Legislature(1993 - 1994)
03/19/1993 03:00 PM House HES
Audio | Topic |
---|
* 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 March 19, 1993 3:00 p.m. MEMBERS PRESENT Rep. Cynthia Toohey, Co-Chair Rep. Gary Davis, Vice Chair Rep. Al Vezey Rep. Pete Kott Rep. Harley Olberg Rep. Tom Brice MEMBERS ABSENT Rep. Con Bunde, Co-Chair Rep. Bettye Davis Rep. Irene Nicholia COMMITTEE CALENDAR *HB 171: "An Act providing coverage for hospice care under the Medicaid program; reordering the priorities given to optional services under the Medicaid program; and providing for an effective date." PASSED WITH INDIVIDUAL RECOMMENDATIONS *HB 178: "An Act adding children under the age of 21 who are eligible for adoption assistance because of special needs to the optional Medicaid coverage list and revising the order of priority in which groups eligible for optional Medicaid coverage are eliminated; and providing for an effective date." PASSED WITH INDIVIDUAL RECOMMENDATIONS (* First public hearing.) WITNESS REGISTER DORIS LUM, Manager Valley Health Services Department Valley Hospital P.O. Box 1687 Palmer, Alaska 99645 Phone: (907) 376-1625 Position Statement: JUDY MATHIS Aide to Rep. Ron Larson Alaska State Legislature State Capitol, Room 502 Juneau, Alaska 99801-1182 Phone: (907) 465-3878 Position Statement: Representing sponsor of HB 171 DAVE WILLIAMS H&SS Planner Division of Medical Assistance Department of Health and Social Services P.O. Box 110660 Juneau, Alaska 99811-0660 Phone: (907) 465-3123 Position Statement: Available to answer questions on HB 171 and HB 178 RITCHIE SONNER, Executive Director Hospice and Home Care of Juneau 3256 Hospital Drive Juneau, Alaska 99801 Phone: (907) 463-3113 Position Statement: Testified in favor of HB 171 PREVIOUS ACTION BILL: HB 171 SHORT TITLE: MEDICAID COVERAGE FOR HOSPICE CARE BILL VERSION: SPONSOR(S): REPRESENTATIVE(S) LARSON TITLE: "An Act providing coverage for hospice care under the Medicaid program; reordering the priorities given to optional services under the Medicaid program; and providing for an effective date." JRN-DATE JRN-PG ACTION 02/22/93 413 (H) READ THE FIRST TIME/REFERRAL(S) 02/22/93 413 (H) HES, FINANCE 03/18/93 (H) HES AT 03:00 PM CAPITOL 106 03/19/93 (H) HES AT 03:00 PM CAPITOL 106 BILL: HB 178 SHORT TITLE: MEDICAID FOR CERTAIN CHILDREN BILL VERSION: SPONSOR(S): LABOR & COMMERCE TITLE: "An Act adding children under the age of 21 who are eligible for adoption assistance because of special needs to the optional Medicaid coverage list and revising the order of priority in which groups eligible for optional Medicaid coverage are eliminated; and providing for an effective date." JRN-DATE JRN-PG ACTION 02/24/93 434 (H) READ THE FIRST TIME/REFERRAL(S) 02/24/93 435 (H) HES, FINANCE 03/18/93 (H) HES AT 03:00 PM CAPITOL 106 03/19/93 (H) HES AT 03:00 PM CAPITOL 106 ACTION NARRATIVE TAPE 93-40, SIDE A Number 000 CHAIR TOOHEY called the meeting to order at 3:18 p.m., noted members present, and announced the calendar. She called HB 171 to the table. HB 171 - MEDICAID COVERAGE FOR HOSPICE CARE DORIS LUM, MANAGER OF VALLEY HEALTH SERVICES AT VALLEY HOSPITAL IN PALMER, testified via teleconference from Palmer in support of HB 171. She said she hoped to provide hospice service at less cost to residents of the Mat-Su Valley. While Alaska has no certified hospice as yet, she hopes to provide hospice care in a fiscally responsible way and to provide mechanisms to do so across the state. The patient base for hospice care is too small to support a hospice unless the facility could be qualified to receive payment through Medicaid. She said the bill would improve the level of service for hospice patients and would be a good deal for the state government. Number 068 JUDY MATHIS, AIDE TO REP. RON LARSON, PRIME SPONSOR OF HB 171, made herself available in Juneau to answer questions on HB 171. REP. BRICE asked Rep. Larson's feelings on changing the bill's effective date. Number 085 DAVE WILLIAMS, H&SS PLANNER, DIVISION OF MEDICAL ASSISTANCE IN THE DEPARTMENT OF HEALTH AND SOCIAL SERVICES, testified in Juneau that the department had asked for the bill's effective date to be delayed from July 1, 1993, to January 1, 1994, because the department did not believe it could hire people or perform the work quickly enough to begin the program by July 1, 1993. He said the bill