HOUSE BILL NO. 96 "An Act relating to Alaska Pioneers' Home and Alaska Veterans' Home rates and services." 1:31:01 PM Co-Chair Wilson indicated there were two amendments for the bill. Representative Knopp had a conceptual amendment when appropriate. Representative Josephson MOVED to ADOPT Amendment 1 (31- LS0646\U.2) (copy on file): Page 3, line 22: Delete "$3,100" Insert "2,976" Page 3, line 24: Delete "6,090" Insert "5,396" Page 3, line 27: Delete "$8,833" Insert "7,814" Page 30, line 30" Delete "$10,000" Insert "8,500" Co-Chair Wilson OBJECTED for discussion. Representative Josephson spoke to the amendment. He reported there had been some objection to the rates and he was offering an amendment that would slightly reduce the rate adjustment. He had learned that the rate adjustment that was currently in the bill exceeded the rate of inflation since 2004 when the rates were last adjusted. He supported HB 96 but thought the rates should be adjusted. He thought Representative Fields would not object to the amendment. He also thought the amendment was consistent with Mr. Teal's testimony from the previous day, in which the fiscal impacts of the Department of Health and Social Services rates were difficult to project. Mr. Teal had noted that steep rate increases, particularly at the 1 and 2 levels of care could increase state costs by driving out self-paying, less costly patients. The amendment would still generate over $1 million in new revenues while aligning the committee substitute with testimony already heard from the public, the Legislative Finance Division, and the sponsor. He asked members for their support of the amendment. Co-Chair Wilson asked Representative Fields to comment on the amendment. 1:33:25 PM REPRESENTATIVE ZACK FIELDS, BILL SPONSOR, supported the amendment. He indicated that it was consistent with overwhelming public testimony and testimony from the Legislative Finance Division. Vice-Chair Ortiz spoke in favor of the amendment. He thought it could help to put the state in a better situation, a goal originally put forth by the administration. Co-Chair Wilson WITHDREW her OBJECTION. There being NO OBJECTION, it was so ordered. Amendment 1 was ADOPTED. Co-Chair Wilson MOVED to ADOPT Amendment 2 (copy on file): Page 4, line 8: Delete "$70" Insert "$160" Page 4, line 13: Delete "$100" Insert "$322" Vice-Chair Johnston OBJECTED for discussion. Co-Chair Wilson explained her amendment. She relayed that the on the previous day the committee had heard that $70 [Bill language: a day for services provided in a home to a recipient who requires the provision of housing, meals, emergency assistance, medication administration, health- related services, recreation, and extensive assistance with activities of daily living for up to eight hours a day between 6:00 a.m. and 6:00 p.m., including meals scheduled during the period the recipient is receiving the services] was not close to the amount per day and that $160 would be more appropriate. She continued that 24 hours per day for up to 14 days was $322 [Bill language: a day for room and board provided in a home to a recipient who requires the provision of housing, meals, emergency assistance, medication administration, health-related services, recreation, and extensive assistance with activities of daily living for 24 hours a day for up to 14 consecutive days]. She was inserting the amounts that had been heard the previous day. Representative Josephson thought the rate increases would be short-lived because of a transition period. He asked if he had heard correctly. Co-Chair Wilson responded that the daily rate for 24-hour care was limited to 14 consecutive days. She highlighted page 4, lines 13-16. There was no limit on the daily rate for 8 hours per day. One service was day service as opposed to an over-night service. Representative Sullivan-Leonard was aware, having personal experience dealing with home healthcare for family members, that the proposed increase did not cover the cost but was closer to what it might be. She would be supporting the amendment. Vice-Chair Johnston WITHDREW her OBJECTION. There being NO OBJECTION, it was so ordered. Amendment 2 was ADOPTED. 1:36:39 PM AT EASE 1:38:16 PM RECONVENED Representative Knopp MOVED to ADOPT Conceptual Amendment 3 (copy on file): Page 1, line 6 Delete "$200" Insert "$500" Co-Chair Wilson OBJECTED for discussion. Representative Knopp explained his amendment. He understood increasing rates for those who could pay. However, there were seniors that simply could not pay. He was trying to offer protection on the lower end. Representative Tilton referred to page 2, line 13. She asked if the amount needed to also be changed for consistency. Co-Chair Wilson read from line 13. She thought the line had to do with payment assistance received by a home resident. She suggested directing the question to Mr. Lasley, the division director. 1:40:38 PM CLINTON LASLEY, DIRECTOR, DIVISION OF ALASKA PIONEERS HOME, DEPARTMENT OF HEALTH AND SOCIAL SERVICES (via teleconference), responded that the $200 was referred to HB 96 and in regulations. The amount was related to an individual on payment assistance. The individual was allowed to keep $200 of their monthly income and could use it for things like clothing and, personal hygiene products. The payment assistance program took taxes and insurance premiums into account. They were taken off the top of their income prior to determining how much they were required to pay. He reiterated that the $200 was for items personal in nature. Co-Chair Wilson suggested that the amendment would give individuals $500 to spend the way they liked. She referred the $200 noted on page 2, line 13. She thought the $200 amount had to do with payment assistance and what funds; were included in the payment assistance. She wondered whether the $200 listed would need to change to $500 as well, or whether they were 2 separate ideas. Mr. Lasley thought the amount on page 2 would need to be changed as well. Representative Knopp MOVED to ADOPT Amendment 1 to Conceptual Amendment 3: Page 1, line 6 Delete "$200" Insert "$500" Page 2, line 13 Delete "$200" Insert "$500" Co-Chair Wilson OBJECTED for discussion. Representative Knopp explained the change. There being NO OBJECTION, it was so ordered. Co-Chair Wilson WITHDREW her OBJECTION. There being NO OBJECTION, it was so ordered. Amended Conceptual Amendment 3 was ADOPTED. Vice-Chair Johnston MOVED to report CSHB 96(FIN) out of Committee with individual recommendations and the accompanying fiscal notes. There being NO OBJECTION, it was so ordered. CSHB 96(FIN) was REPORTED out of committee with four "do pass" recommendations and with six "no recommendation" recommendations and with two new fiscal impact notes by the Department of Health and Social Services. 1:44:30 PM AT EASE 1:45:04 PM RECONVENED