Legislature(1997 - 1998)
03/21/1997 09:05 AM Senate HES
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* first hearing in first committee of referral
+ teleconferenced
= bill was previously heard/scheduled
+ teleconferenced
= bill was previously heard/scheduled
SENATE HEALTH, EDUCATION & SOCIAL SERVICES COMMITTEE
March 21, 1997
9:05 a.m.
MEMBERS PRESENT
Senator Gary Wilken, Chairman
Senator Loren Leman, Vice Chairman
Senator Lyda Green
Senator Jerry Ward
MEMBERS ABSENT
Senator Johnny Ellis
COMMITTEE CALENDAR
SENATE BILL NO. 36
"An Act relating to transportation of public school students;
relating to school construction grants; relating to the public
school foundation program and to local aid for education; and
providing for an effective date."
- HEARD AND HELD
SENATE BILL NO. 11
"An Act relating to state aid for school construction debt; and
providing for an effective date."
- MOVED CSSB 11(HES) OUT OF COMMITTEE
SENATE BILL NO. 96
"An Act regulating hospice care."
- HEARD AND HELD
SENATE BILL NO. 58
"An Act relating to the privilege to drive of minors and to the
penalty for the consumption or possession of alcoholic beverages by
persons under 21 years of age."
- SCHEDULED BUT NOT HEARD
PREVIOUS SENATE COMMITTEE ACTION
SB 36 - See Senate Health, Education & Social Services Committee
minutes dated 2/12/97, 3/14/97, 3/17/97 and 3/19/97.
SB 11 - See Senate Health, Education & Social Services minutes
dated 2/26/97.
SB 96 - See Senate Health, Education & Social Services Committee
minutes dated 2/24/97.
SB 58 - See Senate Health, Education & Social Services minutes
dated 3/10/97.
WITNESS REGISTER
John Cyr, President
National Education Association-Alaska
114 Second Street
Juneau, Alaska 99801
POSITION STATEMENT: Discussed education funding.
Al Weinberg
Single Site School District Consortium
300 Hermit Street #12
Juneau, Alaska 99801
POSITION STATEMENT: Discussed SB 36.
Deborah Vogt, Deputy Commissioner
Department of Revenue
PO Box 110405
Juneau, Alaska 99811-0400
POSITION STATEMENT: Discussed the tax provisions of SB 36.
Brett Huber, Staff
Senator Halford
State Capitol
Juneau, Alaska 99801-1182
POSITION STATEMENT: Discussed the proposed amendment.
Mike Morgan, Facilities Manager
Department of Education
801 W. 10th Street, Suite 200
Juneau, Alaska 99801-1894
POSITION STATEMENT: Discussed the department's overhead charge and
the proposed amendment.
Larry Wiget, Director
Government Relations
Anchorage School District
4600 DeBarr Road
Anchorage, Alaska 99519
POSITION STATEMENT: Supported SB 11 and the amendment.
Bob Doyle, Finance Director
Mat-Su School District
1900 Porcupine Trail
Wasilla, Alaska 99654
POSITION STATEMENT: Supported amendment and discussed the
situation in Mat-Su.
Beth McKibben
Mat-Su Borough Planning Department
350 E Dahlia
Palmer, Alaska 99645
POSITION STATEMENT: Discussed the demographics of Mat-Su.
Charles Huggins, Parent
School Board Member
PO Box 878115
Wasilla, Alaska 99687
POSITION STATEMENT: Discussed the situation in Mat-Su.
Barbara Lacher, Mayor
City of Wasilla
775 E Parks Highway
Wasilla, Alaska 99654
POSITION STATEMENT: Noted the need for a commitment to funding.
Ben Brown, Staff
Senator Kelly
State Capitol
Juneau, Alaska 99801-1182
POSITION STATEMENT: Discussed the changes in CSSB 96(HES).
Paula McCarron
Hospice of Anchorage
3305 Arctic Boulevard #105
Anchorage, Alaska 99503
POSITION STATEMENT: Discussed SB 96.
Patricia Senner, Executive Director
Alaska Nurses Association
237 E Third Avenue #3
Anchorage, Alaska 99501
POSITION STATEMENT: Supported CSSB 96(HES).
Mike Shiffer
Board of Hospice of Anchorage
8561 Ridgeway Avenue
Anchorage, Alaska 99804
POSITION STATEMENT: Supported this legislation.
Tina Kocsis, Director
Hospice of Tanana Valley
PO Box 82770
Fairbanks, Alaska 99708
POSITION STATEMENT: Urged that steps be taken to eliminate any
hardships for volunteer hospices created by
this licensing.
