04/10/2015 01:30 PM Senate HEALTH & SOCIAL SERVICES
| Audio | Topic |
|---|---|
| Start | |
| SB78 | |
| SB74 | |
| SB90 | |
| SB53 | |
| HB4 | |
| HB8 | |
| SB72 | |
| Adjourn |
+ teleconferenced
= bill was previously heard/scheduled
| + | HB 8 | TELECONFERENCED | |
| *+ | SB 72 | TELECONFERENCED | |
| *+ | SB 74 | TELECONFERENCED | |
| *+ | SB 53 | TELECONFERENCED | |
| *+ | SB 90 | TELECONFERENCED | |
| *+ | HB 4 | TELECONFERENCED | |
| *+ | SB 78 | TELECONFERENCED | |
ALASKA STATE LEGISLATURE
SENATE HEALTH AND SOCIAL SERVICES STANDING COMMITTEE
April 10, 2015
1:32 p.m.
MEMBERS PRESENT
Senator Bert Stedman, Chair
Senator Cathy Giessel, Vice Chair
Senator Bill Stoltze
Senator Johnny Ellis
MEMBERS ABSENT
Senator Pete Kelly
COMMITTEE CALENDAR
SENATE BILL NO. 78
"An Act relating to medical assistance reform measures; relating
to eligibility for medical assistance coverage; relating to
medical assistance cost containment measures by the Department
of Health and Social Services; and providing for an effective
date."
- MOVED SB 78 OUT OF COMMITTEE
SENATE BILL NO. 74
"An Act relating to permanent fund dividends; relating to a
medical assistance reform program; establishing a personal
health savings account program for medical assistance
recipients; relating to the duties of the Department of Health
and Social Services; establishing medical assistance
demonstration projects; and relating to a study by the
Department of Health and Social Services."
- MOVED CSSB 74(HSS) OUT OF COMMITTEE
SENATE BILL NO. 90
"An Act relating to the purchase of durable medical equipment
under Medicaid; and providing for an effective date."
- MOVED SB 90 OUT OF COMMITTEE
SENATE BILL NO. 53
"An Act relating to advanced practice registered nursing;
relating to certified direct- entry midwifery; and providing for
an effective date."
- MOVED SB 53 OUT OF COMMITTEE
HOUSE BILL NO. 4
"An Act relating to automated external defibrillators."
- MOVED HB 4 OUT OF COMMITTEE
COMMITTEE SUBSTITUTE FOR HOUSE BILL NO. 8(JUD) AM
"An Act relating to powers of attorney and other substitute
decision-making documents; relating to the uniform probate code;
relating to notaries public; and providing for an effective
date."
- HEARD & HELD
SENATE BILL NO. 72
"An Act relating to caregivers of patients after release or
departure from a hospital; and providing for an effective date."