would require much work on its management information (computer) system to handle four waivers and other changes. REP. BRICE asked Ms. Mathis if she believed Rep. Larson would believe the delay was reasonable. MS. MATHIS indicated that she did. REP. BRICE offered to make a motion for an amendment changing HB 171's effective date to January 1, 1994. Number 109 CHAIR TOOHEY asked a clarifying question on the effective date of the bill and how it related to the change in Medicaid billing services the bill would allow. REP. BRICE said he had asked why the Department of Health and Social Services had asked for the change in effective date for HB 171, and said Mr. Williams had answered his question. He said the change would be appropriate, barring opposition from the sponsor. Number 128 CHAIR TOOHEY asked what difference the change would make. MR. WILLIAMS stated the department could not make the changes to its management information system necessary to meet the bill's conditions by July 1, 1993. He added, though, that no provider was ready to take advantage of the bill's provisions right away, and a six-month delay in the bill's effective date would not harm anyone. Number 140 CHAIR TOOHEY asked if there was any reason the department could not implement the bill's provisions, starting slowly if necessary, by July 1, 1993. REP. BRICE offered his opinion that the sooner the changes got on-line, the better. But he also acknowledged that the department had other priorities relating to other Medicaid waivers that might come before HB 171, which might explain the request for a delay. Number 161 CHAIR TOOHEY called a brief at-ease at 3:26 p.m., and called the meting back to order at 3:28 p.m. REP. VEZEY noted that the bill's effective date was July 1, but the bill does not mandate that the program be in place by July 1. He also questioned the reasonableness of the bill's $10,000 fiscal note from the Department of Health and Social Services, saying the program must surely cost more than $10,000. Number 176 REP. OLBERG said he understood the fiscal note as reflecting the cost of doing the computer work necessary to put the program in place, not of operating the program. MR. WILLIAMS said the fiscal note reflected the cost of changes in the information system to allow the department payment system to process payments to hospices. He said the bill would likely not cost the state any more money. He said the bill would not extend Medicaid coverage to anyone who did not already have it. He said the cost of hospice care for a terminally ill Medicaid patient would be the same as or less than the cost of caring for such a patient in a nursing home or through a home care provider. Number 200 REP. VEZEY stated that without a fiscal note he could not tell how many new people were expected to sign up for health care services under Medicaid. He asked whether Medicaid paid much money for hospital services. MR. WILLIAMS replied that Medicaid paid a great deal for hospital services, especially for terminally ill patients. He said Medicare certification was difficult to obtain. Number 225 REP. VEZEY interrupted, commenting that the program in question was not Medicare, but Medicaid. MR. WILLIAMS clarified that Medicare was a federal insurance program, and that Medicaid often relies on Medicare certification requirements. A hospice would normally have to be certified by the Medicare program in order to receive payment for its services through the Medicaid insurance program, he said. REP. VEZEY commented he believed that Medicaid covered things that Medicare did not. MR. WILLIAMS said that was often true. But in the case of hospice service, Congress first passed certification for hospice care for Medicare, and later allowed hospices that were certified under Medicare to collect from the Medicaid program. He added that he did not anticipate more people availing themselves of hospice care. Those who are terminally ill and likely to die within six months will be receiving service through home care providers or hospices. Hospices are places where the terminally ill go to die, not places where they are encouraged to get well, which means a special kind of service. Number 248 REP. VEZEY said the prospect of care for the terminally ill was an unpleasant thought and one that few people dwell on, but it is nonetheless