Legislature(1997 - 1998)

04/04/1997 10:04 AM HES

Audio Topic
* first hearing in first committee of referral
+ teleconferenced
= bill was previously heard/scheduled
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      SENATE HEALTH, EDUCATION & SOCIAL SERVICES COMMITTEE                     
                         April 4, 1997                                         
                           10:04 a.m.                                          
                                                                               
  MEMBERS PRESENT                                                              
                                                                               
 Senator Gary Wilken, Chairman                                                 
 Senator Loren Leman, Vice Chairman                                            
 Senator Lyda Green                                                            
 Senator Jerry Ward                                                            
 Senator Johnny Ellis                                                          
                                                                               
  MEMBERS ABSENT                                                               
                                                                               
 All members present.                                                          
                                                                               
  COMMITTEE CALENDAR                                                           
                                                                               
 SENATE BILL NO. 149                                                           
 "An Act relating to reports and audits concerning health care                 
 facilities; and providing for an effective date."                             
  -MOVED SB 149 OUT OF COMMITTEE                                               
                                                                               
 SENATE BILL NO. 148                                                           
 "An Act relating to libraries."                                               
  -MOVED SB 148 OUT OF COMMITTEE                                               
                                                                               
 SENATE BILL NO. 146                                                           
 "An Act relating to the public school funding program; relating to            
 the definition of a school district, to the transportation of                 
 students, to school district layoff plans, to the special education           
 service agency, to the child care grant program; imposing a school            
 tax in the unorganized borough; and providing for an effective                
 date."                                                                        
  -SCHEDULED BUT NOT HEARD                                                     
                                                                               
  PREVIOUS SENATE COMMITTEE ACTION                                             
                                                                               
 SB 149 - No previous Senate action to record.                                 
                                                                               
 SB 148 - No previous Senate action to record.                                 
                                                                               
 SB 146 - See Senate Health, Education & Social Services minutes               
          dated 3/24/97.                                                       
                                                                               
  WITNESS REGISTER                                                             
                                                                               
 Jay Livey, Deputy Commissioner                                                
 Department of Health & Social Services                                        
 PO Box 110601                                                                 
 Juneau, Alaska 99811-0601                                                     
  POSITION STATEMENT:   Discussed SB 149.                                      
                                                                               
 Garrey Peska                                                                  
 Alaska State Hospital & Nursing Home Association (ASHNHA)                     
 319 Seward Street                                                             
 Juneau, Alaska 99801                                                          
  POSITION STATEMENT:   Discussed SB 149.                                      
                                                                               
 Mary Jackson, Staff                                                           
 Senator Torgerson                                                             
 State Capitol                                                                 
 Juneau, Alaska 99801-1182                                                     
  POSITION STATEMENT:   Discussed SB 148.                                      
                                                                               
 George Smith, Deputy Director                                                 
 Division of Libraries, Archives & Museums                                     
 PO Box 110571                                                                 
 Juneau, Alaska 99811                                                          
  POSITION STATEMENT:   Discussed SB 148.                                      
                                                                               
 Moe McGee, Director                                                           
 Anchorage Municipal Libraries                                                 
 3600 Denali                                                                   
 Anchorage, Alaska 99503                                                       
  POSITION STATEMENT:   Supported SB 148.                                      
                                                                               
 Greg Hill                                                                     
 Fairbanks North Star Borough Library                                          
 555 Fairbanks Street                                                          
 Fairbanks, Alaska 99709                                                       
  POSITION STATEMENT:   Urged passage of SB 148.                               
                                                                               
 Paul Blair                                                                    
 Glennallen, Alaska                                                            
  POSITION STATEMENT:   Favored the general concept of SB 148.                 
                                                                               
 Joyce Jenkins, Director                                                       
 City of Petersburg Library                                                    
 Petersburg, Alaska                                                            
  POSITION STATEMENT:   Encouraged support of SB 148.                          
                                                                               