- HEARD & HELD
PREVIOUS COMMITTEE ACTION
BILL: SB 78
SHORT TITLE: MEDICAL ASSISTANCE COVERAGE; REFORM
SPONSOR(s): RULES BY REQUEST OF THE GOVERNOR
03/18/15 (S) READ THE FIRST TIME - REFERRALS
03/18/15 (S) HSS, FIN
03/30/15 (S) HSS AT 1:30 PM BUTROVICH 205
03/30/15 (S) Heard & Held
03/30/15 (S) MINUTE(HSS)
04/01/15 (S) HSS AT 1:30 PM BUTROVICH 205
04/01/15 (S) Heard & Held
04/01/15 (S) MINUTE(HSS)
04/03/15 (S) HSS AT 1:30 PM BUTROVICH 205
04/03/15 (S) -- Testimony <Invitation Only> --
04/10/15 (S) HSS AT 1:30 PM BUTROVICH 205
BILL: SB 74
SHORT TITLE: MEDICAID REFORM/PFD/HSAS/ER USE/STUDIES
SPONSOR(s): SENATOR(s) KELLY
03/13/15 (S) READ THE FIRST TIME - REFERRALS
03/13/15 (S) HSS, STA, FIN
03/13/15 (S) HSS AT 1:30 PM BUTROVICH 205
03/13/15 (S) -- MEETING CANCELED --
03/23/15 (S) HSS AT 1:30 PM BUTROVICH 205
03/23/15 (S) Heard & Held
03/23/15 (S) MINUTE(HSS)
04/01/15 (S) HSS AT 1:30 PM BUTROVICH 205
04/01/15 (S) Heard & Held
04/01/15 (S) MINUTE(HSS)
04/02/15 (S) STA AT 9:00 AM BUTROVICH 205
04/02/15 (S) <Pending Referral>
04/03/15 (S) HSS AT 1:30 PM BUTROVICH 205
04/03/15 (S) -- MEETING CANCELED --
04/08/15 (S) HSS AT 1:30 PM BUTROVICH 205
04/08/15 (S) Heard & Held
04/08/15 (S) MINUTE(HSS)
BILL: SB 90
SHORT TITLE: MEDICAID: USED DURABLE MEDICAL EQUIPMENT
SPONSOR(s): SENATOR(s) STOLTZE
03/25/15 (S) READ THE FIRST TIME - REFERRALS
03/25/15 (S) HSS, FIN
04/08/15 (S) HSS AT 1:30 PM BUTROVICH 205
04/08/15 (S) Heard & Held
04/08/15 (S) MINUTE(HSS)
BILL: SB 53
SHORT TITLE: ADVANCED PRACTICE REGISTERED NURSES
SPONSOR(s): SENATOR(s) GIESSEL
02/18/15 (S) READ THE FIRST TIME - REFERRALS
02/18/15 (S) L&C, HSS
03/10/15 (S) L&C AT 1:30 PM BELTZ 105 (TSBldg)
03/10/15 (S) Heard & Held
03/10/15 (S) MINUTE(L&C)
03/12/15 (S) L&C AT 1:30 PM BELTZ 105 (TSBldg)
03/12/15 (S) Moved SB 53 Out of Committee
03/12/15 (S) MINUTE(L&C)
03/13/15 (S) L&C RPT 4DP 1NR
03/13/15 (S) DP: COSTELLO, GIESSEL, MEYER, STEVENS
03/13/15 (S) NR: ELLIS
04/08/15 (S) HSS AT 1:30 PM BUTROVICH 205
04/08/15 (S) Heard & Held
04/08/15 (S) MINUTE(HSS)
BILL: HB 4
SHORT TITLE: AUTOMATED EXTERNAL DEFIBRILLATOR
SPONSOR(s): REPRESENTATIVE(s) WILSON
01/21/15 (H) PREFILE RELEASED 1/9/15
01/21/15 (H) READ THE FIRST TIME - REFERRALS
01/21/15 (H) JUD
02/04/15 (H) JUD AT 1:00 PM CAPITOL 120
02/04/15 (H) Moved HB 4 Out of Committee
02/04/15 (H) MINUTE(JUD)
02/06/15 (H) JUD RPT 4DP 1NR
02/06/15 (H) DP: KELLER, MILLETT, CLAMAN, LEDOUX
02/06/15 (H) NR: GRUENBERG
02/11/15 (H) TRANSMITTED TO (S)
02/11/15 (H) VERSION: HB 4
02/13/15 (S) READ THE FIRST TIME - REFERRALS
02/13/15 (S) HSS, JUD
04/08/15 (S) HSS AT 1:30 PM BUTROVICH 205
04/08/15 (S) Heard & Held
04/08/15 (S) MINUTE(HSS)
BILL: HB 8
SHORT TITLE: POWERS OF ATTORNEY
SPONSOR(s): REPRESENTATIVE(s) HUGHES