important to consider. Number 252 RITCHIE SONNER, EXECUTIVE DIRECTOR OF HOSPICE AND HOME CARE OF JUNEAU, testified in Juneau in support of HB 171. She said Juneau has no Medicare-certified hospices, but Medicare has waived the certification requirement in Juneau, allowing her organization to provide hospice services. She said some Juneau residents receive hospice services through other funding sources, but Hospice and Home Care would like to channel those funds to different directions if those clients could qualify for Medicaid. She echoed Mr. Williams' statement that it would not cost the state any more to allocate hospice services under Medicaid, as people already receive other state funded services. She said hospices allow people to die in dignity and comfort, surrounded by family and friends and not in sterile, often frightening institutions. Number 281 CHAIR TOOHEY called for more public testimony and, hearing none, closed public testimony and asked the will of the committee. REP. BRICE moved passage of HB 171 from the committee with individual recommendations. CHAIR TOOHEY asked for objections, and, hearing none, indicated that HB 171 was passed with individual recommendations. CHAIR TOOHEY then brought HB 178 to the table. HB 178 - MEDICAID COVERAGE FOR CERTAIN CHILDREN DAVE WILLIAMS, FROM THE DIVISION OF MEDICAL ASSISTANCE IN THE DEPARTMENT OF HEALTH AND SOCIAL SERVICES, read a statement saying that HB 178 would continue, after adoption, the Medicaid coverage already provided to children in foster homes under state custody whose mental or medical problems carried large potential financial liabilities which made them difficult to place in adoptive homes. Several years ago the state began to contract with adoptive parents to pay some of the costs associated with these children in an effort to place the children in adoption, he said. The federal government later made Medicaid coverage available to such children in such states that chose to accept it. He said HB 178 would allow the state to leave the medical cost of adopting such children to the Medicaid program, leaving the state to provide, through contracts, money for the nonmedical expenses associated with the adoption of such children. MR. WILLIAMS pointed out that the fiscal notes for the bill reflect the transfer of $35,000 in FY94 from the Department of Family and Youth Services to the general fund, which is offset by another $35,000 allocation to the Division of Medical Assistance, half of which will come from Medicaid and half of which will come from the general fund. The Division of Medical Assistance would pay the costs for medical care for the children in future years, he said. Number 339 REP. VEZEY expressed skepticism that the program would not somehow cost the state more money. MR. WILLIAMS explained again that the state was already subsidizing all the medical costs for some hard-to-adopt children under the subsidized adoption program. Before that program, such children remained in state custody with the state paying all their living costs, not just medical costs. Under HB 178, the state could get half those medical bills paid for by the federal government by taking advantage of the federal government's offer to provide Medicaid coverage for the children. He said the bill would save the state $17,700 in the first year, and the savings would increase as more children take advantage of the program. Number 365 There followed a free-flowing discussion in which Rep. Vezey, Rep. Brice, and Rep. Toohey asked several questions about the fiscal notes for the bill, how the different accounts listed in the fiscal notes would be affected, and how the bill would save the state money. Mr. Williams answered those questions with substantially the same information as he presented earlier. Number 432 REP. OLBERG said HB 178 would free up $17,700 for use elsewhere in the department, and he speculated that the money might be used by the commissioner for travel expenses. Number 467 REP. BRICE moved for passage of HB 178 from the committee with individual recommendations. CHAIR TOOHEY asked for objections, and, hearing none, declared HB 178 passed with individual recommendations. There being no further business before the committee, CHAIR TOOHEY ADJOURNED the meeting at approximately 3:45 p.m.
Document Name | Date/Time | Subjects |
---|