Barbara Rich
PO Box 80482
Fairbanks, Alaska 99708
POSITION STATEMENT: Discussed the cost concerns with SB 96.
Charles Quarre, President
Hospice of the Central Peninsula
HC-1 Box 3336
Sterling, Alaska 99672
POSITION STATEMENT: Requested that volunteer hospices be deleted
from SB 96.
Shelby Larsen, Administrator
Health Facilities Licensing & Certification
4730 Business Park Boulevard, Suite 18
Anchorage, Alaska 99503-7117
POSITION STATEMENT: Supported SB 96.
ACTION NARRATIVE
TAPE 97-31, SIDE A
SB 36 PUBLIC SCHOOL FUNDING
Number 001
CHAIRMAN WILKEN called the Senate Health, Education & Social
Services Committee (HES) to order at 9:05 a.m. and introduced
CSSB 36(HES) as the first order of business.
JOHN CYR , President of NEA-AK, informed the committee that he was
testifying from San Diego, California. Mr. Cyr informed the
committee of the following demographics:
34 percent of Alaskans are children
15 children commit suicide every year
85 children die of injury, homicide, suicide, unintentional
injury
125 babies die before reaching age one
160 babies are born with fetal alcohol syndrome
580 babies are born at low birth weight
600 children are admitted for inpatient psychiatric care
915 babies are born to mothers with less than 12 years of
education
1,235 babies are born to teenager mothers
1,450 children will be arrested for felony offenses
more than 2,000 children will drop out of school
3,500 children are reported as runaways
3,700 children are abused or neglected
10,500 preschoolers live below the poverty level
almost 25,000 children receive AFDC
Mr. Cyr said that all these children are in Alaska's schools. What
is done with the foundation formula has a direct impact on those
children. In the first year Alaska was a state, 44 percent of the
budget went towards education. By 1970, that amount had dropped to
35 percent and in 1991 that was 17 percent. The foundation was
$60,000 in 1987-88, then in 1992 the foundation unit increased to
$61,000. Mr. Cyr noted that in 1996, Alaska ranked last in
resource allocation towards education for all 50 states. Alaska
also ranked last in aggregate salary for education employees after
being inflation adjusted. There has been a 10.9 percent loss in
real buying power since 1985/86. In the classroom, that results in
larger class sizes. Mr. Cyr informed that committee that in his
last year at Wasilla High School, he had 168 children in 5 classes.
One cannot deliver the program needs with that many children.
Alaska ranks 49 in the number of advanced placement classes offered
in the U.S. Alaska pays less attention to marginal students.
Alaskan schools have inadequate technology. Schools do not have
academic or vocational counseling at the elementary level, there is
one counselor at most middle schools. Mr. Cyr believed that the
children of Alaska are being done a great disservice.
Mr. Cyr turned to the foundation formula. He asked if the numbers
on the reallocation of dollars in each of the five years were
available.
CHAIRMAN WILKEN said that those numbers are being developed and
should be available today or the first of the week. Chairman
Wilken reminded Mr. Cyr that in years three through five, the
reallocation becomes a function of the ACD study.
JOHN CYR calculated that over the first two years of the program,
Anchorage gains a little over $16 million, Fairbanks gains $5.1
million, Mat-Su gains $69,000 and Kenai and Juneau pick up a little
less than $1 million. Mr. Cyr asked if those numbers are correct.
CHAIRMAN WILKEN did not know and suggested that Mr. Cyr provide the
committee with his concerns about CSSB 36(HES).
JOHN CYR said that the equalization of funding must be based on
programs and not the equalization of dollars. In fact rural
dollars are being removed from rural children, for the short term
benefits of urban districts. NEA-AK believes that to be a mistake.
Funding must also reflect the needs of students in single site
districts. Mr. Cyr stated that it was unacceptable for the
students of single site districts to be left political hostage
every year. Full funding must come with student growth which is
unprecedented in Alaska. Some mechanism must be built into the
foundation formula for increased renovation, research grants,
incentive grants, new programs for violent students and parental
involvement technology.
Mr. Cyr was pleased that pupil transportation was included as well
as the area cost differential study. Mr. Cyr noted that Alaska has
experienced a 30 percent loss in buying power, inflation proofing
is necessary. Oversight and auditing positions are missing from
this proposal; those positions would assure that education dollars
are being spent on education.
Number 199
SENATOR WARD believed that Mr. Cyr indicated that NEA-AK was
opposed to CSSB 36(HES). Is NEA-AK opposed to or in favor of the
Governor's proposal or Senator Randy Phillip's proposal? Senator
Ward asked if Mr. Cyr had his own proposal. JOHN CYR said that
NEA-AK was not in opposition to CSSB 36(HES) or SB 146 in its
entirety. All of the proposals have some positive aspects. Mr.