01/21/15 (H) PREFILE RELEASED 1/9/15
01/21/15 (H) READ THE FIRST TIME - REFERRALS
01/21/15 (H) JUD
02/13/15 (H) JUD AT 1:00 PM CAPITOL 120
02/13/15 (H) Heard & Held
02/13/15 (H) MINUTE(JUD)
02/23/15 (H) JUD AT 1:00 PM CAPITOL 120
02/23/15 (H) Moved CSHB 8(JUD) Out of Committee
02/23/15 (H) MINUTE(JUD)
02/25/15 (H) JUD RPT CS(JUD) 2DP 4NR
02/25/15 (H) DP: LYNN, KELLER
02/25/15 (H) NR: MILLETT, CLAMAN, GRUENBERG, FOSTER
03/09/15 (H) TRANSMITTED TO (S)
03/09/15 (H) VERSION: CSHB 8(JUD) AM
03/11/15 (S) READ THE FIRST TIME - REFERRALS
03/11/15 (S) HSS, JUD
04/10/15 (S) HSS AT 1:30 PM BUTROVICH 205
BILL: SB 72
SHORT TITLE: DESIGNATED CAREGIVERS FOR PATIENTS
SPONSOR(s): SENATOR(s) GIESSEL
03/11/15 (S) READ THE FIRST TIME - REFERRALS
03/11/15 (S) HSS, L&C
04/10/15 (S) HSS AT 1:30 PM BUTROVICH 205
WITNESS REGISTER
REPRESENTATIVE SHELLEY HUGHES
Alaska State Legislature
Juneau, Alaska
POSITION STATEMENT: Sponsor of HB 8.
GINGER BLAISDELL, Staff
Representative Shelley Hughes
Alaska State Legislature
Juneau, Alaska
POSITION STATEMENT: Explained the sectional analysis of HB 8 on
behalf of the sponsor.
THERESA HOPE, State Long-term Care Ombudsman
Anchorage, Alaska
POSITION STATEMENT: Testified in support of HB 8.
DEBORAH BEHR, Chair
Alaska Uniform Law Commission
Juneau, Alaska
POSITION STATEMENT: Testified in support of HB 8.
MARIE DARLIN
AARP of Alaska
Juneau, Alaska
POSITION STATEMENT: Testified in support of HB 8.
DENISE DANIELLO, Executive Director
Alaska Commission on Aging
POSITION STATEMENT: Testified in support of HB 8 and SB 72.
JANE CONWAY, Staff
Senator Cathy Giessel
Alaska State Legislature
POSITION STATEMENT: Explained the sectional analysis of SB 72 on
behalf of the sponsor.
ANN LOVEJOY
Mountain Pacific Improvement
Anchorage, Alaska
POSITION STATEMENT: Testified in support of SB 72.
DEBBY RETHERFORD, representing herself
Mat-Su, Alaska
POSITION STATEMENT: Testified in support of SB 72.
VICTORIA MARTIN, representing herself
Anchorage, Alaska
POSITION STATEMENT: Testified in support of SB 72.
TERRY SNYDER, State President
AARP
Palmer, Alaska
POSITION STATEMENT: Testified in support of SB 72.
ED ZASTROW, representing himself
Ketchikan, Alaska
POSITION STATEMENT: Testified in support of SB 72.
KEN HELANDER, Advocacy Director
AARP Alaska
Anchorage, Alaska
POSITION STATEMENT: Testified in support of SB 72.
BECKY HULTBERG, CEO
Alaska State Hospital and Nursing Home Association
Juneau, Alaska
POSITION STATEMENT: Testified in opposition to SB 72.
ACTION NARRATIVE
1:32:25 PM
CHAIR BERT STEDMAN called the Senate Health and Social Services
Standing Committee meeting to order at 1:32 p.m. Present at the
call to order were Senators Ellis, Stoltze, Giessel, and Chair
Stedman.
