Legislature(1997 - 1998)
04/04/1997 10:04 AM HES
* first hearing in first committee of referral
= bill was previously heard/scheduled
= bill was previously heard/scheduled
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.