Cyr informed the committee that NEA-AK liked the incentive grants
and Quality Schools Initiative in SB 85. The area cost
differential study is good. Mr. Cyr suggested that the best of
each be packaged as one bill. In further response to Senator Ward,
Mr. Cyr clarified that NEA-AK supports a number of items in this
bill and others as well as opposed to some of the provisions.
SENATOR WARD thought that Mr. Cyr indicated that the communities of
Anchorage, Fairbanks, Juneau, and Kenai were to receive more than
a fair share; is that correct? JOHN CYR said that it is a mistake
to take money from rural children. SENATOR WARD inquired as to how
much those numbers should be reduced for the various communities
Mr. Cyr cited. Does NEA-AK want those allocations to be reduced?
JOHN CYR replied, no. SENATOR WARD said that it would be helpful
to have suggestions regarding the allocations, if Mr. Cyr had such.
JOHN CYR said it would be easy to determine the money necessary to
fund education across the state.
Number 245
SENATOR LEMAN noted that Mr. Cyr supported the incentive grants for
schools while in the past incentive grants for teachers have been
opposed by NEA-AK. Senator Leman asked if this was a philosophical
shift towards his view that teachers should be paid on performance
instead of encouraging mediocrity. JOHN CYR did not know that
mediocrity was being encouraged. Mr. Cyr said that he would be
happy to review any concrete proposals regarding incentive grants
for teachers with Senator Leman.
SENATOR LEMAN said that in the past, NEA-AK's opposition has been
rooted in who actually decides who receives the grant. Senator
Leman believed that there was merit for incentive grants for
schools. Therefore, if an incentive grant is appropriate for
schools it should also be for teachers. Senator Leman urged Mr.
Cyr to think about this issue.
CHAIRMAN WILKEN informed the committee that he had ran some numbers
in order to get a sense of the growth of the formula. Those
numbers say that the formula has grown 50.2 percent in actual
dollars and the ADM has increased 23 percent during that same
period. Therefore, inflation proofing has been built in and the
state has kept up with inflation proofing the formula. With
regards to Mr. Cyr's comments about delivery by program, how would
that be accomplished? JOHN CYR believed that most could agree on
the general areas of what it takes to have a quality school which
makes it possible to determine the program needs of schools. Mr.
Cyr informed the committee that in his last years teaching, his
classroom supplies consisted of a box of chalk. Mr. Cyr suggested
that the costs of supplies should be reviewed in order to deliver
a program.
CHAIRMAN WILKEN pointed out that the ACD study in the bill would
review the cost of running a school, not a school district. JOHN
CYR said that NEA-AK was on board with that. Mr. Cyr inquired as
to what happens to the children when a school with less than 10
students is closed. How many small schools would be closed?
CHAIRMAN WILKEN said that very few, if any schools would close, but
there are centralized correspondence programs within Alaska.
Number 311
AL WEINBERG , representing the Single Site School District
Consortium, appreciated the goals set forth for the revision of the
foundation program. Mr. Weinberg was not convinced that this
proposal was any simpler. Equity is extremely important, but
unfortunately there is no mention that school districts be provided
adequate funding. Mr. Weinberg noted that a purpose statement of
the foundation formula as well as the proposal before the committee
is that the foundation formula provide an equitable level of
educational opportunities. The proposed formula takes portions of
other proposed formulas which means that those components may not
produce the same result, especially with equity. Mr. Weinberg
noted that the adverse impacts occur to single site districts,
REAAs, and rural boroughs. In the second year, 15 single sites
would face reduced funding as would 10 REAAs and 5 rural boroughs.
During this same time, the winner districts would receive an
additional $25 million while the losers would loss about $14
million. Of the $25 million going to the winner districts, $15
million would be given to Anchorage and Fairbanks. Mr. Weinberg
stressed that there is no assurance that the additional $15 million
would benefit the children in those districts because the local
district could reduce its local contribution.
Mr. Weinberg believed that the 20 percent supplemental needs factor
was simpler than the existing categorical funding, however it is
not necessarily more equitable. For instance, the current
percentage statewide in special education enrollment is 14 percent
while the spread ranges from 7.3 percent to 38.9 percent. The
spread is even greater for bilingual education. Mr. Weinberg
pointed out that the 20 percent supplemental needs factor would not
eliminate the federal and state requirements that school districts
identify special needs students and provide appropriate programs
for those students. The concern is that this may adversely effect
equity for the sake of simplicity.
