They would also lose Medicaid. Even if family members in
town could help them pick up some of the cash aspects or pay for
some of the services that the cash would provide. Most of these
individuals are disabled or elderly and it would be difficult for
them to go out, get insurance or to be able to have someone
purchase insurance on their behalf. The health care would still be
a real problem.
Number 1932
CHAIRMAN BUNDE asked if those people were not disabled when they
came into the country, but have become disabled since they
immigrated.
Number 1943
MR. LIVEY answered that he could not tell him for a fact that
everybody who was given immigrant status, prior to August 22, 1996,
was not disabled. Those immigrants are certainly all disabled now
and have passed the program criteria for disability or old age
assistance.
Number 1960
MS. OATES referred to a woman who had cancer, she did not have
cancer as far as she knew when she entered the country.
Number 1989
CHAIRMAN BUNDE said this bill would be heard again to allow input
from Representatives Porter and Dyson.
ADJOURNMENT
There being no further business to conduct, CHAIRMAN BUNDE
adjourned the meeting of the House Health, Education and Social
Services Standing Committee at 3:40 p.m.
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