SB 78-MEDICAL ASSISTANCE COVERAGE; REFORM
1:33:43 PM
CHAIR STEDMAN announced that the first order of business would
be SB 78.
SENATOR GIESSEL moved to report SB 78 from committee with
individual recommendations and attached fiscal note(s). There
being no objection, the motion carried.
SENATOR STOLTZE commented that the bill would be accompanied by
cost containment reform measures.
SB 74-MEDICAID REFORM/PFD/HSAS/ER USE/STUDIES
1:34:24 PM
CHAIR STEDMAN announced the consideration of SB 74.
1:34:32 PM
SENATOR GIESSEL moved to report CSSB 74(HSS) from committee with
individual recommendations and attached fiscal note(s). There
being no objection, the motion carried.
SB 90-MEDICAID: USED DURABLE MEDICAL EQUIPMENT
1:34:58 PM
CHAIR STEDMAN announced the consideration of SB 90.
SENATOR STOLTZE moved to report SB 90 from committee with
individual recommendations and attached fiscal note(s). There
being no objection, the motion carried.
SB 53-ADVANCED PRACTICE REGISTERED NURSES
1:35:17 PM
CHAIR STEDMAN announced the consideration of SB 53.
SENATOR GIESSEL moved to report SB 53 from committee with
individual recommendations and attached fiscal note(s). There
being no objection, the motion carried.
HB 4
HB 4-AUTOMATED EXTERNAL DEFIBRILLATOR
1:35:37 PM
CHAIR STEDMAN announced the consideration of HB 4.
SENATOR GIESSEL moved to report HB 4 from committee with
individual recommendations and attached fiscal note(s). There
being no objection, the motion carried.
CHAIR STEDMAN noted previous public hearings for all five bills.
He thanked the committee for their work.
1:36:43 PM
At ease
1:39:04 PM
CHAIR STEDMAN brought the meeting back to order.
HB 8-POWERS OF ATTORNEY
1:39:39 PM
CHAIR STEDMAN announced the consideration of HB 8.
1:39:47 PM
REPRESENTATIVE SHELLEY HUGHES, Alaska State Legislature, sponsor
of HB 8, related that the bill has approval by AARP and the
Association of Mature Americans. She shared stories of financial
scams that targeted vulnerable adults due to problems with the
Power of Attorney. Last year there were more than 600
allegations of financial exploitation in Alaska as reported by
Adult Protective Services, the Office of Long-Term Care
Ombudsman, and the Office of Public Advocacy and Elder Fraud
Unit. She shared statistics related to Power of Attorney abuse.
She stated that HB 8 strengthens Alaska's existing Power of
Attorney statutes by clarifying the responsibilities of the
person receiving the Power of Attorney and approving the form
itself. The statute remains customized for Alaska and aligns
some of the wording with other states, which is helpful in this
day and age.
She noted new terminology in the bill - the principal, or the
person granting the Power of Attorney, and the agent, the person
who is granted the Power of Attorney. There is also a new
definition for "signing." The current form instructs the
principal to assign everything to the agent unless specifically
crossing out items. The bill changes that so the principal must
mark yes or no for every category. The bill separates out a
special section of items deemed "hot powers," more significant
than routine financial actions. There is a new section on
judicial relief allowing a list of qualified persons who can
petition the court to review the agent's conduct. There is also
a new section about substitute decision-making documents, which
allows for recognition of documents between states on a
temporary basis.
She concluded that HB 8 allows better definitions, clarifies
areas of concern, and will help the principal make better
decisions when it comes to assigning these important
responsibilities of their finances and property to someone. She
said the bill will strengthen existing statutes to better
protect vulnerable adults and to better guide those who help
care for them.
GINGER BLAISDELL, Staff, Representative Shelley Hughes, Alaska
State Legislature, explained the sectional analysis of HB 8 on
behalf of the sponsor. She explained version N.A of the bill:
Section 1 replaces the current definition of an "agent."