Mr. Weinberg applauded the area cost differential study. The
proposed study is a bit more extensive, addressing the size factor
and the single site factor. Mr. Weinberg noted that the
Legislature has not accepted the results of past studies. The
notion that the area cost differential be reviewed by funding
community is meritorious, however the numbers to be in effect prior
to the study are flawed. For example, Bristol Bay and Wales have
the same area cost differential as do Bethel and Lyon Village.
Bethel is a major river port and airport while Lyon Village is one
of the most remote villages in Alaska.
Number 401
With regard to the REAA tax, this is the most regressive tax and is
being imposed in may instances on the poorest in Alaska. Mr.
Weinberg did not have a problem with taxpayer equity in Alaska,
however this proposal does not provide such taxpayer equity. In
conclusion, Mr. Weinberg hoped that the focus remain on the
children and adequate and equitable funding for all children
regardless of geographic location, community wealth, or political
influence.
SENATOR LEMAN understood Mr. Weinberg's testimony to be that the
proposal before the committee was not equitable. Senator Leman
asked Mr. Weinberg if he believed that everyone should participate
in some manner in funding a local share. AL WEINBERG did not have
a problem with that concept. That is not occurring now in the
municipal districts, but there is no contribution from REAAs now.
SENATOR LEMAN expressed interest in Mr. Weinberg's proposal. AL
WEINBERG identified the following as more equitable solutions: a
statewide property tax including REAAs as well as municipal
districts, a statewide income tax applied to all earners in Alaska,
and a flat school tax on all earners in Alaska. By singling out
those in REAAs, the state would be requiring a tax on those
citizens while not requiring a tax on citizens in municipal
districts for the support of schools. Mr. Weinberg recognized that
many municipal districts do levy property taxes on property owners
for the support of schools, but not all municipal districts do.
SENATOR LEMAN pointed out that all municipal districts do
participate with a local share in some way. Senator Leman
understood Mr. Weinberg to mean that in order to make the proposal
before the committee less regressive the tax should apply to more
people, but an income tax is regressive. AL WEINBERG clarified
that an income tax based on the ability to pay is typically
referred to as progressive. A tax that disproportionately takes a
higher percentage of income from poor people than from wealthy
people as would a head tax or a sales tax, is referred to as
regressive.
CHAIRMAN WILKEN inquired as to Mr. Weinberg's thoughts about a two
percent tax or a tax on gross earnings that is remitted on a
quarterly basis, only in REAAs. Chairman Wilken explained that the
numbers show that the local contribution required from the
organized areas to qualify for state need is about 15.6 percent.
The REAA need is about $150 million in 1996, therefore 15 percent
of that would result in about $24 million. In 1995, about $475
million in wages was paid in the REAAs outside of organized areas.
If a five percent labor tax was taken on gross wages, about $23
million would result. Therefore, the REAAs would end up paying
essentially what all the organized areas are paying.
AL WEINBERG did not know if it was more equitable. The only way to
achieve equity is to have a statewide program that impacts all in
the same way. Mr. Weinberg agreed with Chairman Wilken that there
are organized areas that are paying 15 percent of the local school
need in order to qualify for state money and there are REAAs that
do not pay anything to receive that same money. Mr. Weinberg
pointed out that there are those in organized areas who pay nothing
as well. For example, the Denali Borough receives revenue from a
bed tax which is paid primarily by tourists and not the residents
of the borough.
With regard to the issue of single sites, CHAIRMAN WILKEN noted
that there has been much discussion about cutting the budget and
forcing consolidation. Chairman Wilken informed everyone that 13
percent of Alaska's students are in 70 percent of its school
districts. Chairman Wilken hoped that the area cost differential
would provide for consolidation of school districts in Alaska.
There are school districts that need to be consolidated and
hopefully, the study will illustrate how that can be done.
Number 503
DEBORAH VOGT , Deputy Commissioner of the Department of Revenue,
said that she would be discussing the tax provisions of the
legislation. Ms. Vogt understood the rationale for levying a tax
on a portion of Alaska. The courts will review whether the lines
of distinction of a tax are rational or not. As a former Attorney
General, Ms. Vogt was familiar with the standards utilized for
equal protection as applied to tax. Ms. Vogt said that it was a
fairly lax standard. The distinction here is for the purpose of
reducing an inequity and there can be some justification for this.
Ms. Vogt stated that the question would be whether this legislation
provides that equity.
Ms. Vogt agreed with Mr. Weinberg that the flat employment tax is
a very regressive tax. Property taxes are progressive, the tax is
related to the value of the property. Although a sales tax is
traditionally viewed as regressive, it is related to the amount of
goods and services purchased. A flat employment tax would impact
those without the ability to pay more than those making better
wages. Ms. Vogt noted that there are ways to address this such as
the statewide property tax. The oil and gas property tax is a
statewide tax with a credit for any municipal tax paid on that
property which would be possible on a statewide property tax. Ms.
