SENATE BILL NO. 238 "An Act amending the eligibility threshold for medical assistance for persons in a medical or intermediate care facility." 6:54:58 PM THOMAS OBERMEYER, STAFF, SENATOR BETTYE DAVIS, explained that the legislation would amend and restore the Medicaid eligibility threshold for medical assistance for individuals in a medical or intermediate care facility from a specified monthly income limit to 300 percent of the social security income benefit rate. The threshold is also used for people who receive home and community-based waiver services. In 2003, the legislature froze the Medicaid long- term services income eligibility limit at $1,656 per month; at that time the amount was 300 percent of the supplemental security income (SSI). The change created an income ceiling for waiver eligibility, effectively freezing the eligibility limit for the past seven years rather than allowing the limit to adjust annually in tandem with the SSI. In 2009, the income equivalent was $2,022. The result was that small social security cost-of-living adjustments have disqualified many needy, disabled people from the program. Alternatives for preserving eligibility, particularly for those requiring lifetime or long-term care include the creation of a Medicaid qualifying income trust known as the Miller Trust. Trusts have procedural drawbacks, including numerous responsibilities and restrictions, limited access to income, assistance of an attorney, and a trustee to manage trust assets. Mr. Obermeyer asserted that Medicaid services are critical to the well-being of Alaska's most vulnerable citizens. He believed that supporting SB 238 would ensure that eligible Alaskans would continue to receive nursing-home care and in-home services. In addition, the legislature would not have to amend statutes every year or two as the federal poverty level guidelines and supplemental security income levels increase with the cost of living. Mr. Obermeyer pointed out that the bill had a zero fiscal note; making the adjustment would not increase costs to the state. Representative Gara commented that when the legislation was presented by the Commission on Aging as a priority, they were not sure if the fiscal note would be zero. The same number of people would qualify but they need to hire an attorney and create a Miller Trust to move their assets in order to qualify. People would not have to create a Miller Trust if the threshold is changed. Co-Chair Stoltze opened and closed public testimony. Vice-Chair Thomas MOVED to report SB 238 out of Committee with individual recommendations and the accompanying fiscal note. There being NO OBJECTION, it was so ordered. SB 238 was REPORTED out of Committee with a "do pass" recommendation and with attached previously published fiscal note: FN1 (DHS).