Section 2 corrects the definition of "state" by including the
United States Virgin Islands.
Section 3 adds new definitions for "durable", "electronic",
"power of attorney", "principal", "record", and "sign, as they
pertain to the Act.
Section 4 states that an agent is the person granted powers and
the finances belong to the principal. It contains the agent's
acceptance and liability and describes the agent's duties. It
also pertains to the acceptance and termination of Power of
Attorney.
1:50:49 PM
Section 5 is amended to recognize a Power of Attorney executed
in another state.
Section 6 edits the actual form of the Power of Attorney (POA)
and requires the principal to mark a box in each category and
provides optional grant of specific authority to create, amend,
revoke, or terminate a trust; make a gift; create or change
beneficiaries; or revoke a transfer on a death deed. It also
deals with how a notary can witness a signature.
Section 7 adds additional optional provisions.
1:55:06 PM
Section 8 deals with the applicability of provisions.
CHAIR STEDMAN requested further clarification of Section 7
regarding the notary provision.
REPRESENTATIVE HUGHES commented that the provision only applies
to the notary's signing of this document.
CHAIR STEDMAN said he has concerns about it.
MS. BLAISDELL said that the notary provision was brought to
attention by the Office of Public Advocacy.
1:56:34 PM
She continued:
Sections 9 - 11 removes the option to revoke, create, or modify
a trust and includes it in a separate selection on the POA form.
Section 12 allows the agent to use credit and debit cards, and
electronic transactions.
Section 13 adds additional responsibilities and clarification
responsibilities of the agent to manage the affairs of the
principal's businesses.
1:59:02 PM
Section 14 provides for the exercise of investment powers
available under a contract of insurance or annuity.
Section 15 repealed section with respect to gifts and replaced
with instructions regarding retirement plans.
Section 16 amends the section regarding personal relationships,
such as child support under HIPAA rules.
Section 17 amends the section regarding government, military
service, or civil service.
2:02:37 PM
Section 18 is a new subsection that gives specific authority
with respect to gift transactions.
Section 19 is amended to relieve an agent of liability for
breach of duty unless it was committed dishonestly.
Section 20 replaces the term "disability or incompetence" to
"incapacity."
Section 23 addresses judicial relief and allows a number of
people to petition the courts to review an agent's actions.
2:04:04 PM
Section 27 deals with substitute decision-making documents
between states.
MS. BLAISDELL concluded that the statute was updated and
definitions were brought current. HB 8 provides protection for
vulnerable adults and judicial relief.
CHAIR STEDMAN requested an update of the sectional analysis page
numbers to version N.A.
REPRESENTATIVE HUGHES noted that HIPAA is related to payment for
health care services, not about making health care decisions.
2:06:14 PM
CHAIR STEDMAN opened public testimony.
2:06:28 PM
THERESA HOPE, State Long-term Care Ombudsman, testified in
support of HB 8. She related that the Ombudsman frequently
investigates cases in which family members or others misuse the
POA document to exploit vulnerable adults, especially seniors.
HB 8 clarifies and updates definitions in the statute and adds
important protections. She spoke in favor of the changes made to
the POA form. The bill also provides for judicial review when
there is suspicion that the POA is being misused and clarifies
when the document can be terminated.
2:08:53 PM
DEBORAH BEHR, Chair, Alaska Uniform Law Commission, testified in
support of HB 8. She noted that page 37, to the end of the bill,
is a result of the open public process and is a uniform
recognition of Substitute Decision-Making Documents across state
lines. She provided an example. She spoke of the advantages of
the POA document.
2:10:45 PM
MARIE DARLIN, AARP of Alaska, testified in support of HB 8. She
provided the history of the development of the bill. HB 8
continues the work that was started several years ago - the
Advanced Directive bill. She said HB 8 is one more step in the
right direction to help protect vulnerable adults. It is a way
to try and correct some of the problems related to Power of
Attorney.