Vogt acknowledged that such a tax would necessitate a legion of
assessors, furthermore each municipality does not determine its
contribution in the same way. Ms. Vogt said that a more equitable
tax would be a percentage of earnings. In conclusion, Ms. Vogt
mentioned that the legislation exempted nonresidents. She was
unsure as to this exemption because taxes generally apply to the
people who take advantage of the economic opportunity in places
where the tax is levied. In response to Chairman Wilken, Ms. Vogt
said that was located on page 23, line 28.
CHAIRMAN WILKEN held CSSB 36(HES) and informed the committee that
SB 146 would be before the committee Monday, but there would not be
any public testimony.
SB 11 SCHOOL DEBT REIMBURSEMENT
CHAIRMAN WILKEN introduced SB 11 as the next order of business
before the committee. The committee took a brief at ease and
Chairman Wilken announced that SB 58 would not be taken up today.
Chairman Wilken noted that there is an amendment for SB 11.
Number 580
BRETT HUBER , Staff to Senator Halford, noted that Senator Halford
had provided the committee with an amendment for consideration.
The amendment is a result of testimony and committee discussion
during the last hearing of SB 11. The amendment changes the date
of reactivation of the school bond debt reimbursement program from
July 1, 1995 instead of July 1, 1997. The amendment also changes
the reimbursement level from 50 to 70 percent which applies to
future funding that receives authorization and local voter
approval. The amendment broadens the qualification criteria for
DOE to improve the projects which includes a reduction in school
districts' operating costs because of the project or facilities
that require modification/rehabilitation to improve the
instructional program. Mr. Huber pointed out that adoption of this
amendment would allow the Mat-Su three school package approved by
local voters in 1995 as well as the Anchorage package scheduled for
April for the reimbursement program.
TAPE 97-31, SIDE B
CHAIRMAN WILKEN noted that SB 11 would be held for a committee
substitute to include these changes. Mr. Morgan is present to
discuss the overhead charge from DOE.
SENATOR WARD moved to adopt the amendment which reads as follows:
Page 3, line 30:
Delete " 1997 "
Insert " 1995 "
Page 4, line 7:
Delete " 50 "
Insert " 70 "
Page 4, line 10
Delete " 1997 "
Insert " 1995 "
Page 5, line 26, following "enrollment;":
Delete "or"
Insert "[OR]"
Page 5, line 28, following "codes":
Insert ";
(C) operating costs that would be reduced by the
project;
or
(D) facilities that require modification or
rehabilitation for the purpose of improving the
instructional program "
Page 5, line 29:
Delete "takes effect July 1, 1997"
Insert "is retroactive to July 1, 1995"
Page 5, following line 29:
Insert a new bill section to read:
" *Sec. 6. This Act takes effect immediately under AS
01.10.070(c)."
CHAIRMAN WILKEN noted that the reimbursement level has bounced
around. He believed that it would be best to make the percentage
75 and discussed that with Senator Halford. Chairman Wilken asked
if Mr. Huber and Senator Halford had discussed that issue. BRETT
HUBER said that he had talked with Senator Halford about that
issue. Senator Halford is not opposed to that idea, that is a
policy call. CHAIRMAN WILKEN requested that Mr. Huber notify
Senator Halford that was discussed and requested that it be
included in the forthcoming CS.
MIKE MORGAN , Facilities Manager for the Department of Education,
explained that as districts apply for reimbursement of the
principle the district has paid on bonds, the interest the district
paid, and for any fees associated with the bonds. When the
department includes that in the budget request for the year, the
department adds the overhead amount to that district's request.
There are no reductions in the request of the district. Mr. Morgan
clarified that as long as the Legislature fully funds the requests
of districts, the district receives 100 percent. If there is a
reduction in funding, that is not taken from the districts.
With regard to the amendment, Mr. Morgan noted that the amendment
was in response to a suggestion by the department. Mr. Morgan
noted that as written, the amendment has language saying "if a
district can demonstrate an operating cost reduction". Therefore
if a district shows that it can save $1,000 per year with a
project, but the cost of the project is $12 million the department
would have to approve that project. On the grant side, there are
statute provisions that specify that the grant should be reviewed
and in the best interest of the state. There is an opportunity for
abuse.
BRETT HUBER said that portion of the amendment was included per the
department's testimony at the last hearing. Mr. Morgan's point
makes sense, as the criteria is broadened and the percentage of
state funding is increased; those are issues to review.
CHAIRMAN WILKEN asked if there was any objection to the amendment.