                                                                               
  ACTION NARRATIVE                                                             
                                                                               
  TAPE 97-35, SIDE A                                                           
                                                                               
          SB 149 HEALTH CARE FACILITY AUDITS & REPORTS                        
                                                                              
 Number 001                                                                    
                                                                               
  CHAIRMAN WILKEN  called the Senate Health, Education & Social                
 Services Committee (HES) to order at 10:04 a.m. and introduced                
  SB 149  as the first order of business before the committee.                 
  JAY LIVEY , Deputy Commissioner for the Department of Health &               
 Social Services, noted that the committee packet contained a                  
 position paper from the Alaska State Hospital & Nursing Home                  
 Association (ASHNHA) which describes the four sections of SB 149.             
 SB 149 clarifies that the department has the ability to do audits             
 and other financial inspections of hospitals and nursing homes in             
 order to establish reimbursement rates for Medicaid.  In the past,            
 there has been some ambiguity whether the department's statute                
 specifies that ability.                                                       
                                                                               
  GARREY PESKA , ASHNHA, added that SB 149 would repeal a state filing         
 deadline that has been superseded by federal deadlines.  Under                
 state law, facilities must file a year end report with the                    
 department within 120 days of the end of the facility's fiscal                
 year.  Due to changes in federal deadlines, facilities no longer              
 receive the documents necessary from federal payment intermediaries           
 until five months after the year end.  SB 149 would allow the                 
 department to set that deadline so as to coincide with the federal            
 deadlines.  SB 149 includes language that acknowledges that the               
 department is not required to audit every hospital and nursing home           
 every year for Medicaid.  Those facilities are all audited by                 
 independent CPAs every year and therefore it would be appropriate             
 for Medicaid audits to be done less frequently.                               
                                                                               
  CHAIRMAN WILKEN  noted that Douglas Jones and Randal Schlapia from           
 DHSS were present to answer questions.  Chairman Wilken said that             
 he intended to report SB 149 out of committee.                                
                                                                               
  SENATOR ELLIS  asked if there would be a review of the independent           
 CPAs' audit during the years the department does not perform an               
 audit.  How many years could a small facility participate in                  
 Medicaid without a state audit of the program?   JAY LIVEY  said that         
 a criteria had not yet been developed by which the department would           
 choose to do a facility audit every year.  The department and                 
 ASHNHA are contemplating changes to the rate setting system which             
 would eliminate the need for yearly audits.  Therefore, the                   
 department wanted to ensure that statute allowed the department the           
 discretion not to perform yearly audits.                                      
                                                                               
 Number 120                                                                    
                                                                               
  SENATOR ELLIS  inquired as to the length of time SB 149 allows for           
 the department not to audit.   JAY LIVEY  said that SB 149 does not           
 specify a schedule.   SENATOR ELLIS  believed that under SB 149 the           
 department could choose not to perform an audit on a facility with            
 a Medicaid program.   JAY LIVEY  acknowledged that possibility under          
 SB 149, but said that the department had no intention of doing                
 such.  Unless a change occurred in the current rate setting system,           
 the department would intend to audit every year.   GARREY PESKA               
 noted that federal law requires that the department have an audit             
 program.  Mr. Peska suggested that for a small facility an audit              
 every other year would be appropriate.  Such a facility could have            
 a contract based on the number of encounters rather than actual               
 cost or a contract based on a quarterly lump sum of the previous              
 year's reimbursement could be utilized.                                       
                                                                               
  SENATOR ELLIS  asked how small an operation would be before the              
 program would be considered as a program not materially                       
 participating in Medicaid.   JAY LIVEY  pointed out that the problem          
 with Medicaid is that it is a $350 million program.  Even a                   
 facility with a relatively small share of that budget could be                
 receiving $2 or $3 million in state expenditures which would be a             
 large portion in another context.  Mr. Livey said that the                    
 materiality would need review and the department has not begun                
 regulations describing that materiality.                                      
                                                                               
 Hearing no further discussion,  CHAIRMAN WILKEN  said that he would           
 entertain a motion.                                                           
                                                                               
  SENATOR GREEN  moved to report SB 149 out of committee with                  
 individual recommendations and accompanying fiscal notes.  Without            
 objection, it was so ordered.                                                 
                                                                               
                                                                               
                                                                             
                    SB 148 PUBLIC LIBRARIES                                   
                                                                              
 Number 200                                                                    
                                                                               
  CHAIRMAN WILKEN  noted that SB 146 would not be taken up today, but          
 would be before the committee on Wednesday.  Chairman Wilken                  
 announced that  SB 148  was the last order of business before the             
 committee.                                                                    
                                                                               
  MARY JACKSON , Staff to Senator Torgerson, informed the committee            
 that SB 148 is a companion to HB 197.  SB 148 establishes a                   
 definition of public library in order to provide a criteria for               
 funding libraries under existing grant programs.                              
                                                                               