2:13:03 PM
DENISE DANIELLO, Executive Director, Alaska Commission on Aging,
testified in support of HB 8. She said the bill is important in
light of the increasing senior population. She especially liked
the fact that the bill conforms to the Unified Power of Attorney
Act and makes the law interstate compatible. She said she
supports increasing the principal's control regarding decision
making. She suggested that there be notification to the public
to let them know of these changes.
CHAIR STEDMAN closed public testimony.
SENATOR GIESSEL thanked the sponsor.
CHAIR STEDMAN held HB 8 in committee.
SB 72-DESIGNATED CAREGIVERS FOR PATIENTS
2:15:58 PM
CHAIR STEDMAN announced the consideration of SB 72.
SENATOR CATHY GIESSEL, Alaska State Legislature, sponsor of SB
72. She read from the sponsor statement:
SB 72 seeks to improve post-discharge health outcomes
by improving coordination with designated caregivers,
providing training to them on discharge tasks,
reducing preventable and costly hospital readmissions
and enabling older Alaskans to stay in their own homes
longer.
At any given time, around 88,000 Alaskans are
providing some type of caregiving services and
supports to a loved one, friend or neighbor.
Caregivers are increasingly being asked to perform
complex nursing and medical tasks - such as dispensing
numerous medications, administering injections and
providing wound care - often with inadequate skill
training.
Caregivers are a critical link in the transitional
care for frail adults and those with disabilities;
with few exceptions, caregivers are responsible for
providing and coordinating much of the care received
at home following discharge. Untrained and unsupported
caregiving jeopardizes the patient's recovery, as well
as often puts the caregiver at risk for their own
injury and burnout, frequent symptoms of those caring
for others.
SB 72 contains three important provisions:
The name of a caregiver is recorded when a loved one
is admitted into a hospital facility, if the patient
so desires to name a caregiver.
The designated caregiver is notified of the patient's
discharge home or transfer to another facility as soon
as practicable
The hospital must attempt to consult with the
designated caregiver about the discharge plan
describing the patient's aftercare needs and offer
training to the caregiver for aftercare tasks.
The value of family caregiving in Alaska is valued at
over a billion dollars a year….money that would
otherwise likely have to come from the state coffers
for paid caregiving in the home or in a facility.
Unsupported caregivers are more likely to experience
burnout, develop their own health problems, or see
their loved one moved into a facility for more
expensive care. Most of all, SB 72 will help people
continue to live independently at home, and will
support the family caregivers who make this possible.
2:18:48 PM
JANE CONWAY, Staff, Senator Cathy Giessel, Alaska State
Legislature, explained the sectional analysis of SB 72 on behalf
of the sponsor. She read from the sectional:
Sec. 1: Amends 18.20 by adding a new section:
Article 5: Caregivers of Hospital Patients after
Discharge
Sec. 18.20.500 Naming a caregiver. Gives a patient the
opportunity to name a caregiver to provide aftercare
following discharge and outlines the details of that
process.
Section 18.20.510 Release of medical information.
This section provides hospital to ask for patient
consent to release the patient's medical info to the
caregiver. (b) allows for the patient to prohibit the
release of the medical records, thereby releasing the
hospital from its obligation to notify or inform a
caregiver.
Section 18.20.520 Notice to named caregiver. Requires
the hospital to notify the named caregiver of the
planned discharge date and time or of a transfer to
another facility as soon as it can.
Section 18.20.530 Caregiver not obligated. This
section says that if a person is named by the patient
as the caregiver, that person has the right to refuse
the designation.
Section 18.20.540 Discharge plan. Requires the
hospital to prepare a discharge plan for the patient
and assesses the named caregiver's skills to provide
the prescribed aftercare to the patient. It outlines
what needs to be included in the discharge plan and
provides a hospital contact or hospital contractor
contact who can answer questions the caregiver might
have.