Hearing none, the amendment was adopted. SB 11 was held for the
pending committee substitute. Chairman Wilken realized there were
witnesses via teleconference for SB 11.
LARRY WIGET , Director of Government Relations for the Anchorage
School District, supported SB 11 and the amendment. This Spring
Anchorage voters will be asked to approve a bond for capital
construction in the amount of $24,593,000. Currently, there is no
debt reimbursement if these bonds pass and changing the effective
date to July 1, 1995 would include these bonds. Mr. Wiget said
that a state to local match provides an incentive for voters to
approve bonds, enables districts to stretch dollars to cover much
needed school construction and demands public accountability.
BOB DOYLE , Finance Director for the Mat-Su School District,
supported the amendment. Mr. Doyle indicated the need for
assurance that the Legislature is committed to funding SB 11 and
the intent of debt reimbursement. Next year, Mat-Su expects 12,606
students. Mat-Su is the third largest district in the state with
an annual growth of seven percent over the last 20 years. Mr.
Doyle emphasized that the Mat-Su district is growing at two percent
per year which equates to 250 students per year. Therefore, the
district would need to build a new elementary school every two
years in order to house those students, but that has not been done.
Mat-Su has 1,000 students that are taught in portables and the
majority of the schools are over capacity. Mr. Doyle pointed out
that three necessary schools were approved by voters and are
awaiting legislative support. Mr. Doyle discussed some of the
projects included in the six year capital improvement program for
Mat-Su.
BETH MCKIBBEN , the Mat-Su Borough Planning Department, said that
the Mat-Su Borough is one of the fastest growing areas in the
state. Between 1990 and 1996, Mat-Su's population increased by
11,076 which is a 4.7 percent annual increase, the highest annual
growth rate in Alaska. Since 1990, the Meadow Lakes population has
increased by 2,311 with an annual average growth rate of 13.1
percent. Palmer has increased by 7.9 percent annually, Big Lake by
7.3 percent annually, and Butte by 3 percent. Ms. McKibben said
that those communities are four of the fastest growing areas in
Alaska.
CHARLES HUGGINS , parent and school board member, noted that most in
the Mat-Su district were pleased with the 50-50 proposition, and
even more pleased with the 70-30 proposition. Mr. Huggins informed
the committee that the elementary school in Big Lake has a capacity
of 500 which increased to 723 students this year. This increase
resulted in the need for portables and an increase in staffing.
Mr. Huggins stressed that accommodating that increase in students
is challenging. There have been some special sessions with the
community in order to determine how to reduce those numbers, but
that is disruptive. The public questions why new schools cannot be
built. Mr. Huggins echoed Ms. McKibben's comments that Meadow Lake
is one of the fastest growing areas in Alaska and there is not even
an elementary school in that community. Mr. Huggins discussed the
situation in the Talkeetna School where the ceiling in one room is
covered with visqueen that connects to a hose in order to evacuate
the incoming water. The amendment heads in a positive direction
for that situation. Also the community is reviewing year-round
schooling in order to accommodate the population.
Number 412
BARBARA LACHER , Mayor of Wasilla, believed that the ease with which
the amendment was adopted would indicate the ease with which the
forthcoming CS would be reported out of committee. Mayor Lacher
hoped that when the bill is before the entire Legislature, there
will be a commitment to funding in the short term as well as the
long term. Mayor Lacher was pleased with the consideration of the
increased percentage. Mayor Lacher informed the committee that
increasing the percentage from 50 to 70 percent would save the
average homeowner $100 per year and over a 20 year bond repayment
that would result in a savings of $2,000 per year. Mayor Lacher
said that the Mat-Su Borough would help with this legislation.
CHAIRMAN WILKEN requested that Mr. Morgan submit some written
testimony regarding over head charges in order that the testimony
could be sent to some of the school districts.
SB 96 REGULATION OF HOSPICE CARE
CHAIRMAN WILKEN introduced SB 96 as the next order of business and
noted that there was a CS for consideration. Chairman Wilken said
that he would entertain a motion.
SENATOR LEMAN moved to adopt CSSB 96(HES), Lauterbach version dated
3/10/97, for discussion purposes. Without objection, it was so
ordered.
BEN BROWN , Staff to Senator Kelly, recalled that there had been
some questions regarding why volunteer hospice programs were being
regulated. After conferring with Hospice of Anchorage, the
requestor of the bill, Mr. Brown said that the legislation attempts
to provide some consumer protection and provide a standard. SB 96
would allow people to know what to expect when entering into a
hospice situation. In order to avoid a loophole in the original
bill, the CS specifies under Article 2 which standards are applied
to the volunteer hospice programs. Mr. Brown emphasized that SB 96
intends to establish minimal standards. Mr. Brown acknowledged the
concern that the regulations adopted to enforce the standards could
be complicated.