  GEORGE SMITH , Deputy Director of the Division of Libraries,                 
 Archives & Museums, discussed the history of Alaska's support of              
 public libraries.  Mr. Smith noted that the $1 to $1 match of the             
 grant program has not been possible for a number of years, every              
 library receives the basic $5,000 grant.  The match has been                  
 prorated and in recent years, no more than $2,000 match has been              
 provided.  In the last three or four years, no library has received           
 more than $7,000.  Mr. Smith explained that about five years ago,             
 a number of libraries requested that a law defining a public                  
 library be developed.  SB 148 was developed through the work of               
 Public Library Directors of the 19 largest libraries in Alaska.               
 The legislation was also reviewed by the Education Subcommittee of            
 the Alaska Municipal League who would like to see SB 148 move                 
 forward.                                                                      
                                                                               
 Number 285                                                                    
                                                                               
 SB 148 addresses two major issues.  Firstly, SB 148 addresses some            
 administrative issues found in the following sections.  Section 6             
 specifies the minimum levels of service that a public library                 
 should provide to be eligible for a grant.  Section 5 provides a              
 structure for Library Boards if the community decides to have such.           
 Mr. Smith noted that many cities do not have such a board, rather             
 the city council acts in that capacity.  Section 2 requires                   
 nonprofit corporations that run public libraries to conduct board             
 meetings in public.  Of Alaska's 85 public libraries, 22 are                  
 operated by nonprofit corporations.  Section 6 allows nonprofits in           
 unorganized boroughs, outside of cities to qualify as a community             
 per the Department of Community & Regional Affairs definition of              
 community.                                                                    
                                                                               
 Secondly, SB 148 radically restructures the nature of the grant               
 program which is located in Section 3.  Currently, a community can            
 receive a $5,000 grant without any local effort.  There is a                  
 matching portion that does require local effort.  SB 148 specifies            
 that a library would not be eligible for a grant without local                
 effort at a minimum of $5,000.  The current law requires that the             
 match be in money, but SB 148 would allow in-kind service which               
 recognizes the efforts of volunteer services.  This would stabilize           
 many of the small libraries.  Mr. Smith acknowledged that a few               
 libraries at the lower end who have never contributed locally will            
 have to decide whether to contribute or close.  Based on libraries'           
 annual reports, between five and ten libraries will face a                    
 difficult question regarding whether to provide local effort.  On             
 the other hand, 15-20 libraries will fair better because of the in-           
 kind service.  Under SB 148 if there is ever more money for this              
 program, any amount available above $7,000 per library would be               
 distributed on a per capita basis.                                            
                                                                               
 Mr. Smith pointed out that Section 7 sunsets two public library               
 construction grant programs which no longer exist.  Mr. Smith noted           
 that the state library has been giving public library grants,                 
 interlibrary cooperation grants, and regional services grants. The            
 regional services grants never appeared in law, although those                
 grants have been functioning since the 1970s.  Sections 1 and 2               
 clarify that situation by recognizing regional services grants                
 which provides books by mail service.                                         
                                                                               
 Number 391                                                                    
                                                                               
  SENATOR LEMAN  referred to page 2, line 6 when asking if that                
 language would prevent libraries from charging shipping fees.                 
  GEORGE SMITH  said that the language would not prevent the charge of         
 transportation fees.  Across the country, a sizable interlibrary              
 loan fee has evolved and in addition there is a shipping cost.                
 SB 148 would merely eliminate the interlibrary loan fee and charge            
 only the shipping fee which all libraries in Alaska have done for             
 many years.                                                                   
                                                                               
  SENATOR LEMAN  asked if there was a standard methodology regarding           
 how in-kind services are valued.   GEORGE SMITH  said that this would         
 need to be addressed in regulation.  Mr. Smith believed that in-              
 kind service should be valued slightly under the level of a city              
 clerk in that particular region, but not less than $10 per hour.              
                                                                               
  SENATOR LEMAN  suggested that Mr. Smith consider a minimal cash              
 contribution from the community in order to help establish the                
 community's ownership of the library.  Senator Leman referred to              
 page 4, line 3 which refers to the items the library would provide            
 free of charge.  Senator Leman assumed that the library could                 
 charge fees for fines, copying, etc.   GEORGE SMITH  said that there          
 is no charge for a resident of the community to check out a book.             
 Mr. Smith noted that libraries with a data base service would be              
 allowed to charge a fee.                                                      
                                                                               
