CS FOR SENATE BILL NO. 32(FIN) "An Act relating to medical assistance payments for home and community-based services and provision of personal care services in a recipient's home; and providing for an effective date." 8:26:33 PM SENATOR ELLIS, stated that the current rate system for the home and community based Medicaid services is broken. He noted that Department of Health and Social Services (DHSS) released new regulations that mimic this bill. He opined that the passage of SB 32 was necessary to fund the changes and ensure that they will be maintained over time. Home and community based Medicaid services are the key to improving the quality of life for seniors and children with developmental disabilities. He added that SB 32 creates an equitable and predictable process for all long term care providers. States with long established high proportions of home and community based services showed an overall decrease in spending of 3 percent between 1995 and 2005. While home and community based services are optional, nursing homes are not. 8:29:41 PM Senator Ellis pointed out that long term care is the fastest growing segment of the Medicaid budget. Growth is controlled by supporting home and community based services. MAX HENSLEY, STAFF, SENATOR ELLIS, detailed a sectional analysis. He noted that Section 1, Page 1 details the rate review process. He pointed out that the rate clauses must be approved by the commissioner within the current cost containment statutes. The cost surveys are preformed every four years. He mentioned that Section 2 creates a report to the legislature on the trends of those rates. He continued that Section 3 repeals that report after 2014. He finished with Section 4 including a delayed effective date of July 1, 2011 to allow the department to create methodology for the cost surveys. 8:31:33 PM Representative Gara noted that a person must be nursing home eligible in order to receive the community based services. Senator Ellis responded that hospitals and nursing homes already receive rate review and cost increases under current statute. Home and community based services are the most humane, cost effective, and least restrictive form of care. The legislation seeks to address the defective piece of the system. Mr. Hensley stated not all persons who receive home and community based services would be eligible for nursing homes. The vast difference in cost between institutional care and home based services greatly outweighs the larger number of people receiving waiver services. Representative Fairclough asked about Page 2, Lines 9 and 10 and the reference to market basket data. Mr. Hensley responded that market basket data was the standard home health inflation rate. Last year's projection was 2.8 percent and this year's is 2.1 percent. Representative Fairclough noted that Page 2, Line 1 and the reference to payment established, the word "of" requires deletion. Vice-Chair Thomas asked if the bill addresses personal care attendants. He wondered if a convicted felon would be eligible as a personal care attendant. 8:35:14 PM GWEN LEE, ALASKA ASSOCIATION ON DEVELOPMENTAL DISABILITIES (via teleconference), stated that she is a provider who offers care to children and adults with disabilities. She testified in support of the legislation. She noted the inequities in the system where the nursing homes and hospitals receive the regular rate review, however, the providers in the home and community based system are critical to the system. 8:38:11 PM EMILY ENNIS, ALASKA ASSOCIATION ON DEVELOPMENTAL DISABILITIES (via teleconference), echoed the testimony of Gwen Lee. She noted that the support is critical to the long term care system in Alaska. She urged support. Co-Chair Stoltze closed public testimony. Senator Ellis thanked the committee for the help. SB 32 Was HEARD and HELD in Committee for further consideration.