Some of the definitions were also changed in Article 3. On page 8,
the Administrative Procedure Act is referenced in order to protect
those whose license is revoked. The definition of "hospice
program" was changed by deleting the reference to "discrete entity"
because some of the Hospitals and Nursing Homes feared that would
not allow them to offer a hospice program within the institution.
The definition of "interdisciplinary team" was changed to include
a primary health care provider in order to cover a physician or an
advanced nurse practitioner allowing flexibility. The definition
on line 14, page 9 was changed to "primary health care provider" to
conform with the aforementioned change.
SENATOR LEMAN asked for clarification regarding the change from
primary physician to health care provider with regard to page 9,
line 9. BEN BROWN clarified that the definition of "medical
director" would still require a licensed physician and that
definition only applies to the certified programs. The definition
of "interdisciplinary team", those who coordinate the care plan of
a dying person, was changed to a health care provider. The other
change to a health care provider is located on line 14, page 9.
Number 250
CHAIRMAN WILKEN inquired as to the burden this would create for a
volunteer hospice, a noncertified hospice, with regard to the cost
and administrative requirements. Chairman Wilken requested that
Mr. Brown submit an answer to the committee in writing.
PAULA MCCARRON informed the committee that she had been employed
with Hospice of Anchorage since 1982. She noted the changes to
accommodate the volunteer hospices. Ms. McCarron informed the
committe of legislation in Virginia which did not include the
volunteer hospice category, now those volunteer hospices are
battling to preserve the volunteer programs since there is no
definition allowing for the volunteer hospice to exist. Ms.
McCarron believed that SB 96 would preserve the tradition of
volunteer hospices as well as legitimizing the volunteer programs
by increasing funding opportunities in the future. Hospice of
Anchorage has grown from volunteer efforts of concerned community
members and health care workers who desired an alternative to
terminally ill persons to stay at home. There have been many
changes since that time. Ms. McCarron noted that the average
length of a hospital stay for hospitalized patients is down to
three or four days. Hospitals once had social admissions which
would alleviate the stress of family members caring for a dying
loved one; this is rarely an option. Coverage for nursing and
assisted living homes is limited and out of the reach for most
Alaskans. All of these factors with the increasing aging
population and people living alone translates into a growing need
for quality hospice services. SB 96 is primarily a consumer
protection act.
PATRICIA SENNER , Registered Nurse and Executive Director of the
Alaska Nurses Association (ANA), supported CSSB 96(HES) which will
help develop the type of quality services needed for this time in
life. The Nursing Association likes the two-tier approach in the
legislation. A minimal standard for volunteer hospices prevents
them being regulated out of business while providing the public an
avenue in which to take action against unscrupulous providers. Ms.
Senner noted that those hospices receiving reimbursement receive it
from national insurance companies who may require licensure for
reimbursement. Ms. Senner said that the ANA is pleased with the
bill's emphasis on the role of the registered nurse and advanced
nurse practitioners. Advanced nurse practitioners were requested
for inclusion in the definition of primary care provider. In
Alaska, advanced nurse practitioners are allowed to have
independent practice and are increasingly caring for dying seniors.
Ms. Senner emphasized that the ANA completely agrees with the
hospice philosophy as outlined in the bill.
Number 140
MIKE SHIFFER , Board of Hospice in Anchorage, informed the committee
that Hospice of Anchorage is a private nonprofit organization that
does not receive any state funds. Alaska needs licensed hospice
programs. The environment of health care is changing. Hospice
programs make it possible for the terminally ill to die in a home
environment by focusing on comfort care. Hospice involves the
coordinated use of and interdisciplinary team including physicians,
nurses, social workers, therapists, pastoral and bereavement
counselors, and volunteers. The unique component of hospice's
interdisciplinary team is its volunteers. Hospice of Anchorage
provides hospice services without regard for ability to pay.
Hospice works with the patient and family to accept death as a
natural part of life; the family and the patient are considered the
unit of care. Mr. Shiffer noted that hospice addresses the
spiritual, emotional, social, physical care and comfort of the
patient. Licensure will ensure that hospice services are provided
according to an established standard. Mr. Shiffer strongly
supported this legislation. Mr. Shiffer referred Chairman Wilken
to page 6, subsection (j) which clarifies his previous question.
TINA KOCSIS , Director of Hospice of Tanana Valley, said that she
would speak to the issue of the two different hospices in Alaska,
volunteer hospices and certified or for profit hospices. With
regards to the notion that certified hospices are more organized
than volunteer hospices, Ms. Kocsis said that was not correct.
