CS FOR SENATE BILL NO. 73(FIN) "An Act relating to assisted living homes; and providing for an effective date." SHARON CLARK, STAFF, SENATOR MILLER testified in support of the legislation, on behalf of the sponsor. She observed that the State of Alaska with its scattered population represents a unique challenge to provide services to residents who need assisted living supports. The intent of this bill is to provide good health care for long-term care residents in assisted living homes. While the term Assisted Living in Alaska includes smaller and larger facilities, the primary focus is on smaller facilities (15 beds or less.) Assisted living homes, which were formerly called adult foster care homes, provide a cost effective alternative to institutional care. The program is regulated by the old general assistance regulations, which need to be revisited and updated to be in line with the standard of care that is practiced by the other assisted living programs. The rate was established in 1983 at $35 dollars a day. The Alaska Rate Study Report completed December 1998 found that the value of $35 dollars in 1983 would be equal to $68.30 in 1998 dollars. The rate study concludes that the general relief rate be increased by $38.31. Ms. Clark reiterated that the purpose and intent of the legislation was to increase the daily rate paid to the "mom and pop" (15 beds and less) facilities by the state for the vulnerable adults that are unable to provide safely for their own medical, emotional and personal care needs. She noted that the original intent by Senator Miller was to increase the base rate from $34.50 dollars to $70.00 dollars per day, based on individual care needs. Senator Miller acknowledged that the increase to $70 dollars was not supportable with the current budget. He therefore supports a base rate of $42.25 dollars a day the first year and $51.00 dollars a day for the second and following years. This would include a geographical cost of living differential. Ms. Clark observed that Senator Miller has a personal interest in the legislation as the result of the care of his father. Ms. Clark referred to a report published by the from the Alaska Commission on Aging "Alaska Seniors', Living Longer, Growing Strong" February 1998. "Alaska is second in the nation in a proportional growth of our senior population- with a 42% increase in people age 65+ in only 6 years (1990- 1996... Equally impressive is the anticipated long-term growth of Alaska Senior population. In 1980, there were 11, 547 people over the age of 65. Using moderated growth projections, population experts agree this number may reach 80,927 by the year 2015. This is a cost of 600% increase in only 35 years." Ms. Clark maintained that caregivers cannot afford to remain in business. She questioned how care would be given to Alaska's seniors. Nursing homes and hospitals cost over $300 dollars a day. She stressed that an increase in the rate would keep people in their own communities and in smaller homes.   Representative Phillips noted that the rate was increased to $75 dollars in the House HESS Committee. Ms. Clark stated that the sponsor supports the increase. Co-Chair Therriault observed that the issue is the overall cost. The Alaska Mental Health Trust Authority will cover a portion for the first two years. The Trust indicated that they would cover an additional year at a smaller amount. Representative Phillips observed that the Trust and the Division of Mental Health have requested in the fiscal note that the payment be increased to $100 dollars. DWIGHT BECKER, PROGRAM COORDINATOR, DIVISION OF SENIOR SERVICES, DEPARTMENT OF ADMINISTRATION, ANCHORAGE provided information on the legislation. He responded to a question by Vice Chair Bunde. He agreed that closer of the "mom and pop" organizations would result in increased state support and cost. KAY BURROWS, DIRECTOR, DIVISION OF SENIOR SERVICES, DEPARTMENT OF ADMINISTRATION ANCHORAGE testified via teleconference in support of the legislation. She stressed the need for small assisted living homes to receive an increased rate. ALISON ELGEE, DEPUTY COMMISSIONER, DEPARTMENT OF ADMINISTRATION testified in support of the legislation. The legislation impacts both the Division of Senior Citizens and Division of Mental Health clientele. General relief payments do not go to every assisted living client. Personal resources are offset. The department also looks at other forms of public assistance and waivers. Vice Chair Bunde questioned the impact of the loss of small assisted living homes. Ms. Elgee responded that the information was not currently available. She clarified that the concern is that the existing assisted living providers would refuse to accept general relief clients. These clients are vulnerable and subject to abuse. More expensive alternatives would be required if they were not cared for by the smaller private providers. Assisted living homes cost approximately $70 dollars a day versus $300 dollars a day in a nursing home. Not all of the placements would be eligible for nursing home assistance. She explained that the Department of Administration initiated a study in response to complaints that the rates ($35 dollars a day) were insufficient. She explained that the 1998 study identified a cost of $70 dollars a day. Individuals in assisted living are allowed to keep $75 to $100 dollars a day in personal needs allowance before the department offsets the cost. Vice Chair Bunde questioned if people could be feed for $35 dollars a day, let alone be cared for at that rate. SB 73 was heard and HELD in Committee for further consideration.