Section 18.20.550 Caregiver instruction. Requires a
hospital or hospital contractor to instruct a named
caregiver on the tasks outlined in discharge plan for
aftercare. The section outlines the various means by
which this can be done and that the instruction must
be culturally sensitive and comply with federal law.
It requires that the training be done before the
discharge if possible, unless that would delay the
discharge; in that event the training can take place
as soon as possible after the patient's discharge.
Section 18.20.560 Recording obligations. This section
outlines what must be recorded in the patient's
medical record.
Section 18.20.565 No delay of discharge or transfer.
This section states that the required caregiver
instruction cannot delay a patient's discharge or
transfer to another facility.
Section 18.20.570 Construction of provisions. States
that the provisions of this bill do not create a
liability for the hospital, a hospital contractor or
employee for their performance or non-performance of
tasks.
Section 18.20.580 Coordination with other authority.
The provisions in this bill do not override the duties
of an agent under an advance health care directive or
the powers or duties of a legal guardian.
Section 18.20.585 Regulations. Gives the Department of
Health and Social Services the authority to write
regulations to carry out the provisions of this bill.
Section 18.20.590 Definitions. Provides 10 definitions
of terms used in the bill.
Sec. 2 Adds a new section that gives the Department of
Health and Social Services the authority to adopt
regulations necessary to implement the provisions of
the bill and that the regulations will take effect on
January 1, 2016.
Sec. 3 Allows the Department to begin the regulation
process immediately
Sec. 4 Provisions of the bill are effective on January
1, 2016.
2:23:16 PM
CHAIR STEDMAN opened public testimony.
2:23:48 PM
ANN LOVEJOY, Mountain Pacific Improvement (MPI), testified in
support of SB 72. She related that MPI is a quality improvement
organization for Alaska and is under contract with the Centers
for Medicare and Medicaid. She listed the reasons MPI supports
the bill - it is beneficial for people and for the health
industry. It benefits people who are discharged from the
hospital without clear roles and responsibilities for who will
deliver their aftercare. She said one of the drivers for high
readmission rates and for very poor health outcomes is that
individuals do not receive the necessary aftercare. Secondly,
readmission is a very important issue because the industry is
receiving negative payment adjustments, or penalties, for
excessively high rates of readmissions. If a hospital took the
extra time to educate the caregiver, the readmissions rates
would go down. Another benefit to the industry is that their
accreditation would be assured. The bill does not mandate what
the caregiver education says, it just says the education must be
done.
2:27:10 PM
DEBBY RETHERFORD, representing herself, testified in support of
SB 72. She said she has personal experience with being a
caregiver of a senior relative. She stressed how important this
bill is because it requires the hospital to provide the
caregiver with instructions.
2:30:29 PM
VICTORIA MARTIN, representing herself, testified in support of
SB 72. She shared a personal experience as a caregiver who was
given no instructions after a patient was discharged. She said
it was important for the hospital to provide the information for
a discharge plan. She said she does not want to see another
person go through what she had to.
2:33:38 PM
TERRY SNYDER, State President, AARP, testified in support of SB
72. She suggested that everyone will be a caregiver at some time
during their lives. She shared that 65 percent of older persons
with long-term care needs will need to be cared for by family
and friends, the majority of whom are women. She said it is
essential that the caregiver and the patient are given
instructions for a discharge plan with successful outcomes. The
state must develop methods for Alaskans to be caregivers at home
and avoid costly readmissions. The bill will benefit Alaskans of
all ages and will save money.
2:36:48 PM
ED ZASTROW, representing himself, testified in support of SB 72.
He shared a personal story of his experience with a hospital
discharge in Ketchikan. He said the discharge program in
Ketchikan is similar to the plan in SB 72. He said his wife, his
caregiver, was schooled in how to care for him and they were
assisted in how to prepare home accommodations. However, others
did not receive the same discharge information and became
confused. He opined the bill would address that situation.