According to the National Hospice Organization and Medicare
standards, volunteer hospices have medical directors. The position
is merely voluntary. As a volunteer hospice in Fairbanks, it does
not employee nurses, physical therapists, or other related medical
personnel but work closely with home health nursing providers.
Patients are not charged for any services and no payments are
received from any third-party payers. The Hospice of Tanana Valley
is supported by donations, memorials, fundraisers, and small grants
from the community. Hospice of Tanana Valley is the largest, most
comprehensive bereavement program in Alaska. Ms. Kocsis noted that
Hospice of Tanana Valley exceeds the regulations specified in the
bill and the National Hospice Organization and Medicare Certified
Standards.
TAPE 97-32, SIDE A
Ms. Kocsis urged the committee to take steps to eliminate any
hardships that may be created for volunteer hospices because of
this licensing process.
BARBARA RICH said that most of the issues regarding the volunteer
hospices had been addressed in the CS before the committee. Ms.
Rich was concerned with the cost this would pose for hospices with
limited funds. If this bill is passed, Ms. Rich hoped that the
Department of Health would develop regulations that would be easy
to adhere. The regulations in the bill are lower than required of
the hospice in Fairbanks.
CHAIRMAN WILKEN asked Ms. Kocsis to review page 6, lines 9-27 of
the CS; would that level of paper work be acceptable. TINA KOCSIS
said that the level specified in the bill is already being exceeded
in the Tanana Valley Hospice. The specifications in the bill are
fine.
BEN BROWN clarified that regarding the presence of a medical
director at volunteer hospices, Mr. Brown only meant that the bill
does not require that of volunteer hospices. Mr. Brown pointed out
that only lines 9-20 on page 6 apply to volunteer hospices.
Number 071
CHARLES QUARRE , President of Hospice of the Central Peninsula,
noted that Hospice of the Central Peninsula was a volunteer hospice
that serves approximately 20 clients annually. Hospice of the
Central Peninsula is a member and adheres to all the guidelines of
the National Hospice Organization. Hospice of the Central
Peninsula has one part-time director and about 50 volunteers. Mr.
Quarre expressed concern that this legislation would create an
additional burden. Mr. Quarre requested that the volunteer
hospices be deleted from the legislation because all the
requirements under Article 2 are being adhered to.
BEN BROWN clarified that Article 2 could be deleted or steps can be
taken to ensure that the department does not adopt regulations more
stringent than specified in the language of the statute.
Furthermore, the department can be prohibited from adopting
regulations and only adopt guidelines or procedures. Mr. Brown
noted that Mr. Larsen who will do the inspections and regulation
can speak to this issue.
SHELBY LARSEN , Administrator of Health Facilities Licensing &
Certification, supported SB 96. The licensing process is not
burdensome. There is a two to three page application that must be
completed annually. The licensing process also includes an on site
inspection which would be followed by a report. If the volunteer
agencies are already adhering to the standards specified in the
bill, the report would be brief. The purpose of the bill and
subsequent regulations would be to ensure that quality is
maintained in the future. Oversight is also important; only
minimal oversight occurs with certified hospice organizations. Mr.
Larsen believed that more oversight was necessary. Mr. Larsen
informed everyone that the department has a policy that any
organizations effected by the regulations are involved in order to
have input. It is not the intent of the department to develop
regulations that would put hospice organizations out of business.
The regulations are developed for minimum standards, quality care,
and protection of the clients. Mr. Larsen stressed that there will
not be an annual fee, there has never been an annual fee charged
for licensure although that is an option of the department.
CHAIRMAN WILKEN referred to page 7, line 8 when asking if proof of
auto insurance and a valid driver's license were required of other
volunteer organizations. SHELBY LARSEN did not know. CHAIRMAN
WILKEN asked Mr. Brown to follow up on that matter.
CHAIRMAN WILKEN asked Mr. Larsen to provide the committee examples
of why this licensure is necessary. SHELBY LARSEN said that Alaska
has not had any problems. As resources are shrinking, the health
industry is attempting to find resources. There are organizations
that, in an attempt to capture resources, say that hospice care is
provided when it is not. In some areas, as managed care has
developed, hospice-like services may be provided but in a
fragmented manner through the HMOs. Those are not true hospices.
SB 96 would ensure that when an organization says that it provides
hospice services that it truly does, not just pieces. Mr. Larsen
said that managed care is creeping into Alaska and this is a
concern for the future.
CHAIRMAN WILKEN held SB 96. There being no further business before
the committee, the meeting was adjourned at 10:53 a.m.
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