HB 455 An Act making and amending operating and capital appropriations and ratifying certain state expenditures; and providing for an effective date. HB 455 was HELD in Committee for further discussion. 1 HOUSE BILL 455 "An Act making and amending operating and capital appropriations and ratifying certain state expenditures; and providing for an effective date." DEPARTMENT OF HEALTH AND SOCIAL SERVICES JILL SANDLEBEN, ALASKA GERIATRICS EXCHANGE NETWORK (AGENET), JUNEAU, testified in opposition to the proposed Medicaid reduction in HB 455. She explained how the Medicaid program affects the Home Waivers Program. This program provides 4 services to clients in order to bring seniors out of nursing home facilities and into home care services. She emphasized that the program provides more services at a lower per client cost. NANCY SLAGLE, DIRECTOR, DIVISION OF BUDGET REVIEW, OFFICE OF MANAGEMENT AND BUDGET, OFFICE OF THE GOVERNOR, provided a sectional overview of HB 455, the supplemental legislation. * Sec. 21 Medicaid State Programs $7,000.0 This request provides for the disproportionate share payments for API operations. JANET CLARKE, DIRECTOR, DIVISION OF ADMINISTRATIVE SERVICES, DEPARTMENT OF HEALTH AND SOCIAL SERVICES, provided the Committee with a handout which explains the Medicaid disproportionate share payments made to state hospitals which serve a disproportionate share of low income patients. The payments are matched 50/50 by the federal government and the State. [Attachment #5]. * Sec. 22 Waivers Services $0.0 This request would transfer funds from Waivers Authorization to the Community DD grants. Ms. Clarke explained that whatever remains from the waivers will be distributed to the grantees. Representative Hanley pointed out that 10% of the final quarterly advance is held from the grant money until all bills are received by the Department. Ms. Clarke stated that was not the policy this year due to cash flow problems. Grantees would receive all the money available for the appropriation. Representative Brown requested that the Committee consider introducing a House Fiance Committee bill which would address Section #22 of the proposed legislation to expedite the net zero appropriation. * Sec. 23 McLaughlin Youth Center $215.0 This request would cover the increased costs due to the increase in gang-related violent admissions. * Sec. 24 Johnson Youth Center $41.0 This request would cover the increased costs due to a population increase in violent youth crimes resulting in contractual services. 5 * Sec. 25 Laboratory Services $358.7 This request would move money from program receipts to the general fund to cover a delayed implementation of a program for collecting lab fees resulting in the loss of program receipts. Ms. Clarke explained that the Department tried to adopt regulations for the laboratory fees. There was public concern regarding the fee schedule. Regulations were withdrawn due to public concern and testimony. The fee schedule is currently being reworked in order to match what Medicaid has paid. * Sec. 26 Post Mortem Examinations $201.8 This request would cover costs related to delayed implementation of the Medical Examiner Program. (Tape Change, HFC 94-46, Side 1). * Sec. 27 Designated Evaluation & Treatment $271.0 This request would cover the costs of increased client caseload and inpatient days. Ms. Clarke stated that the Department has been unable to come to an agreement with the Fairbanks Memorial Hospital on a daily rate. The Department has contracted with the North Star Hospital in Anchorage for an interim agreement to handle any of the Fairbanks overflow. Currently, Sitka and Anchorage are the only sites being covered. Representative Hanley questioned why the program was running over cost when so few sites were being covered. Ms. Clarke stated that the program pays for psychiatric designated treatment services in hospitals. Last year there were unforeseen late bills from hospitals which the Department was responsible to pay. * Sec. 28 Alaska Psychiatric Institute $624.6 This request would cover costs of an eighteen percent increase in admissions and a fund change due to the Disproportionate Share Program. Ms. Slagle explained that this was a transfer of money from the Medical Assistance Division to API where it will be used for operations. At that time, given the availability of mental health funds, they will be used elsewhere. Representative Hanley pointed out that a large portion of the funds would replace Mental Health Trust money. This 6 will be a cost savings to the State. * Sec. 29 Harborview Development Center $598.2 This request would cover the costs related to certification deficiencies and heating. Ms. Slagle stated that the request would address the steam heat plant obligations and problems encountered with the fast-track certification which Harborview encountered last year. Ms. Clarke noted that $100 thousand dollars of the requested amount resulted from a construction delay in the steam heat plant at Harborview, a joint project between the Department of Transportation and Public Facilities (DOTPF) and Harborview. The remaining amount will cover personnel services. DEPARTMENT OF MILITARY AND VETERANS' AFFAIRS * Sec. 30 Veteran's Death Gratuity $37.5 This request would cover the death gratuity claims received in FY93. Ms. Slagle pointed out that the program is no longer being funded although these applicants were not considered in the appropriation requests last year. This request would conclude the program. DEPARTMENT OF NATURAL RESOURCES * Sec. 31 Fire Suppression $4,643.8 This request would cover fire suppression costs. NICO BUS, ACTING DIRECTOR, SUPPORT SERVICES DIVISION, DEPARTMENT OF NATURAL RESOURCES, stated that the total request would include 1,754 actual fires and the remaining would cover the fixed costs owed to the federal government for fighting fires on state land. Mr. Bus explained that the front section of the budget itemized the amount of money used for fixed costs and would not cover any fire activity. The average fire suppression costs for the past five years is $9.5 million general fund dollars. * Sec. 32 Various $0.0 This request addresses the ratification of prior 7 year expenditures. DEPARTMENT OF FISH AND GAME * Sec. 33 Administrative Services $20.0 This request would grant additional compensation to vendors for king salmon tag sales. * Sec. 34 Subsistence $60.5 This request would provide a fund source change from federal to general fund program receipts. Ms. Slagle pointed out this would be a fund source change to program receipts from federal receipts resulting from an anticipated federal grant but in reality received from the University of Utah. This would correct the funding source. * Sec. 35 Various $0.0 This component would clarify ratification of prior year expenditures. KEVIN BROOKS, DIRECTOR, DIVISION OF ADMINISTRATION, DEPARTMENT OF FISH AND GAME, explained that Section #35 resulted from an audit by Legislative Audit, OMB and the Division of Finance to clean up old balances. Many of the balances have been over-spent and some are uncollected revenues. All items listed in Section #5 occurred between 1985 and 1991. The expenditures have already occurred and the fund balance is not affected yet the expenditures did exceed appropriation levels. * Sec. 36 Fisheries Management ($10.0) This request would address the Wood River project, reappropriation and reduction in those funds. Ms. Slagle stated that Section 36 would change the project title and reduce the amount by $10 thousand dollars. DEPARTMENT OF PUBLIC SAFETY * Sec. 37 Motor Vehicle Administration $331.9 This request would cover the data processing charge back. Ms. Slagle explained that when the charge back process was initiated, the amount provided to the Division of Motor Vehicles was less that required. Consequently, DMV was 8 short funded last year. * Sec. 38 Contract Jails $70.4 This request would fully fund prisoner transportation costs negotiated in FY94. HB 455 was HELD in Committee for further consideration.