2:39:17 PM
KEN HELANDER, Advocacy Director, AARP Alaska, testified in
support of SB 72. He stated that the bill is about caregivers.
He said at any given moment there are about 88,000 family
caregivers in Alaska. Over a course of a year, about 128,000
people serve in that role to some degree. This represents over a
billion dollars in care that otherwise would have likely been
borne by the state.
He referred to an article in the Fairbanks Daily News Minor that
covered the annual cost of care report from Genworth Financial,
which tracks the costs of long-term care across the country. In
the U.S, one year in a nursing home is equal to three years'
tuition at a private college. Alaska has the highest average
cost of nursing home care in the nation - $281,415 a year. The
degree to which we can support family caregivers, saves families
and the state money.
He described a survey by AARP of 800 Alaskans from age 45 and
over to hear about their experiences in caregiving. Among the
findings, 56 percent identified themselves as being a current or
former caregiver; 50 percent said it was likely they would
provide care for a friend or family member. The average Alaska
caregiver is over 55 and female, who works full or part time, in
addition to caregiving for someone over the age of 73. They all
face challenges; emotional and financial stress, balancing jobs
and caregiving, finding enough rest, difficulty managing
medications and medical tasks. There is a need for support for
patients living at home, for respite for caregivers, and
resources and training for caregivers. Most indicated that there
was no instruction after a hospital discharge. They agreed that
hospitals should keep families informed of major decisions and
the discharge and keep records.
He pointed out that discharged plans are required, but are
complex and not clear. Hospitals are aware of the need to
improve the transition from hospital to home and some are
working hard to do so. He concluded that the bill provides the
incentive for all hospitals to do so.
2:45:25 PM
DENISE DANIELLO, Executive Director, Alaska Commission on Aging,
testified in support of SB 72. She stated that it is a very
important bill and it contains many important provisions, such
as instruction and training. The senior population is growing
and will need to rely increasingly more on their family
caregivers.
2:47:25 PM
BECKY HULTBERG, CEO, Alaska State Hospital and Nursing Home
Association, testified in opposition to SB 72. She said she is
willing to work with the sponsor on the bill. She said she is
very concerned about successful transitions from hospital to
home. This work is happening well in some places. The bill does
not address a lack of caregivers, nor many of the problems of
those with chronic diseases. She listed problems with the bill.
Setting this in statute does not provide for changes in process,
medicine, and technology. There is a great deal of variety in
hospitals across Alaska. Imposing the same standards on all-
sized hospitals will not work. This bill is setting a fourth
level of administrative regulation on a nursing process. The
focus should be on patient care and quality, not on resources
for keeping records.
2:51:36 PM
She voiced specific concerns. The hospital is expected to
contact and follow up with a caregiver, which is a huge
requirement of nurses. It requires hospitals to assess the
caregiver's ability to provide aftercare, which could be very
challenging for hospitals. There is no explanation of what a
hospital's obligation is when the caregiver is incapable. There
are concerns about how hospitals will provide instruction "as
soon as possible" and a problem with aftercare follow up. It is
a problem that hospitals are required to document and instruct
caregivers, but caregivers have no accountability to accept that
instruction. Language is unclear about who provides the
instruction and records information. She pointed out that the
electronic health network said it could cost about $100,000 to
capture this information.
2:54:29 PM
She said the concepts in the bill have been identified by AARP
as a priority. She suggested looking at other states to identify
how to support the intent of the bill.
2:55:16 PM
SENATOR STOLTZE asked what the nurses' organizations think.
MS. HULTBERG explained they have only received feedback from
their own association's administrative nurses, but not from
nurses' associations.
2:56:20 PM
CHAIR STEDMAN held SB 72 in committee.
2:56:29 PM
There being nothing further to come before the committee,
Chair Stedman adjourned the Senate Health and Social Services
Standing Committee at 2:56 p.m.