 Number 459                                                                    
                                                                               
  MOE MCGEE , Director of Anchorage Municipal Libraries, supported             
 SB 148.  Ms. McGee discussed the meetings that took place between             
 various library directors with state library staff in order to                
 draft public library law for Alaska.  This process resulted in a              
 closeness between the directors which will benefit future                     
 endeavors.  From the Anchorage perspective, Ms. McGee was pleased             
 with the per capita provisions beyond the basic grant.  Ms. McGee             
 appreciated the support of the state library in this process.                 
                                                                               
  GREG HILL , Fairbanks North Star Borough Library, informed the               
 committee of a report from the National Center for Education                  
 Statistics which reports that 44 percent of all U.S. households               
 used a public library last month.  The report also found that 65              
 percent of all U.S. households used a public library in the last              
 year.  Alaska ranks even higher; 56 percent of Alaskans used a                
 public library last month and 76 percent of Alaskans used a public            
 library last year.  Mr. Hill believed it time for legislation to              
 define public libraries to be used to lay the foundation for the              
 future.  SB 148 requires local commitment and provides an incentive           
 with the recognition of in-kind service.  Mr. Hill urged the                  
 passage of SB 148.                                                            
                                                                               
  PAUL BLAIR , testifying from Glennallen, informed the committee that         
 the Glennallen library was in an unincorporated borough with a                
 minimum of $5,000 grant.  Mr. Blair said that either way, the                 
 Glennallen library would be hurt.  Mr. Blair referred to the                  
 language in Section 2, subsection (b) stating " Only one library in          
 a city or unincorporated community is eligible for a public library           
 assistance grant during a fiscal year. "  Does that language apply           
 to an unincorporated borough with nine libraries or does that not             
 apply to an unincorporated borough?                                           
                                                                               
  GEORGE SMITH  explained that there could be any number of recognized         
 libraries within an unincorporated borough, the language only                 
 refers to within one community as defined by Community & Regional             
 Affairs.  If Community & Regional Affairs recognizes a community as           
 eligible for state grants, SB 148 would as well.                              
                                                                               
  PAUL BLAIR  indicated the need for more specific language on that            
 matter.   GEORGE SMITH  pointed out that the Community & Regional             
 Affairs law specifies that each viable community is separate and              
 eligible, although that is not mentioned in SB 148.                           
                                                                               
 Number 527                                                                    
                                                                               
  PAUL BLAIR  believed that the specified range of $5,000 to $7,000            
 for matching grants would hurt the small libraries such as in                 
 Glennallen.  Mr. Blair cited a case in Glennallen in which there              
 was a small in-kind base to draw from as well as greater utility              
 expenses; that would create difficulties matching grants greater              
 than $7,000.  Mr. Blair suggested that the low end of the range be            
 lowered and the high end be raised so as to consider the smaller              
 libraries.   GEORGE SMITH  noted that Glennallen is one of the more           
 stable smaller libraries which has had the maximum matching amount            
 for years.  SB 148 could actually help Glennallen, especially with            
 the in-kind matching allowed.  Mr. Smith agreed that a maximum of             
 more than $7,000 would be nice, but the reality is that there is a            
 limited amount of money available.                                            
                                                                               
  PAUL BLAIR  said that he was in favor of the general content of              
 SB 148.                                                                       
                                                                               
  JOYCE JENKINS , Director of the Petersburg Library, echoed the               
 comments regarding the time spent on this legislation.  The                   
 increased accountability for libraries through the definition are             
 important and need to be in law.  Ms. Jenkins commented that the              
 greatest difficulty was balancing the needs of the small and large            
 libraries which SB 148 achieves.  Ms. Jenkins encouraged the                  
 committee's support of SB 148.                                                
                                                                               
  SENATOR WARD  moved to report SB 148 out of committee with                   
 individual recommendations and accompanying fiscal notes.  Without            
 objection, it was so ordered.                                                 
                                                                               
  CHAIRMAN WILKEN  asked if there was anything else to come before the         
 committee.                                                                    
                                                                               
  SENATOR ELLIS  inquired as to the progress of the sex offender               
 registration bill.   CHAIRMAN WILKEN  said that he would work on              
 that.  There being no further business before the committee, the              
 meeting was adjourned at 10:50 a.m.                                           
                                                                               
                                                                               

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